Prevacid vs Prilosec

What is Prevacid? What is Prevacid used for?

Prevacid is a Brand name for a medication that contains lansoprazole as an active ingredient. This drug is known as a proton pump inhibitor and works by decreasing the amount of acid which is produced in the stomach.

It is used to treat conditions such as:  gastroesophageal reflux disease – GERD, esophagitis, Zollinger-Ellison syndrome, Helicobactor pylori and other bacterial infections in the stomach. Prevacid can be also used as a prevention of stomach ulcers that can be caused after long-term use of corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs).

Prevacid is also available as OTC product indicated for frequent heartburn that happens 2 or more days per week, but, it can’t relief acute heartburn. Prevacid is available in the form oral suspension, orally disintegrating tablets, delayed release capsule, injectable solution, and 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.

What is Prilosec? What is Prilosec used for?

Prilosec is a Brand name for a medicine containing omeprazole as an active ingredient. This drug is a proton pump inhibitor that works by decreasing production of stomach acid. Prilosec is indicated for the treatment of:   esophagitis, gastroesophageal reflux disease – GERD, Zollinger-Ellison syndrome and Helicobactor pylori infections a type of bacteria that may provoke stomach ulcers.

Prilosec can be also used as a prevention of stomach ulcers that can be caused after long-term treatment of corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs).  It is not indicated for immediate relief of heartburn symptoms.

Prilosec is available in the form of a capsule or liquid suspension to be taken by mouth. It is most commonly used in doses of 10 mg, 20 mg and 40 mg.  FDA approved omeprazole in 1989. It is available as OTC and prescription medicine.

How Prevacid and Prilosec work in the body?

Lansoprazole from Prevacid and omeprazole from Prilosec belong to the class of proton pump inhibitor drugs that works by suppressing secretion of stomach acid through specific inhibition of the enzyme system known as (H+,K+)-ATPase located on the secretory surface of the parietal cell.

These drugs work by inhibiting the final step of acid production in stomach. Effect is dose-related leading to inhibition of both basal and stimulated acid secretion by different stimuli.

Differences and similarities between Prevacid and Prilosec

Is lansoprazole (Prevacid) or omeprazole (Prilosec) more effective

Prevacid and Prilosec are in general similar medicines, however there are some differences. Active ingredient of Prevacid is lansoprazol while Prilosec’s active ingredient is omeprazole. Both drugs belong to the therapeutic group of proton pump inhibitors and have almost the same mechanism of actions.

Chemically they are also very similar. Their chemical structures belong to the class of organic compounds known as sulfinylbenzimidazoles. Both compounds 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 omeprazole, while omeprazole contain 2 metoxy groups more.  In theory, lansoprazole should be more reactive than omeprazole.

Both drugs have rapid absorption. Lansoprazole bioavailability is much better and is 80% compared to just 30-40 % after omeprazole use. Poor bioavailability of omeprazole after oral use is caused by intensive presystemic metabolism of the drug.

However, this value increases slightly when omeprazole is given repeatedly.  These drugs have almost the same ratio of 97% for lansoprazole and 95% for omeprazole for plasma protein binding. These drugs are metabolized in the liver with CYP450 enzyme system. Both drugs are metabolized with CYP2C19 and CYP3A4 liver enzymes. Omeprazole metabolism is stereoselective.

Lansoprazole is excreted in about one-third of the administered dose in the urine and two-thirds in the feces. So biliary excretion is very important for lansoprazole metabolites. Primary route of omeprazole metabolites excretion is urinary. Elimination half-lives of these drugs are very short with approximately 1-1.5 hours for lansoprazole and 0.5 hours for omeprazole.

Beside their short retention in the systemic circulation of approximately 12-18 hours for lansoprazole and 6-8 hours for omeprazole, their ability to inhibit proton pump last for more than 24 h and thus their effects.

Both drugs have the same indications. They are both used to treat gastroesophageal reflux disease, Zollinger-Ellison syndrome, esophagitis, ulcers, Helicobacter pylori infections. Both drugs are useful to treat frequently occurring symptoms of heartburn; however neither drug is efficient for acute treatment of this symptom.

Studies showed that lansoprazole is more effective in acid reflux long-term treatment and it is known to work faster.  Studies that compared these drugs in the treatment of erosive esophagitis showed that patients treated with lansoprazole had a statistically significant advantage in symptom relief during the treatment period of 8 weeks.

Pharmacokinetic differences, such as lansoprazol’s increased bioavailability, could play a role in better efficacy of symptom control compared to omeprazole.

However antacids may reduce the absorption of lansoprazole from the gastrointestinal tract thus decreasing its efficiency which is not case for omeprazole. Therefore Lansoprazole should not be taken for one hour after taking antacids. Lansoprazol may also lower iron absorption from the body. Patients with any sort of anemia should avoid this drug and talk to their doctor before using.

Omeprazole may enhance anticoagulant’s anti-clotting effects such as those of warfarin. Doctor should monitor your blood clotting time – INR, before taking this medication and after discontinuation.  Recent studies have been showed that both drugs may increase the risk of bone fractures when they are taken for a long term.

Prevacid vs Prilosec side effects

Prevacid possible side effects Prilosec possible side effects
Headache (3-7%)Headache (7%)
Diarrhea (1-5%)Abdominal pain (5%)
Constipation (1-5%)Diarrhea (4%)
Nausea (1-3%)Nausea (4%)
Abdominal pain (1-3%)Vomiting (3%)
Anxiety (< 1%)Flatulence (3%)
Angina (< 1%)Dizziness (2%)
Palpitations (< 1%)Upper respiratory infection (2%)
Syncope (< 1%)Acid regurgitation (2%)
Edema (< 1%)Constipation (2%)
Anorexia (< 1%)Rash (2%)
Dry mouth (< 1%)Cough (1%)
Tenesmus (< 1%)
Flatulence (< 1%)
Melena (< 1%)
Myalgia (< 1%)
Tinnitus (< 1%)
Allergic reaction (< 1%)

Which one is expensive Prevacid or Prilosec?

According to

·     The cost for Prevacid delayed release capsule 15 mg is around $198 for a supply of 30 capsules

·     The cost for Prevacid delayed release capsule 30 mg is around $75 for a supply of 10 capusles

×          The cost for Prilosec delayed release capsule 10 mg is around $214 for a supply of 10 capsules

×          The cost for Prilosec delayed release capsule 20 mg is around $238 for a supply of 10 capsules

×          The cost for Prilosec delayed release capsule 40 mg is around $349 for a supply of 10 capsules

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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