Prevacid vs. Protonix

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

Key Takeaways

  • Both Prevacid and Protonix are proton pump inhibitors that reduce stomach acid to treat GERD and related conditions, but they differ in available forms and FDA-approved age ranges.

  • Prevacid is available over the counter, while Protonix requires a prescription and is approved for use in children as young as 1 year old.

  • Both drugs carry similar long-term risks, including bone fracture, low magnesium, and C. difficile infection, so duration of use should be discussed with a doctor.

Prevacid vs. Protonix Drug Summary

Prevacid

Prevacid (lansoprazole) is a proton pump inhibitor used to treat GERD, ulcers, and hypersecretory conditions by reducing stomach acid production. It comes as a delayed-release capsule, an orally disintegrating tablet, or an IV injection, and is also sold over the counter for frequent heartburn.

Protonix

Protonix (pantoprazole) is also a proton pump inhibitor that lowers stomach acid to heal erosive esophagitis caused by GERD and to treat hypersecretory conditions. It's taken as a delayed-release tablet, an oral suspension, or an IV infusion, and is available by prescription only.

Prevacid vs. Protonix Side Effects

Prevacid

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

Protonix

Most common
Headache (>2%)
Abdominal pain (>2%)
Diarrhea (up to 9%)
Nausea (>2%)

Prevacid vs. Protonix Dosage

Prevacid

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 15 mg once daily At the start
Maximum dose 60 mg once daily If needed
Dose changes 3 increases As tolerated

Protonix

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 40 mg once daily Weeks 1-8
Maximum dose 80 mg twice daily If needed
Dose changes 2 increases As tolerated

Prevacid vs. Protonix Indications

Prevacid

Prevacid is FDA-approved to heal duodenal and gastric ulcers, treat erosive esophagitis, manage GERD, and eradicate H. pylori as part of triple therapy. It's also used for pathological hypersecretory conditions like Zollinger-Ellison syndrome and to lower the risk of NSAID-related stomach ulcers.

  • Duodenal ulcer healing and maintenance

  • Gastric ulcer healing

  • Erosive esophagitis healing and maintenance

  • GERD treatment

  • H. pylori eradication (triple therapy)

Protonix

Protonix is FDA-approved for short-term treatment and maintenance of erosive esophagitis caused by GERD, as well as for pathological hypersecretory conditions such as Zollinger-Ellison syndrome. It is not intended to provide immediate relief of heartburn symptoms.

  • Short-term erosive esophagitis treatment

  • Maintenance of erosive esophagitis healing

  • Zollinger-Ellison syndrome and hypersecretory conditions

  • Pediatric use for short-term GERD/EE (ages 1+)

  • IV formulation for patients unable to take oral medication

Prevacid vs. Protonix Pros and Cons

Prevacid

Prevacid's availability in an over-the-counter form and its multiple delivery formats make it a flexible option for many patients, and its broad set of approved uses covers ulcer prevention and H. pylori therapy that Protonix does not address. Both drugs carry similar long-term risks tied to prolonged acid suppression.

Pros

  • Available over the counter as well as by prescription

  • Comes in capsule, orally disintegrating tablet, and IV forms

  • Approved for H. pylori eradication and NSAID-ulcer risk reduction

Cons

  • Not approved for infants under 1 year old

  • Long-term use linked to fundic gland polyps

  • Narrower pediatric approval data than Protonix

Protonix

Protonix's IV and oral suspension options, along with its pediatric approval down to age 1, make it a practical choice for patients who need alternative dosing forms or younger treatment. It carries a narrower set of FDA-approved uses than Prevacid and is prescription-only, without an over-the-counter option.

Pros

  • FDA-approved for children as young as 1 year old

  • Available as an oral suspension for those who can't swallow tablets

  • Offers a high-dose IV option for hypersecretory conditions

Cons

  • Not sold over the counter; prescription only

  • Not intended for immediate relief of heartburn symptoms

  • Narrower set of FDA-approved uses (no H. pylori or NSAID-ulcer indication)

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