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

Most common
headache (up to 6.9%)
abdominal pain (up to 5.2%)
nausea (up to 4%)
diarrhea (up to 4%)

Prevacid

Most common
headache (up to 7%)
abdominal pain (up to 5%)
nausea (up to 3%)
diarrhea (up to 3.8%)

Prilosec vs. Prevacid Dosage

Prilosec

Dosage
Dosage Table
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

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

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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