What is the Difference Between Prilosec and Nexium?

Prilosec and Nexium are both proton pump inhibitors (PPIs) used to treat conditions involving excessive stomach acid production, such as gastroesophageal reflux disease (GERD) and Zollinger-Ellison syndrome. They have some differences in their chemical structure and effects, which include:

1. Chemical Makeup: Prilosec contains two isomers of the drug omeprazole, while Nexium only contains one isomer, esomeprazole. Isomers are molecules that have the same chemical makeup but are arranged differently.
2. Effectiveness: There is some evidence that Nexium provides more effective acid control, lasts for longer, and works faster than Prilosec. However, some studies have failed to find a significant difference between the two medicines, and the American College of Gastroenterology reports that there are no major differences between them.
3. Price: Nexium is typically more expensive than Prilosec. However, generic versions of the drugs have similar prices.
4. Side Effects: Although side effects with PPIs are generally uncommon, Nexium may be more likely than Prilosec to cause side effects such as diarrhea, nausea, vomiting, or headache.
5. Drug Interactions: Esomeprazole (Nexium) is broken down differently in the liver than omeprazole (Prilosec), which may result in fewer drug interactions.
6. Warning: Prilosec should not be taken with the blood thinner clopidogrel. It is unclear whether Nexium has a similar interaction with clopidogrel, as it has not been evaluated.

Ultimately, both Nexium and Prilosec are considered effective treatments for GERD and acid reflux, and a healthcare provider will recommend the medication that works best for an individual's health history, current medical needs, and other medications they may be taking.

Comparative Table: Prilosec vs Nexium

Here is a table comparing the differences between Prilosec and Nexium:

Both Prilosec and Nexium are proton pump inhibitors (PPIs) used to treat gastroesophageal reflux disease (GERD) and other acid-related conditions. They work by reducing the amount of acid produced in the stomach. Prilosec contains two isomers of omeprazole, while Nexium contains only one isomer, specifically S-omeprazole. Some studies suggest that Nexium provides better acid control and faster symptom relief, but both drugs are considered effective. Nexium is typically more expensive than Prilosec, but they have similar prices for their over-the-counter forms. Both medications have similar side effects and drug interactions, but Prilosec should not be taken with the blood thinner clopidogrel. A healthcare provider will recommend the medication that works best for your health history, current medical needs, and in consideration of any other medications you take.