Last reviewed by Miljan Krcobic on August 28th, 2018.
What is Nexium? What is Nexium used for?
Nexium is a Brand name for a medicine that contains esomeprazole as an active ingredient. Esomeprazole is a proton pump inhibitor drug that works by decreasing the acid amount produced in the stomach. It is indicated for the treatment of conditions that causes too much of stomach acid production such as: gastroesophageal reflux disease, erosive esophagitis, Zollinger-Ellison syndrome and Helicobactor pylori infections.
Nexium is also used in prevention of stomach ulcers that can be caused after long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Nexium relieves symptoms of difficulty swallowing, heartburn, and persistent cough caused by acid reflux. It can also restore acid damage in stomach and esophagus, prevents ulcers, and may even be very helpful in prevention of cancer in the esophagus.
Nexium is available in the form of a delayed-release capsule or a liquid suspension to be taken by mouth. It is available in doses of 10 mg, 20 mg and 40 mg. FDA approved esomeprazole in 2001. OTC Nexium is originally manfucatured by Pfizer drug company.
What is Prevacid? What is Prevacid used for?
Prevacid is a Brand name for a medicine that contains lansoprazole as an active ingredient. Lansoprazole is a proton pump inhibitor drug that works by decreasing the acid amount produced in the stomach.
It is indicated for the treatment of conditions that causes too much production of stomach acid such as: esophagitis, gastroesophageal reflux disease, Zollinger-Ellison syndrome and Helicobactor pylori and other bacterial infections in the stomach. Prevacid is also used in prevention of stomach ulcers that can be caused after long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
OTC Prevacid is commonly used to treat recurrent heartburn that happens 2 or more days per week. However, it is not efficient for acute relief of heartburn. Prevacid is available in the form injectable solution, oral suspension, orally disintegrating tablets, delayed release capsule, sprinkles. It is most commonly used in doses of 15 and 30 mg. FDA approved lansoprazol in 1995 and is originally manufactured by Novartis drug company.
How Nexium and Prevacid work in the body?
Esomeprazole from Nexium and Lansoprazole from Prevacid belongs to a class proton pump inhibitor drugs that works by suppressing gastric acid secretion by specific inhibition of the (H+,K+)-ATPase enzyme system located on the secretory surface of the parietal cell.
These drugs work by blocking the final step of acid production in stomach. Effect is dose-related and leads to inhibition of both basal and stimulated gastric acid secretion by different stimuli.
Differences and similarities between Nexium and Prevacid
Nexium and Prevacid are in general similar medicines, however there are some differences.
Active ingredient of Nexium is esomeprazole while Prevacid’s active ingredient is lansoprazole. Both drugs belong to the therapeutic group of proton pump inhibitors and have almost the same mechanism of actions.
Chemically they are very similar. Their chemical structures belong to the class of organic compounds called sulfinylbenzimidazoles. Both compunds contain polycyclic aromatic structure with a sulfinyl group which is attached at the position 2 of a benzimidazole moiety. Lansoprazole contains 3 Fluor atoms more than esomeprazole, which in theory means that it should be more reactive than esomeprazole.
Both drugs have rapid absorption, however esomeprazole bioavailability is slightly better and is 90% after oral use compared to 80% after lansoprazole use. Both drugs have at the same ratio of 97% to plasma proteins.
These drugs are metabolized in the liver with CYP450 enzyme system. Both drugs are metabolized with CYP2C19 and CYP3A4 liver enzymes, but lansoprazole is also metabolized with CYP2C9 enzymes while esomeprazole is not. Approximately 80% of the orally administered esomeprazole is excreted as metabolites thorough the urine and the remaining 20% are excreted in feces.
Lansoprazole is approximately excreted in one-third of the administered dose in the urine and two-thirds in the feces. This shows a significant biliary excretion of the lansoprazole metabolites. Their elimination half-lives are almost the same with approximately 1-1.5 hours, so according to this it can be estimated that these drugs will be fully eliminated from systemic circulation within 12 to 18 hours.
Both drugs have the same indications. They are both used to treat gastroesophageal reflux disease, esophagitis, Zollinger-Ellison syndrome, ulcers, Helicobactor pylori infections. Both drugs are useful to treat repetitive symptoms of heartburn; however neither drug is efficient for acute treatment of this symptom.
There are 2 similar studies which compared the efficacy of these two drugs for esophagitis treatment. And results were different. First, smaller study on 284 patients showed that after 4 weeks healing rates were 77.0% for lansoprazole compared to 78.3% for esomeprazole and after 8 weeks, result were 91.4% for lansoprazole and 89.1% for esomeprazol. Authors concluded that these drugs were equivalent.
Bigger, randomized study on 5241 patients showed that esomeprazole was superior to lansoprazole after 8 weeks of treatment, for healing and symptom relief with next rate 92.6% for esomeprazole and 88.8% for lansoprazole.
Another study found that lansoprazole 30mg used once daily or esomeprazole 40mg used once daily for 2 weeks effectively increase the number of days and nights without heartburn and reduced severity of daytime and night-time heartburn in patients with symptomatic GERD.
Nexium vs Prevacid side effects
|Nexium possible side effects||Prevacid possible side effects|
|Headache (2-11%)||Headache (3-7%)|
|Flatulence (10%)||Diarrhea (1-5%)|
|Indigestion (6%)||Constipation (1-5%)|
|Nausea (6%)||Nausea (1-3%)|
|Abdominal pain (1-6%)||Abdominal pain (1-3%)|
|Diarrhea (2-4%)||Anxiety (< 1%)|
|Xerostomia (3-4%)||Angina (< 1%)|
|Dizziness (2-3%)||Palpitations (< 1%)|
|Constipation (2-3%)||Syncope (< 1%)|
|Somnolence (1-2%)||Edema (< 1%)|
|Pruritus (1%)||Anorexia (< 1%)|
|Dry mouth (< 1%)|
|Tenesmus (< 1%)|
|Flatulence (< 1%)|
|Melena (< 1%)|
|Myalgia (< 1%)|
|Tinnitus (< 1%)|
|Allergic reaction (< 1%)|
Which one is expensive Nexium or Prevacid?
According to drugs.com:
· The cost for Nexium delayed release capsule 20 mg is around $250 for a supply of 30 capusles
· The cost for Nexium delayed release capsule 40 mg is around $122 for a supply of 15 capusles
· The cost for Prevacid delayed release capsule 15 mg is around $198 for a supply of 30 capusles
· The cost for Prevacid delayed release capsule 30 mg is around $75 for a supply of 10 capusles
Prices depend on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.
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