Compare Nexium vs. Zantac

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Nexium
(Esomeprazole)

Zantac 75
(Ranitidine)

Treats heartburn and stomach ulcers. Nexium (Esomeprazole) gives you long-lasting heartburn relief. But this purple pill ain't cheap! The generic forms of alternative drugs work just as well, and are usually less expensive.Relieves heartburn. Zantac 75 (Ranitidine) works well for heartburn but may not last as long or start working as quickly as other antacids.
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Reviews & ratings
Button Group. All currently active
Button Group. All currently active
5.442903752039152Nexium
Reviews for Nexium (Esomeprazole)
75%
of people say Nexium (Esomeprazole) is worth it
59%
say it works well
11%
say it's a big hassle
Reviews for Zantac 75 (Ranitidine)
72%
3% vs. Nexium (Esomeprazole)
43%
16% vs. Nexium (Esomeprazole)
7%
+4% vs. Nexium (Esomeprazole)
Side effects
NexiumZantac

The Nexium FDA package insert doesn’t have numbers about how common side effects are.

More about Nexium side effects »

The Zantac FDA package insert doesn’t have numbers about how common side effects are.

More about Zantac side effects »
How it works
NexiumZantac
Nexium (Esomeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.Zantac 75 (Ranitidine) is an H2 blocker. It blocks the chemical histamine, which lowers acid production in your stomach. This treats heartburn and helps ulcers heal.
Type of medication
NexiumZantac
Acid reducer
Proton pump inhibitor
Prescription or OTC
Acid reducer
Histamine blocker
Prescription or OTC
Available as
NexiumZantac
  • Extended release
  • Pill
  • Oral solution
  • Injection
Used for (click to learn more)
NexiumZantac
Risk factors for serious side effects
NexiumZantac
    • Helicobacter pylori infection
    • Autoimmune disease
    • Being hospitalized
    • Antibiotic use
    • Osteoporosis
    • Age 50 or older
    • Using high medication doses
    • Long-term therapy (1 year or more)
    • Smoking
    • Use of other medications that weaken bones
      Detailed Nexium (Esomeprazole) risks & warnings »
        • Current kidney problems
        • Current liver problems
        • Acute Porphyria
        • History of Phenylketonuria (PKU)
        Detailed Zantac 75 (Ranitidine) risks & warnings »
        Pregnancy category
        NexiumZantac
        BFDA pregnancy category (Probably safe)

        Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

        See the FDA package insert
        BFDA pregnancy category (Probably safe)

        Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

        See the FDA package insert
        Alcohol
        No specific alcohol-related info.No specific alcohol-related info.
        Food
        • Take 1 hour before a meal.
        No specific food-related info.
        Kidneys and liver
        No specific kidneys and liver-related info.
        • People with kidney disease may need to take a lower dose.
        • Zantac 75 (Ranitidine) is processed by the kidney and liver. If you have kidney or liver problems, you may need a different dose to prevent this increased risk for side effects.
        Sex
        No specific sex-related info.No specific sex-related info.
        Sleep
        No specific sleep-related info.No specific sleep-related info.
        Weight
        No specific weight-related info.No specific weight-related info.
        Upsides and benefits
        NexiumZantac
        • Most people can take Nexium without any noticeable day-to-day side effects.
        • Nexium lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once or twice a day.
        • In studies it was better than a placebo (sugar pill) and as good as other proton pump inhibitors at treating heartburn.
        • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
        • Available as both a generic and over-the-counter option, so it's pretty affordable.
        • Most people can take Ranitidine without any noticeable day-to-day side effects.
        • Ranitidine lasts longer than many other antacids like Maalox and Tums, and you only need to take it once or twice a day.
        • Few drug interactions.
        • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
        • Available as both a generic and over-the-counter option, so it's pretty affordable.
        Downsides and risks
        NexiumZantac
        • Doesn't start working as fast as some other antacids like Tums, Rolaids, or Maalox.
        • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
        • Can cause low levels of magnesium in the blood. You might need to take a magnesium supplement if you use Nexium long-term.
        • Can be expensive—especially the purple brand-name pill. Other alternatives are usually cheaper than Nexium and work just as well.
        • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Nexium.
        • Other antacids like Maalox, Tums, or Rolaids often start to work more quickly than Ranitidine.
        • Medication like omeprazole (proton pump inhibitors) works better at healing and preventing stomach ulcers than medication like Ranitidine (H2 blockers).
        Tips from our pharmacists for people taking the medication
        NexiumZantac
        • Take 1 hour before a meal.
        • Don't chew or crush capsules; swallow them whole.
        • If you have trouble swallowing you can carefully open the capsules and sprinkle the inside pellets onto applesauce. Swallow the applesauce without chewing or crushing the pellets.
        • When using Nexium long-term, take a calcium citrate with vitamin D supplement daily to prevent bone loss. Be sure it's calcium citrate because it works the best when using a proton pump inhibitor.
        • Get a blood test for your magnesium level once a year; you may need a magnesium supplement while using Nexium.
        • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Nexium.
        • Works best if you take it with a full glass of water.
        • Starts working in one hour.
        • If heartburn doesn't improve or lasts more than 2 weeks, talk to your doctor.
        • People with kidney disease may need to take a lower dose.
        Learn more
        More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
        More about ZantacSide effectsReviews & ratingsAlternativesFDA package insert