Individuals with gastroesophageal reflux disease (GERD) often take either Prilosec (omeprazole) or Nexium (esomeprazole). Both medications belong to a family of drugs called proton pump inhibitors (PPIs). This $13.9 billion annual business is a big deal. In fact, PPIs are the third-highest category of drugs sold in the United States. Still, as someone newly diagnosed with GERD, it can be difficult to choose which drug to take. This especially true when comparing Nexium versus Prilosec, two PPI drugs typically prescribed for extreme reflux cases instead of H2 blockers. That said, here are the key differences and similarities between the two most popular PPIs in the category.*
*Competitor PPIs, including Aciphex (rabeprazole), Protonix (pantoprazole), Zegerid (omeprazole and sodium bicarbonate) and Dexilant (dexlansoprazole) have similar side effects. However, we won’t discuss them here.
Nexium Versus Prilosec: Drug Similarities
Both Nexium and Prilosec can cause severe side effects. These are mostly due to destroying so much “good” bacteria found in stomach acid.
Some of the most common shared side effects include:
- Severe diarrhea (often resulting in the bacterial infection C-diff)
- Nausea
- Vomiting
- Headache
- Osteoporosis and bone fracture (likely caused by magnesium and calcium deficiencies)
- Bacterial inflammation of the colon
- Pneumonia
- Nutritional deficiencies
Proton pump inhibitors (including Nexium and Prilosec) however, have also been linked to more extreme side effects such as heart attack, dementia, and Alzheimer’s – especially when used for an extended period of time.
Reasons for Prescribing
Most doctors prescribe PPI drugs to treat the following conditions (or their symptoms):
- GERD
- Heartburn
- Esophagitis
- Stomach and duodenal ulcers
- Zollinger-Ellison Syndrome (a disease where the tumors produce excessive stomach acid)
Nexium Versus Prilosec: Comparing Efficacy and Price
The American Family Physician website reviewed bot PPIs. The biggest difference between them was price. Up until March 2014, Nexium was only available by prescription – and was much more expensive than Prilosec, but after coming out with a generic version of omeprazole, it has become more comparable to Prilosec pricing
But as far as the clinical outcomes go? Dr. Robert Dachs says the two are comparable and any studies showing otherwise are negligible. He goes on to state, “I feel comfortable saying there are no differences in efficacy among any PPIs … If I were to choose a PPI, I would first look at cost. It also has been suggested that PPIs are associated with increased rates of community-acquired pneumonia and Clostridium difficile colitis (C-diff). In conclusion, PPIs are not cheap and may not be benign.”
Nexium Versus Prilosec: Differences in Drug Interactions
The FDA discovered and warned consumers about one slight difference. Prilosec reduces blood thinner clopidogrel (Plavix)’s effectiveness. Therefore, the FDA recommends not taking these drugs together. However, Nexium and other PPIs may also reduce Plavix’s efficacy. The FDA states, “It is unknown how other PPIs may interfere with Plavix. Other drugs that should not be used with Plavix because they may have a similar interaction with CYP2C19 include Nexium (esomeprazole), Tagamet and Tagamet HB (cimetidine), Diflucan (fluconazole), Nizoral (ketoconazole), VFEND (voriconazole), Intelence (etravirine), Felbatol (felbamate), Prozac, Serafem, Symbyax (fluoxetine), Luvox (fluvoxamine) and Ticlid (ticlopidine).”
Nexium Versus Prilosec: Outcomes
Regardless of the type, all PPIs include side effect risks — many of which can be deadly or life-altering. If you or a loved one took these drugs and experienced devastating side effects, you may be eligible for compensation. Because drug manufacturers failed to warn prescribing physicians and consumers about potential dangers, lawsuits are underway. For more information about the claims being made and to see if you have a case, fill out a free Nexium claims review today.
Related: Alternatives to Nexium and Prilosec for Acid Reflux
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.