Prilosec vs. Prevacid
See how Prilosec and Prevacid compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Prilosec and Prevacid are both proton pump inhibitors that reduce stomach acid to treat GERD, ulcers, and related conditions.
Both drugs share very similar side effect profiles, with headache and abdominal pain being the most common in each.
Prevacid offers an orally disintegrating tablet and IV form, while Prilosec is available as capsules, tablets, and oral suspension granules.
Prilosec vs. Prevacid Drug Summary
Prilosec
Prilosec (omeprazole) is a proton pump inhibitor that lowers stomach acid to treat GERD, ulcers, and erosive esophagitis. It comes as a delayed-release capsule, tablet, or oral suspension, taken once or twice daily depending on the condition. Prilosec is available both over the counter and by prescription.
Prevacid
Prevacid (lansoprazole) is a proton pump inhibitor used to treat GERD, ulcers, and erosive esophagitis, and to reduce NSAID-related ulcer risk. It comes as a capsule, an orally disintegrating tablet, or an IV injection for hospital use. Prevacid is also sold over the counter in addition to its prescription form.
Prilosec vs. Prevacid Side Effects
Prilosec
Prevacid
Prilosec vs. Prevacid Dosage
Prilosec
Prevacid
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | Weeks 1-4 |
| Maximum dose | 20 mg twice daily | Days 1-10 |
| Dose changes | 1 increase | As tolerated |
| 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 |
Prilosec
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | Weeks 1-4 |
| Maximum dose | 20 mg twice daily | Days 1-10 |
| Dose changes | 1 increase | As tolerated |
Prevacid
| 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 |
Prilosec vs. Prevacid Indications
Prilosec
Prilosec is FDA-approved to treat duodenal and gastric ulcers, erosive esophagitis from GERD, and symptomatic GERD. It is also used to maintain healing of erosive esophagitis and, combined with antibiotics, to eradicate H. pylori infection. Higher doses treat rare hypersecretory conditions like Zollinger-Ellison syndrome.
Duodenal and gastric ulcer treatment
Erosive esophagitis from acid-mediated GERD
Maintenance of healed erosive esophagitis
Symptomatic GERD
H. pylori eradication with antibiotics
Prevacid
Prevacid is FDA-approved to heal duodenal and gastric ulcers, treat erosive esophagitis, and manage GERD. It is also used with antibiotics for H. pylori eradication and to lower the risk of NSAID-associated gastric ulcers. Like Prilosec, higher doses can treat hypersecretory conditions such as Zollinger-Ellison syndrome.
Duodenal and gastric ulcer healing
Erosive esophagitis healing and maintenance
Gastroesophageal reflux disease (GERD)
H. pylori eradication with antibiotics
Reduced risk of NSAID-associated ulcers
Prilosec vs. Prevacid Pros and Cons
Prilosec
Prilosec has the longest history of use among PPIs, having been the first approved in the U.S. in 1989. It comes in more oral formulations than Prevacid, though it lacks an IV option for hospitalized patients.
Pros
Longest track record of any PPI, approved since 1989
Available as capsule, tablet, or oral suspension granules
Roughly $15 to $95 per month without insurance, before savings programs
Widely available over the counter for short-term use
Cons
No IV formulation for hospitalized patients
Requires a lower dose in Asian patients on maintenance therapy
Reports of cutaneous and systemic lupus erythematosus
Not approved for NSAID-associated ulcer prevention
Prevacid
Prevacid offers formulation options Prilosec does not, including an orally disintegrating tablet and an IV form for hospital settings. It also carries an approved use for reducing NSAID-related ulcer risk that Prilosec lacks.
Pros
Orally disintegrating tablet option for easier swallowing
IV formulation available for hospitalized patients
Approved to reduce risk of NSAID-associated gastric ulcers
Also available over the counter for short-term use
Cons
Roughly $14 to $530 per month without insurance, before savings programs
Increased risk of fundic gland polyps with use beyond one year
Not approved for GERD in infants under 1 year of age
Heart valve thickening seen in juvenile animal studies
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