Prevacid vs. Omeprazole

See how Prevacid and Omeprazole compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Prevacid and omeprazole are both proton pump inhibitors that reduce stomach acid to treat GERD, ulcers, and H. pylori infection, and both are sold over the counter or by prescription.

  • Prevacid comes as a capsule, an orally disintegrating tablet, or an IV injection, while omeprazole is only available as a delayed-release capsule.

  • Generic omeprazole is typically much less expensive than brand-name Prevacid, though both drugs have low-cost generic versions for most patients.

Prevacid vs. Omeprazole Drug Summary

Prevacid

Prevacid (lansoprazole) is a proton pump inhibitor that lowers stomach acid to treat GERD, ulcers, erosive esophagitis, and H. pylori infection. It comes as a delayed-release capsule, an orally disintegrating tablet, or an IV injection, with dosing that ranges from once daily to twice daily depending on the condition. It has been FDA-approved since 1995 and is sold both by prescription and over the counter.

Omeprazole

Omeprazole (brand name Prilosec) is a proton pump inhibitor that lowers stomach acid to treat GERD, duodenal and gastric ulcers, erosive esophagitis, and H. pylori infection. It comes only as a delayed-release capsule, taken once or twice daily depending on the condition. It has been FDA-approved since 1989 and is also sold over the counter at a lower dose.

Prevacid vs. Omeprazole Side Effects

Prevacid

Most common
Headache (up to 7%)
Abdominal pain (up to 5%)
Diarrhea (up to 3.8%)
Nausea (up to 3%)

Omeprazole

Most common
Headache (up to 7%)
Abdominal pain (up to 5%)
Diarrhea (up to 4%)
Nausea (up to 4%)

Prevacid vs. Omeprazole Dosage

Prevacid

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg once daily At the start
Maximum dose 30 mg twice daily If needed
Dose changes 1 increase As tolerated

Omeprazole

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 60 mg once daily If needed
Dose changes 3 increases As tolerated

Prevacid vs. Omeprazole Indications

Prevacid

Prevacid treats a range of acid-related conditions, from short-term ulcer healing to long-term GERD maintenance. It is also combined with antibiotics to eradicate H. pylori and used to lower the risk of NSAID-related stomach ulcers.

  • Duodenal ulcer healing and maintenance

  • Gastric ulcer healing

  • Erosive esophagitis healing and maintenance

  • GERD (prescription and over-the-counter)

  • H. pylori eradication and Zollinger-Ellison syndrome

Omeprazole

Omeprazole treats duodenal and gastric ulcers, GERD, and erosive esophagitis, and is combined with antibiotics to eradicate H. pylori. It is also approved for children as young as 1 month for erosive esophagitis and for adults with rare acid-hypersecretion disorders.

  • Duodenal ulcer treatment

  • Gastric ulcer treatment

  • Erosive esophagitis healing and maintenance

  • Symptomatic GERD (ages 2 and up)

  • H. pylori eradication and pathologic hypersecretory conditions

Prevacid vs. Omeprazole Pros and Cons

Prevacid

Prevacid offers more dosage forms than omeprazole, including an orally disintegrating tablet and an IV option for patients who cannot swallow capsules. It also carries a couple of FDA indications omeprazole's label does not include, though the brand-name version can cost far more without coverage.

Pros

  • Available as a capsule, orally disintegrating tablet, or IV injection

  • Approved for GERD in children as young as 1 year old

  • Carries an FDA indication to reduce NSAID-associated ulcer risk

  • Available over the counter as well as by prescription

Cons

  • Not approved for infants younger than 1 year old

  • Brand-name Prevacid can cost far more than generic omeprazole, roughly $14 to $530 a month before savings programs

  • Long-term use carries a specific label warning for fundic gland polyps

Omeprazole

Omeprazole has been generic for decades, making it one of the least expensive PPIs on the market, and its label covers a broader pediatric age range for erosive esophagitis than Prevacid's. It comes only as a capsule, so patients who cannot swallow pills have fewer options than with Prevacid.

Pros

  • Generic omeprazole is inexpensive, often $4 to $25 a month without insurance

  • Approved for erosive esophagitis in infants as young as 1 month old

  • Long real-world track record, FDA-approved since 1989

  • Available over the counter at a lower dose without a prescription

Cons

  • Only available as a capsule, with no orally disintegrating tablet or IV form

  • Not approved for reducing NSAID-associated ulcer risk

  • GERD indication starts at age 2, a year later than Prevacid's pediatric approval

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