Have been on omeprazole for 1 1/2 months after being on nexium for a couple years and the feeling of a lump in my throat is back and I suffer from much gas. Can't afford nexium anymore due to 50% co-pay & mandatory 3 month renewals from mail order drug.With nexium I was symptom free almost all the time. very frustrating
Does omeprazole and nexium 40mg have the same ingredients. Nexium seems to work much better?
Question posted by zoot on 11 Feb 2014
Last updated on 12 April 2018
6 Answers
Saek519
10 March 2016
Years ago "no one" could give me an explanation as to the difference. Shortening the story i called the manufacturer and talked to some one im their lab. There is a molecular difference. Nexium im the process of manufacturing has been taken one step further. It does not have to go thru the liver to be effective. Something like pre digested milk would work. Probably reason for price difference. But when new i feel pharmaceutical company took advantage to those who had to have it and would cost $400. Good product tho.
Braveheartz
19 Dec 2014
According to a government study, Nexium 40 MG (esomeprazole) provides more effective acid control than Prilosec 40 MG (omeprazole). I understand that there are some variabilities among people as one might work better for you than the other, but in a study of 135 people, the mean shows that Nexium works better. The link is below for you to read.
obrn
22 Jan 2015
I read the abstract, and the study group (130 patients) was too small to absolutely conclude that Nexium is better than Prilosec. If this was a larger study it would hold a little more weight. You also have to consider the relationship that the NIH and large drug companies have.
gvkent
23 Feb 2015
This was not a government study but a NIH abstract of an study paid for AstraZebeca, the company that makes Nexium.
IsisBlackfeather
6 March 2015
My insurance put me on the generic Prilosec after being on Nexium 40mgs for 8 years and it lead to so much pain. My doctor had to fight the insurance company to get me back on Nexium and now I take 40 mgs twice a day. I got really lucky this month because they released the generic for Nexium and the cost cut helped greatly. For me, there is no better medication for GERD or ulcers. People who don't have GERD can truly not know just how painful and debilitating it can be. Mine is very severe. I recommend the Nexium generic if price is an issue.
gvkent
6 March 2015
Individually sometimes one person will respond better to one PPI better than another, but as a group, there is no significant difference between different drugs in this category of drugs (PPIs).
caddy1038
23 March 2015
I too suffer from horrible GERD. For me I can only take Nexium/Esomeprazole the Omeprazole hurts my gut.
Lonesomejack
5 April 2015
I clicked on Braveheartz's link, and also on the name of the author of the study in question. Apparently the author works for the manufacturer of the two drugs. I would not call this "a government study." It's a study by the manufacturer, and therefore should be viewed with caution.
slgallagher
2 June 2015
The S-enantoimer has been shown to contribute the majority of the efficacy (useful effect). Omeprazole is the racemate so is 50% S and 50% R. Nexium (Esomeprazole) is only the S-enantiomer so 20mg of nexium has the same effect as 40mg of generic omeprazole. So you could take 40mg omeprazole and have the same effect but then you have 20mg of a drug that is not contributing to lowering the symptoms. It is only adding to the negative side, ie adding to toxicity and needing to be metabolised.
I do not work for, nor am I affiliated with AZ in any way. Just a PhD Biochemist with GERD
yepthatsme1983
15 Feb 2017
I agree with you and I also have read some studies through a major Hospital in the area that I live in I have taken Prilosec and it makes me extremely nauseous it almost makes my symptoms worse with Nexium I have no symptoms I'm not nauseous and it works 10 times better for me so there is a difference
buttstock
17 Nov 2014
Astra-Zenica had the patent for omeprazole. Toward the end of the 17 year patent, the legal /technical brains at AZ thought about providing more profit streams, and wanted to patent "Nexium." Many thought they (AZ) couldn't do it, but they somehow got it through the FDA and got it patented.
"Nexium" is the s-isomer of omeprazole. Nexium is actually called esomeprazole. If you remember your chemistry (organic), an s-isomer is a mirror image of the "other" form. That's it. Look at your right hand, then look at your left hand. They are "s-isomers" of each other.
There is NO performance difference between Rx Nexium and OTC omeprazole/Prilosec.
It is just a way for AZ to improve profitability. They make no claim that Nexium, "the purple pill" works any better or worse than any other product (ie omeprazole). Why would they? There is no difference. Mirror image and more expensive.
Big pharm rip off. Buyer beware.
Msmisch
24 Feb 2016
There is a difference. I have tried all of those different kind and the otc nexium also and there is a difference.
MedChemist
6 Sep 2016
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I'm sorry but you have forgotten your organic chemistry. First of all, the S-isomer is the mirror image of the R-isomer and vice versa. The drugs are mirror images of each other, not S-isomers of each other as you state.
Furthermore, the idea that non-superimposable mirror images have the same biological activity is nonsense. Most times, one has the desired biological activity and the other does not. The mirror image with greater biological activity is called the eutomer while the one with lower activity (lower or none at all) is called the distomer. The ratio of the eutomer to distomer activities is called the eudysmic ratio.
They would not come up with this term if both mirror images always had the same biological activity.
The way to think about it is like this. Consider a box of nails. When you take the mirror image of a nail, it looks just like the nail from which it came. The mirror images are superimposable so we don't have "S-isomer" nails and "R-isomer" nails. A left handed carpenter and a right handed carpenter can drive a nail into a wall with a hammer with equal facility. Now, think about a box containing both left-handed and right-handed screws. The right-handed carpenter will prefer to screw the right-handed screws into the wall while the left-handed carpenter would prefer to drive in the left-handed screws. Why? Because to be screwed into a wall, a right-handed screw requires different motions from a right hand than a left hand. A nail, on the other hand, requires the same motions from both.
How does this relate to drugs? The body is a bunch of left hands (or right hands, pick one but the point is that most chemicals in the body, proteins in particular, are like hands or screws, not nails, and only one mirror image is present). So, the mirror images of drugs interact with those chemicals differently exactly the same way left handed and right handed screws interact differently with a carpenter trying to screw one into the wall with his right hand. The body is made up of all right-handed carpenters. There is absolutely no reason whatever to assume a priori that mirror image drugs will have identical biological activity. In fact, absent any information except that the chemicals are mirror images, assume that one will have biological activity and the other will not.
Why do some pairs of mirror images both have biological activity while some pairs do not? This is a bit harder to explain but it depends on what is actually making the chemical such that it's mirror images are not identical (unlike the mirror images of a nail that are identical) and how that chemical interacts with chemicals in the body. Think about this. It might be more difficult to screw a left-handed screw into the wall with your right hand than it would be to do the same with a right handed screw, right? However, if you dropped a box filled with both left- and right-handed screws onto the floor and were made to pick them up all with your right hand, do you think it would be easier to pick up one type of screw over the other? I think not. So, it is not simply the fact that a left-handed something is interacting with a right-handed something; it is the nature of that interaction.
In the case of omeprazole, both mirror images do turn out to have biological activity and sufficient activity to both be useful as drugs. Whether or not the difference is substantive is another question but the fact that they are mirror images ABSOLUTELY DOES NOT MEAN THAT THEY ARE IDENTICAL.
MedChemist
6 Sep 2016
Sorry about the stuff at the top of my other comment.
I'm sorry but you have forgotten your organic chemistry. First of all, the S-isomer is the mirror image of the R-isomer and vice versa. The drugs are mirror images of each other, not S-isomers of each other as you state.
Furthermore, the idea that non-superimposable mirror images have the same biological activity is nonsense. Most times, one has the desired biological activity and the other does not. The mirror image with greater biological activity is called the eutomer while the one with lower activity (lower or none at all) is called the distomer. The ratio of the eutomer to distomer activities is called the eudysmic ratio. They would not come up with this term if both mirror images always had the same biological activity.
The way to think about it is like this. Consider a box of nails. When you take the mirror image of a nail, it looks just like the nail from which it came. The mirror images are superimposable so we don't have "S-isomer" nails and "R-isomer" nails. A left handed carpenter and a right handed carpenter can drive a nail into a wall with a hammer with equal facility. Now, think about a box containing both left-handed and right-handed screws. The right-handed carpenter will prefer to screw the right-handed screws into the wall while the left-handed carpenter would prefer to drive in the left-handed screws. Why? Because to be screwed into a wall, a right-handed screw requires different motions from a right hand than a left hand. A nail, on the other hand, requires the same motions from both.
How does this relate to drugs? The body is a bunch of left hands (or right hands, pick one but the point is that most chemicals in the body, proteins in particular, are like hands or screws, not nails, and only one mirror image is present). So, the mirror images of drugs interact with those chemicals differently exactly the same way left handed and right handed screws interact differently with a carpenter trying to screw one into the wall with his right hand. The body is made up of all right-handed carpenters. There is absolutely no reason whatever to assume a priori that mirror image drugs will have identical biological activity. In fact, absent any information except that the chemicals are mirror images, assume that one will have biological activity and the other will not.
Why do some pairs of mirror images both have biological activity while some pairs do not? This is a bit harder to explain but it depends on what is actually making the chemical such that it's mirror images are not identical (unlike the mirror images of a nail that are identical) and how that chemical interacts with chemicals in the body. Think about this. It might be more difficult to screw a left-handed screw into the wall with your right hand than it would be to do the same with a right handed screw, right? However, if you dropped a box filled with both left- and right-handed screws onto the floor and were made to pick them up all with your right hand, do you think it would be easier to pick up one type of screw over the other? I think not. So, it is not simply the fact that a left-handed something is interacting with a right-handed something; it is the nature of that interaction.
In the case of omeprazole, both mirror images do turn out to have biological activity and sufficient activity to both be useful as drugs. Whether or not the difference is substantive is another question but the fact that they are mirror images ABSOLUTELY DOES NOT MEAN THAT THEY ARE IDENTICAL.
gyrkin
16 Sep 2016
MadChemist has it right with his explanation and left handed and right handed screw threading analogy.
Kkiefsanma
12 April 2018
They are different! I've tried Prilosec Prevacid and Nexium Prilosec is the only one the pink little ones that I can take with my asthma medications the others give bad side effects!
Mctam
25 Aug 2014
Gerd sufferer.I was on Prilosec for quite a while and stopped cold turkey.
I just stopped eating late at night and started eating less.It has made a big difference in my life .Give it a try.
Sabrina1234
26 Aug 2014
Unfortunately it usually comes back , but I hope you cured . For most of us it is a daily battle
Mctam
26 Aug 2014
Prilosec does not cure Gerd but you can manage the symptoms by controlling
what,when and how much you eat.
CM60
10 March 2016
I have a hyheital hernia and very bad acid reflux. The only thing that works and i have yried just about everything to get off this pill without the recurring heartburn. I went on the bernstein diet and never had a bit of heartburn. My throat almost cleared up but the unfortunate part is i could not stay on it. I stopped my nexium cold turkey and not a bit of heartburn while one the diet. Dr need to come ip with a diet specifically for this. One that does not keep you in starvation mode. I do not endorse any diet but it really works but way to expensive.!
DzooBaby
11 Feb 2014
Nexium is Esomeprazole and Prilosec is omeprazole. They are both proton pump inhibitors and chemically similar but different too. many people feel the Nexium (esomeprazole) works a little better. It is a newer generation drug than omeprazole.
Sabrina1234
11 Feb 2014
Omeprazole is prilosec , nexium is a newer more advanced version both were patiented by same company only nexium has no generic form yet. If its been a month ± you need to find another , there are many choices . I would try lansoprazole (prevacid) it is on generic list and otc . I hope I helped and I hope you find relief
Sabrina1234
17 Nov 2014
Nexium 20mg otc take 2
beachgal25
3 Dec 2014
Nexium is now available as a generic in 20 mg doses. Cost is around $46.00 mo. if you need to take 40 mg daily! Purchasing it OTC does not contribute to your donut hole with your insurance, which is a big advantage. Hope this helps!
gentlearts
27 Aug 2015
I have been getting generic Nexium through a Canadian pharmacy, and it is much cheaper. I am thinking of going from 40 mg to 23mg OTC just because there is less hassle. If you do well on a lower dosage, the cost is about the same as getting 40mg from out of the country. I tried the lower dosage briefly and it worked fine. I'll wait to decide for sure until I check with my butts and guts Dr. next week.
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nexium, omeprazole, gerd, gas, throat, lump
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