Compare Omeprazole vs. Nexium

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

Prilosec (Omeprazole)

Prescription or OTC

Nexium (esomeprazole)

Over-the-counter
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.

5.5/ 7 average rating with 1167 reviewsforOmeprazole
Treats heartburn and stomach ulcers.

Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term.

5.5/ 7 average rating with 1239 reviewsforNexium
Upsides
  • 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
  • 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.
Used for
Dosage forms
  • Extended release
  • Pill
  • Injection
  • Packet
Price
Lowest price near you
$4
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Lowest price near you
$32.5
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Reviews
1167 
80%
think this treatment is worth it
59%
think this treatment works well
8%
think this treatment is a hassle

Have you used Prilosec (Omeprazole)?

Leave a review
1239 
75%
think this treatment is worth it
59%
think this treatment works well
11%
think this treatment is a hassle

Have you used Nexium (esomeprazole)?

Leave a review
Side effects
9possible side effects
  • Upper respiratory infection
    75%
  • Fever
    33%
  • Headache
    7%
  • Abdominal pain
    5%
  • Nausea
    4%
  • Diarrhea
    4%
  • Accidental injuries
    4%
  • Vomiting
    3%
  • Flatulence
    3%
See more detailed side effects
The Nexium (esomeprazole) FDA package insert doesn’t have numbers about how common side effects are.
Risks and warnings
  • Severe stomach inflammation (atrophic gastritis)

    Helicobacter pylori infection

    ...and 1 more risk factors

  • Severe diarrhea

    Being hospitalized

    ...and 1 more risk factors

  • Broken bones

    Osteoporosis

    ...and 5 more risk factors

See more detailed risks and warnings
  • Severe diarrhea

    Being treated at a hospital

  • Bone fractures

    High dose Nexium (esomeprazole)

    ...and 3 more risk factors

See more detailed risks and warnings