Prilosec vs. Protonix
See how Prilosec and Protonix compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both Prilosec and Protonix are proton pump inhibitors that lower stomach acid to treat GERD and erosive esophagitis, but neither is approved for fast, on-demand heartburn relief.
Prilosec is available over the counter and covers more approved uses, including ulcers and H. pylori treatment, while Protonix is prescription-only and also comes as an IV injection.
Protonix is FDA-approved for children as young as 1 year old for short-term GERD treatment, an indication not listed for prescription Prilosec.
Prilosec vs. Protonix Drug Summary
Prilosec
Prilosec (omeprazole) is a proton pump inhibitor that reduces stomach acid to treat ulcers, erosive esophagitis, and GERD. It comes as a delayed-release capsule, tablet, or oral suspension, usually taken once daily before a meal. It is also sold over the counter for frequent heartburn.
Protonix
Protonix (pantoprazole) is a proton pump inhibitor that lowers stomach acid to treat erosive esophagitis from GERD and hypersecretory conditions like Zollinger-Ellison syndrome. It comes as a delayed-release tablet, oral suspension, or IV injection, usually taken once daily before a meal. Protonix is prescription-only but is also approved for children age 1 and older.
Prilosec vs. Protonix Side Effects
Prilosec
Protonix
Prilosec vs. Protonix Dosage
Prilosec
Protonix
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | At the start |
| Maximum dose | 120 mg three times daily | If needed |
| Dose changes | 4 increases | As tolerated |
| 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 |
Prilosec
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | At the start |
| Maximum dose | 120 mg three times daily | If needed |
| Dose changes | 4 increases | As tolerated |
Protonix
| 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 |
Prilosec vs. Protonix Indications
Prilosec
Prilosec is FDA-approved for a broad range of acid-related conditions, from ulcer healing to long-term GERD management. It also has a role in combination therapy to eradicate H. pylori infection.
Duodenal and gastric ulcer treatment
Erosive esophagitis caused by GERD
Maintenance of erosive esophagitis healing
Symptomatic GERD
Protonix
Protonix's approved uses focus on healing erosive esophagitis and controlling acid in hypersecretory disorders. It is one of the few PPIs approved for children and available in an IV form for patients who cannot take pills.
Short-term treatment of erosive esophagitis (GERD)
Maintenance of erosive esophagitis healing
Zollinger-Ellison syndrome and hypersecretory conditions
Approved for children age 1 and up (short-term EE/GERD)
Prilosec vs. Protonix Pros and Cons
Prilosec
Prilosec has the longest track record of any PPI and the widest set of FDA-approved uses, including ulcers and H. pylori treatment. It is also the only one of the two sold without a prescription.
Pros
Available over the counter as Prilosec OTC
Broader range of FDA-approved uses, including ulcers and H. pylori
Comes in capsule, tablet, and oral suspension forms
Cons
No IV formulation for patients who can't take it by mouth
Recommended lower dose for Asian patients on maintenance therapy
Not FDA-approved for use in children
Protonix
Protonix offers more formulation flexibility for hospitalized or pediatric patients but has a narrower set of approved uses than Prilosec. It always requires a prescription, even at the lowest dose.
Pros
Available as an IV injection for patients who can't take it orally
FDA-approved for children as young as 1 year old
Delayed-release oral suspension option for those who can't swallow tablets
Cons
Not available over the counter, always needs a prescription
Narrower range of approved uses, with no ulcer or H. pylori indication
Wide list price range depending on formulation and pharmacy
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