Comparison of Prevacid and Nexium




Prevacid is a popular drug used for the treatment of the gastrological problems, including frequent persistent heartburn, gastroesophageal reflux disease, gastric ulcer, ulcer in the upper intestine, gastrin-secreting tumors and other conditions. Nexium is a powerful drug used for the treatment of peptic ulcer and reflux esophagitis.


The main active ingredient of the drug is Lansoprazole. It is produced in the form of pills, chewing tablets, suspension. The available dosage is 15mg and 30 mg.  Esomeprazolee magnesium is the main active component of Nexium. It could be found in the form of light-pink tablets (20 mg and 40 mg).


  • The main advantage of the pills is fast effect, relief can be felt after 1–3 hours after the administration of the tablets.
  • Usually the treatment course takes only 4 weeks to provides the relief of symptoms in duodenal ulcers.
  • Faster elimination of clinical symptoms.
  • The absence of clinically significant side effects.
  • Affordable price.
  • A significant advantage in the speed of heartburn relief and improvement in the quality of life of patients in the first week of treatment.
  • The drug helps in the formation of immunoglobulin substances to Helicobacter pylori, inhibiting their growth.
  • It is able to finally cope with pathologies in their early stages so that a complete cure occurs.




  • The drug is characterized by excellent lipophilicity, which ensures its high penetrating and absorbing abilities into parietal cell structures, where it is converted into sulfonamide derivatives, which have a depressing effect.
  • The overwhelming effect of the drug is due to the specific dosage. When taking 40 mg of the drug, the production of hydrochloric acid secretion is inhibited by 84–96%. In the first days of the course, the effectiveness of the drug is increasing, but there is no rebound increase in secretion.
  • It has a cytoprotective effect, and also increases the oxygen saturation of gastric tissues, inhibits pepsin formation and increases the content of pepsinogen.
  • 88% of patients have a complete cure in the treatment of reflux pathologies. Usually it takes two months of therapy.


  • Prevacid slows down the process of digestion, so it is necessary to eat during the treatment period in small portions. Food is digested poorly and takes a long time because taking Prevacid reduces the release of hydrochloric acid, which helps food to be digested.
  • The drug may interact adversely with certain medications. For example, Prevacid helps slow down the elimination of anticoagulants or Diazepam.
  • It is impossible to take medicine during pregnancy and breast feeding.
  • The medicine intake is not recommended during the pregnancy.
  • In high doses, it can cause depressive disorders, diarrhea, liver disease and skin rashes of a predominantly allergic nature.
  • It is not used if the patient has hypersensitivity (allergy) to one of the components that make up the drug.
  • Use in children age is contraindicated.

Used for

Prevacid is used:

  • If the patient suffer from peptic ulcer;
  • In the presence of reflux esophagitis, erosive and ulcerative esophagitis;
  • With erosive and ulcerative lesions of the duodenum and stomach, which may be caused by taking non-steroidal anti-inflammatory drugs or stress ulcers;
  • With erosive and ulcerative lesions of the stomach and duodenum associated with the activity of Helicobacter Pylori (as part of a complex of therapeutic measures).
Nexium is prescribed for the treatment of the category of patients who suffer from diseases of the digestive system, both in chronic form and in the acute stage.


Side effects

During the drug intake, as is the case with most other medicines, some adverse reactions could occur, although they are quite rare. In some clinical situations, patients experience:

  • Dyspeptic disorders, diarrhea or delayed bowel movements;
  • General malaise and lack of appetite;
  • Cephalgia, drowsiness and dizziness;
  • flatulence, abdominal tenderness;
  • Depressive states, causeless anxiety;
  • Candidiasis of intestinal localization, increased bilirubin level;
  • Anemia and myalgia;
  • Nasal congestion, pharyngitis;
  • Baldness;

If the patient has hypersensitivity to drugs, then it may well manifest itself with traditional allergic reactions such as rashes, lacrimation, skin itching, runny nose, etc.

The drug is capable of providing a number of side effects, which should be taken into account when recommending it for treatment.

Digestive system

Patients complained of variability in appetite and nausea. Occasionally there were cases of diarrhea or constipation. Also, in some cases, the development of ulcerative colitis, gastrointestinal candidiasis, increased bilirubin levels and liver enzyme activity have been reported.

Central nervous system

The main complaints are headaches. In rare cases, anxiety and depression developed, as well as ailments accompanied by dizziness.

Respiratory system

The most common side effects are shown in the form of cough, rhinitis, pharyngitis, flu-like syndrome and the development of infections in the upper respiratory tract. However, these occurrences are rare.

Hematopoietic system

There have been rare reports of thrombocytopenia, sometimes anemia.


Sometimes a rash on the skin can be observed. There exist some rare cases of erythema multiforme and photosensitivity.


Rarely, alopecia and myalgia.

Risks and risk factors

With caution, Prevacid is prescribed to patients with liver or kidney failure, and with long-term therapy, a regular study of the blood flow pattern is demanded.

It can provoke cephalalgia and dizziness, therefore it is not recommended to combine the use of drugs with work on complex mechanisms or during the driving.

Before prescribing Prevacid, the possibility of malignant neoplasms in the stomach and esophagus should be excluded, since Prevacid can mask the symptoms and thus delay the correct diagnosis.


When using antibacterial agents, sometimes life-threatening pseudomembranous colitis may occur. Therefore, it is important to consider this when patients have diarrhea.

In patients with kidney failure, binding to blood proteins is reduced by 1–1.5%.

In patients with varying degrees of chronic liver failure, the period of absorption increases from 1.5 hours to 3.2–7.2 hours.

Due to the limited data on the safety of using Nexium as maintenance therapy for more than 1 year, it is necessary to regularly assess the risk/benefit ratio for this group of patients.

Elderly patients should also be careful with the drug intake.


The lowest price of Prevacid 30 mg is $142 per 7 tablets. The lowest price of Nexium 20 mg is $299 per 30 capsules.