Compare Omeprazole vs. Nexium

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

Prilosec
(omeprazole)

Nexium
(esomeprazole)

Treats heartburn and stomach ulcers. Prilosec (Omeprazole) gives you long-lasting heartburn relief. Choose the cheapest proton pump inhibitor because they all work equally well for heartburn.Treats heartburn and stomach ulcers. Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term.
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Coupons for Omeprazole
Best available price for 30 (20mg) capsules of omeprazole
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
5.53Omeprazole
Reviews for Omeprazole
80%
of people (All ages) say Omeprazole is worth it
59%
say it works well
8%
say it's a big hassle
1167 reviews
Have you used Prilosec (omeprazole)?
Worth itNot sureNot worth it
Reviews for Nexium
75%
+5% better vs. Omeprazole
59%
Same vs. Omeprazole
11%
+3% better vs. Omeprazole
1239 reviews
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
Side effects
OmeprazoleNexium
  • Upper respiratory infection 75%
  • Fever 33%
  • Headache 7%
  • Abdominal pain 5%
  • Nausea 4%
  • Diarrhea 4%
  • Accidental injuries 4%
  • Passing gas 3%
  • Vomiting 3%
More Omeprazole side effects »

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

More about Nexium side effects »
How it works
OmeprazoleNexium
Prilosec (Omeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.Nexium (esomeprazole) is a proton pump inhibitor (PPI). It treats heartburn and heals ulcers by lowering the amount of acid in your stomach.
Type of medication
OmeprazoleNexium
Prescription or OTCOver-the-counter
Available as
OmeprazoleNexium
  • Extended release
  • Pill
  • Injection
  • Packet
Used for
OmeprazoleNexium
  • GERD
  • H Pylori Bacterial Infection
Risk factors for serious side effects
OmeprazoleNexium
  • Helicobacter pylori infection
  • Autoimmune disease
  • Being hospitalized
  • Antibiotic use
  • Osteoporosis
Detailed Prilosec (omeprazole) risks & warnings »
  • Being treated at a hospital
  • High dose Nexium (esomeprazole)
  • Long-term treatment with Nexium (esomeprazole)
  • Low bone mineral density
  • Aged 65 years or older
Detailed Nexium (esomeprazole) risks & warnings »
Pregnancy

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Interactions
OmeprazoleNexium
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Omeprazole.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Omeprazole.
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
Food
OmeprazoleNexium
  • Take 1 hour before a meal.
No food related info.
Kidneys and liver
OmeprazoleNexium
No kidneys and liver related info.
  • Nexium (esomeprazole) can cause acute kidney damage that can occur at any time during treatment. If you notice blood in the urine, changes in urine output, swelling of the body, weight gain, fever, or confusion, stop taking Nexium (esomeprazole) and speak to your doctor immediately.
Upsides and benefits
OmeprazoleNexium
  • Most people can take Omeprazole without any noticeable day-to-day side effects.
  • Omeprazole lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once or twice a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
  • In studies it was better than a placebo (sugar pill) and as good as other proton pump inhibitors at treating heartburn.
  • Available as both a generic and over-the-counter option, so it's pretty affordable.
  • Most people can take Nexium (esomeprazole) without any noticeable day-to-day side effects.
  • Nexium (esomeprazole) lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need quicker relief.
  • Nexium (esomeprazole) is inexpensive, with over-the-counter and generic options.
  • Coupons are available for the brand name - speak to your doctor or pharmacist.
  • The packet form is a good option if you have trouble swallowing pills.They can be mixed with water for easier swallowing.
Downsides and risks
OmeprazoleNexium
  • 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 Omeprazole long-term.
  • Although the generic is affordable, other medications might still be cheaper than Omeprazole.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Omeprazole.
  • Doesn't start working right away like antacids (Tums, Rolaids, or Maalox).
  • It can take several days or weeks to start feeling benefits.
  • May not be the best choice for patients 65 years of age and older due to risk of bone fractures and severe diarrhea.
Tips from our pharmacists for people taking the medication
OmeprazoleNexium
  • 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 Omeprazole 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 Omeprazole.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Omeprazole.
  • Take Nexium (esomeprazole) with a full glass of water 1 hour before eating.
  • Starts working in as little as an hour.
  • It can take 1 to 4 days to take full effect.
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
  • Do not take Nexium (esomeprazole) for more than 14 days, unless directed by your doctor. Speak to your doctor if your symptoms don't go away after 2 weeks.
  • Nexium (esomeprazole) capsules can be opened and sprinkled on 1 tablespoon of applesauce, cottage cheese, or yogurt. Swallow immediately after.
Learn more
More about OmeprazoleSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Prilosec (omeprazole)?
Worth itNot sureNot worth it
More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it