Compare pantoprazole vs. Nexium

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

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Protonix (pantoprazole)

Prescription only

Nexium (esomeprazole)

Over-the-counter
Treats heartburn and excess release of stomach acid.

Protonix (pantoprazole) is usually only taken once a day for long-lasting heartburn relief, but it can increase your risk of bone fractures if you've used it for a long time.

3.8/ 5 average rating with 584 reviewsforpantoprazole
Treats heartburn and stomach ulcers.

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

4.0/ 5 average rating with 1239 reviewsforNexium
Upsides
  • Most people can take Protonix (pantoprazole) without any noticeable day-to-day side effects.
  • Protonix (pantoprazole) 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 with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
  • Unlike other proton pump inhibitors, it can be taken with or without food and have the same effectiveness.
  • Can be used in children age 5 or older.
  • 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.
  • Needs to be taken every single day for a certain period of time to be effective.
  • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
  • Only available as a prescription medicine, not over the counter.
  • Can lower the magnesium level in your body so you may need to take a supplement for it.
  • 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.
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Used for
  • GERD
  • H. Pylori bacterial infection
  • Prevention and treatment of NSAID-induced gastric ulcers
Dosage forms
  • Pill
  • Packet
  • Pill
  • Injection
  • Packet
Price
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Reviews
584 reviews so far
68%
saidit'sworth it
51%
saiditworked well
13%
saidit'sa big hassle

Have you used Protonix (pantoprazole)?

Leave a review
1239 reviews so far
75%
saidit'sworth it
59%
saiditworked well
11%
saidit'sa big hassle

Have you used Nexium (esomeprazole)?

Leave a review
Side effects
8possible side effects
  • Headache
    12%
  • Diarrhea
    9%
  • Nausea
    7%
  • Stomach pain
    6%
  • Vomiting
    4%
  • Gas
    4%
  • Dizziness
    3%
  • Joint pain
    3%
See more detailed side effects
The Nexium (esomeprazole) FDA package insert doesn’t have numbers about how common side effects are.
Risks and risk factors
  • Weakened bones
    • Using multiple daily doses and/or for 1 year or longer
    • People age 65 or older
    • High risk of bone fractures
  • Severe diarrhea
    • People who are being treated in the hospital
  • Kidney problem
  • Lupus
    • People with lupus
  • Low Vitamin B-12 level
    • Taking Protonix (pantoprazole) for more than 3 years
  • Low magnesium level
    • Diuretics (water pills)
    • Digoxin
See more detailed risks and warnings
  • Stomach cancer
  • Kidney injury
  • Severe diarrhea
    • Being treated at a hospital
  • Bone fractures
    • High dose Nexium (esomeprazole)
    • Long-term treatment with Nexium (esomeprazole)
    • Low bone mineral density
    • Aged 65 years or older
  • Lupus
See more detailed risks and warnings