{"id":4319,"date":"2019-05-27T11:36:59","date_gmt":"2019-05-27T15:36:59","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=3389"},"modified":"2026-03-23T14:37:55","modified_gmt":"2026-03-23T18:37:55","slug":"nexium-vs-prilosec","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/nexium-vs-prilosec\/","title":{"rendered":"Nexium vs. Prilosec: Differences, similarities, and which is better for you"},"content":{"rendered":"

Drug overview & main differences<\/a> | Conditions treated<\/a> | Efficacy<\/a> | Insurance coverage and cost comparison<\/a> | Side effects<\/a> | Drug interactions<\/a> | Warnings<\/a> | FAQ<\/a><\/p>\n

Are you experiencing heartburn? If so, you\u2019re not alone<\/a>\u2014more than 60 million Americans experience heartburn at least once a month, and many of these patients have heartburn symptoms every day.<\/p>\n

Nexium (esomeprazole magnesium) and Prilosec (omeprazole magnesium) are two medications in a drug class called proton pump inhibitors, or PPIs. PPIs work by blocking and decreasing acid production, thereby preventing heartburn<\/a> and achieving acid control.<\/p>\n

These drugs are approved by the FDA. They are used to treat symptoms of gastroesophageal reflux disease<\/a> and other gastrointestinal conditions. Although both Nexium and Prilosec are PPIs, they do have some differences, which we discuss below.<\/p>\n

What are the main differences between Nexium and Prilosec?<\/h2>\n

Nexium\u00a0is known by its generic name of esomeprazole<\/a>, and Prilosec is known by its generic name of omeprazole<\/a>. The generic names sound similar for a reason\u2014esomeprazole is a chemical isomer of omeprazole. Both drugs are made up of the same chemicals but are arranged in different ways.<\/p>\n

Both Nexium and Prilosec are available in brand and generic, and as prescription drugs and over-the-counter as Nexium OTC and Prilosec OTC. The dosage and length of treatment vary by age and the condition being treated.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Main differences between Nexium and Prilosec<\/span><\/th>\n<\/tr>\n<\/thead>\n
<\/td>\nNexium<\/strong><\/td>\nPrilosec<\/strong><\/td>\n<\/tr>\n
Drug class<\/strong><\/td>\nProton pump inhibitor (PPI)<\/td>\nProton pump inhibitor (PPI)<\/td>\n<\/tr>\n
Brand\/generic status<\/strong><\/td>\nBrand and generic<\/td>\nBrand and generic<\/td>\n<\/tr>\n
What is the generic name?<\/strong><\/td>\nEsomeprazole magnesium<\/td>\nOmeprazole magnesium<\/td>\n<\/tr>\n
What form(s) does the drug come in?<\/strong><\/td>\nRx: delayed-release capsules, suspension, packets, injection
\nOTC: capsules, mini capsules, tablets<\/td>\n		Rx: delayed-release capsules, suspension
\nOTC: delayed-release tablets<\/td>\n<\/tr>\n
What is the standard dosage?<\/strong><\/td>\nVaries by indication: usually 20-40 mg once or twice daily (adult dose)<\/td>\nVaries by indication: usually 20-40 mg once or twice daily (adult dose)<\/td>\n<\/tr>\n
How long is the typical treatment?<\/strong><\/td>\n10 days to 6 months, many patients take for longer<\/td>\n10 days to 8 weeks, many patients take for longer<\/td>\n<\/tr>\n
Who typically uses the medication?<\/strong><\/td>\nAdults and children<\/td>\nAdults and children<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

Want the best price on Nexium?<\/h3>\n

Sign up for Nexium price alerts and find out when the price changes!<\/p>\n

Get price alerts<\/a><\/p>\n<\/div>\n

Conditions treated by Nexium vs. Prilosec<\/h2>\n

Nexium and Prilosec are both used in the treatment of gastroesophageal reflux disease (GERD), to eradicate H. pylori, to lower the risk of duodenal ulcer recurrence, and for pathological hypersecretory conditions.<\/p>\n

Nexium is also indicated for the risk reduction of NSAID-associated gastric ulcers.<\/p>\n

Prilosec is also indicated for the treatment of active duodenal ulcer or active benign gastric ulcer, treatment of erosive esophagitis (EE) due to acid-mediated GERD, and maintenance of healing of EE due to acid-mediated GERD.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Condition<\/strong><\/td>\nNexium<\/strong><\/td>\nPrilosec <\/strong><\/td>\n<\/tr>\n
Treatment of gastroesophageal reflux disease (GERD)<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Risk reduction of NSAID-associated gastric ulcer<\/td>\nYes<\/td>\nOff-label<\/td>\n<\/tr>\n
H. pylori eradication to reduce the risk of duodenal ulcer recurrence<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Pathological hypersecretory conditions (including Zollinger-Ellison Syndrome)<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Treatment of active duodenal ulcer<\/td>\nOff-label<\/td>\nYes<\/td>\n<\/tr>\n
Treatment of active benign gastric ulcer<\/td>\nOff-label<\/td>\nYes<\/td>\n<\/tr>\n
Treatment of erosive esophagitis (EE) due to acid-mediated GERD<\/td>\nOff-label<\/td>\nYes<\/td>\n<\/tr>\n
Maintenance of healing of EE due to acid-mediated GERD<\/td>\nOff-label<\/td>\nYes<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Is Nexium or Prilosec more effective?<\/h2>\n

In trials<\/a> comparing standard doses of Nexium 40 mg and Prilosec 20 mg (along with other PPIs) in patients with GERD symptoms, Nexium provided the most acid control out of all of the drugs. In another study<\/a>, patients treated with Nexium experienced faster symptom relief than patients treated with Prilosec and other PPIs. Although Nexium may be more effective, both drugs are quite popular among prescribers.<\/p>\n

The best medication is the one that works best for you, with the least amount of side effects. Consult your healthcare provider, who can help select the best drug for you based on your symptoms, medical condition(s), and other drugs you take that could interact with Nexium or Prilosec.<\/p>\n

\n

Want the best price on Prilosec?<\/h3>\n

Sign up for Prilosec price alerts and find out when the price changes!<\/p>\n

Get price alerts<\/a><\/p>\n<\/div>\n

Coverage and cost comparison of Nexium vs. Prilosec<\/h2>\n

Both Nexium and Prilosec are usually covered by insurance and Medicare Part D. Usually, the prescription generic version is covered. The OTC versions are usually only covered (with a prescription) under certain insurance plans. Copays vary by plan.<\/p>\n

The out-of-pocket price for 30 capsules of generic Nexium<\/a> 40 mg can be over $300. You can pay under $50 by using a SingleCare card at participating pharmacies<\/p>\n

The out-of-pocket price for 30 capsules of generic Prilosec<\/a> 20 mg averages $50 or more. With a SingleCare\u00a0omeprazole<\/a> coupon, the price starts at $15, depending on which pharmacy you use.<\/p>\n\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nNexium<\/strong><\/td>\nPrilosec<\/strong><\/td>\n<\/tr>\n
Typically covered by insurance?<\/strong><\/td>\nYes, as Rx generic (usually not OTC)<\/td>\nYes, as Rx generic (usually not OTC)<\/td>\n<\/tr>\n
Typically covered by Medicare Part D?<\/strong><\/td>\nYes, as Rx generic (usually not OTC)<\/td>\nYes, as Rx generic (usually not OTC)<\/td>\n<\/tr>\n
Standard dosage<\/strong><\/td>\nExample: 40 mg capsule daily<\/td>\nExample: 20 mg capsule daily<\/td>\n<\/tr>\n
Typical Medicare Part D copay<\/strong><\/td>\n$14<\/td>\n$0-$20<\/td>\n<\/tr>\n
SingleCare cost<\/strong><\/td>\n$46<\/td>\n$9-$20<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Get a prescription coupon<\/b><\/a><\/p>\n

Common side effects of Nexium vs. Prilosec<\/h2>\n

The most common side effects of Nexium are abdominal pain, diarrhea, headache, and nausea. The most common side effects of Prilosec are headache, abdominal pain, diarrhea, and nausea. Both medications are generally well-tolerated.<\/p>\n

This is not a full list of side effects. Consult your healthcare provider for a full list of adverse effects.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nNexium<\/strong><\/td>\nPrilosec<\/strong><\/td>\n<\/tr>\n
Side Effect<\/strong><\/td>\nApplicable?<\/strong><\/td>\nFrequency<\/strong><\/td>\nApplicable?<\/strong><\/td>\nFrequency<\/strong><\/td>\n<\/tr>\n
Abdominal pain<\/td>\nYes<\/td>\n3.8-5%<\/td>\nYes<\/td>\n5%<\/td>\n<\/tr>\n
Constipation<\/td>\nYes<\/td>\n2%*<\/td>\nYes<\/td>\n2%<\/td>\n<\/tr>\n
Diarrhea<\/td>\nYes<\/td>\n4.3%<\/td>\nYes<\/td>\n4%<\/td>\n<\/tr>\n
Nausea<\/td>\nYes<\/td>\n4%*<\/td>\nYes<\/td>\n4%<\/td>\n<\/tr>\n
Headache<\/td>\nYes<\/td>\n3.8%<\/td>\nYes<\/td>\n7%<\/td>\n<\/tr>\n
Vomiting<\/td>\nYes<\/td>\n<1%<\/td>\nYes<\/td>\n3%<\/td>\n<\/tr>\n
Flatulence<\/td>\nYes<\/td>\n3%*<\/td>\nYes<\/td>\n3%<\/td>\n<\/tr>\n
Rash<\/td>\nYes<\/td>\n<1%<\/td>\nYes<\/td>\n2%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

*Percent not reported but occurred at a similar rate to Prilosec
\nSource: DailyMed (Nexium<\/a>), DailyMed (Prilosec<\/a>)<\/p>\n

Drug interactions of Nexium and Prilosec<\/h2>\n

Because Nexium and Prilosec are similar drugs with similar structures, they have similar drug interactions. PPIs should not be taken with antiretrovirals. Nexium or Prilosec could decrease levels of atazanavir or nelfinavir, so the antiretroviral would not work properly, and the interaction could even cause drug resistance. On the other hand, taking saquinavir with a PPI has the opposite effect, increasing levels of saquinavir, which could lead to toxicity.<\/p>\n

Combining Nexium or Prilosec with digoxin can increase levels of digoxin and lead to toxicity. Taking Nexium or Prilosec with warfarin can lead to increased levels of warfarin, which could cause bleeding or even death. Nexium or Prilosec can interact with Plavix<\/a> (clopidogrel<\/a>), diazepam<\/a>, cilostazol<\/a>, and other drugs. This is not a complete list of drug interactions. Consult your healthcare provider for a full list of drug interactions.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Drug<\/strong><\/td>\nDrug Class<\/strong><\/td>\nNexium<\/strong><\/td>\n\u00a0Prilosec<\/strong><\/td>\n<\/tr>\n
Atazanavir
\nNelfinavir
\nSaquinavir<\/td>\n		Antiretrovirals<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Digoxin<\/td>\nCardiac glycoside<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Warfarin<\/td>\nAnticoagulant<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Diazepam<\/td>\nBenzodiazepine<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Clopidogrel<\/td>\nAnti-platelet<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Cilostazol<\/td>\nVasodilator<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Rifampin
\nSt. John\u2019s wort<\/td>\n		CYP3A4 enzyme inducers<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Tacrolimus<\/td>\nImmunosuppressant<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Citalopram
\nSertraline<\/td>\n		SSRI antidepressant<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Phenytoin<\/td>\nAnticonvulsant<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Warnings of Nexium and Prilosec<\/h2>\n