Esomeprazole (Nexium) and omeprazole (Prilosec) and are two of the most popular prescriptions for GERD (gastroesophageal reflux or acid reflux), but which one is better?
Why they’re prescribed?
Omeprazole and Esomeprazole are both PPIs and as such, they used to treat gastric acid-related conditions, including GERD, heartburn, esophagitis, or inflammation or erosion of the esophagus, duodenal ulcers caused by Helicobacter pylori, or nonsteroidal anti-inflammatory drugs (NSAIDs).
They have also been prescribed for the treatment of Zollinger-Ellison syndrome, a disease in which tumors cause the production of excessive stomach acid, Multiple Endocrine Adenomas, Several stomach ulcers, and Systemic Mastocytosis.
Both drugs can be gotten on prescription and over-the-counter (OTC). Omeprazole is available in tablet and capsule forms. While Esomeprazole can be gotten in tablet, capsule, and as liquid suspensions.
How do They Work?
Omeprazole and Esomeprazole belong to the class of drugs known as proton pump inhibitors (PPI). Proton pumps line the cells of the stomach and are responsible for producing hydrochloric acid (the main constituent of stomach acid). By inhibiting these proton pumps, Omeprazole reduces the amount of acid produced in the stomach.
These type of drugs have been used since 1981. They’re considered the most effective medication for reducing stomach acid. They work best when you take them an hour to 30 minutes before a meal. You’ll need to take them for several days before they’re fully effective.
By reducing the production of acid in the stomach, they stop the excess acid flowing back into the food pipe (esophagus) and so relieve painful heartburn symptoms associated with acid reflux. Omeprazole medication also allows the esophagus to heal if it has been damaged by the acid.
What is the Difference Between Omeprazole and Esomeprazole?
Omeprazole and Esomeprazole are remarkably similar. However, there are minor differences in their chemical makeup. The differences are more prominent in their branded variants. For example, Prilosec contains two isomers of the active ingredient omeprazole, while Nexium only contains one isomer.
While this may not be the biggest difference, it alters how drugs work. In Nexium (Esomeprazole), its ingredients are made to be processed more slowly than Prilosec (Omeprazole) in your body. This means that levels of the drug are higher in your bloodstream and that esomeprazole may decrease acid production for a longer period of time.
For this reason, Esomeprazole tends to work slightly faster than omeprazole in relieving symptoms. Esomeprazole is also created to be broken down by the liver, so as to reduce interaction with other drugs. Furthermore, pharmaceutical companies may add different inactive ingredients in producing branded variants of these drugs.
Omeprazole or Esomeprazole, which is Better?
Both drugs have undergone years of clinical trials, and results indicate that Omeprazole and Esomeprazole may offer some advantages to people with treating certain conditions.
An older study from 2002 found that esomeprazole provided more effective control of GERD than omeprazole at the same doses. According to a later study in 2009, esomeprazole offered faster relief than omeprazole in the first week of use. After one week, symptom relief was similar.
In 2007, American Family Physician published an article questioning some of the results of clinical trials. According to the article, the size of the studies, the condition of patients, the amount of active ingredients used in the studies, among other factors affect the results of clinical results.
After analyzing 41 studies on the effectiveness of PPIs, the article concluded that there’s little difference in the effectiveness of PPIs, especially when used for extended periods.