Compare Nexium vs Prilosec head-to-head for uses, ratings, cost, side effects, interactions and more. Nexium rated 7.9/10 vs Prilosec rated 7.9/10 in overall patient satisfaction. Prilosec omeprazole Remove Prilosec from your drug comparison Add to compare Prevacid decreases stomach acid production which promotes the healing of gastric and duodenal ulcers and other inflamed gastrointestinal tissue areas. Prevacid vs Prilosec comparison. Both Prevacid and Prilosec are proton pump inhibitors that work by inhibiting the proton pumps in the stomach that produce acid. They treat the same medical issues, those primarily associated with over-production of acid in the stomach and the resultant ef. Both Prilosec and Nexium interfere with the function of St. John’s Wort and rifampin, while Prevacid does not. On the other hand, Prevacid contains phenylalanine, meaning patients with phenylketonuria may want to choose one of the other two. Prilosec (omeprazole) gives you long-lasting heartburn relief but has some risks if used long term. Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term. Zantac 75 (ranitidine) is an effective and inexpensive medicine for hearburn with few side effects, but may interfere with other drugs. In general, Nexium and Prilosec are very similar. There is very little chemical difference between them. Some studies suggest that Nexium is an improvement on Prilosec, but those have been done on a lower dose of Prilosec. Compare Nexium vs. Omeprazole, which is better for uses like: GERD, Reflux and Heartburn. Compare head-to-head ratings, side effects, warnings, dosages, interactions and patient reviews. Patients rated Nexium and Omeprazole evenly with 3.4/5. Comparison Studies. While Nexium and Prilosec are very similar in terms of effectiveness, studies do show that Nexium is likely slightly more efficacious. Studies have shown that Nexium (esomeprazole) is metabolized slower than Prilosec (omeprazole), which leads to higher drug concentrations and prolonged suppression of stomach acid. This may make Nexium more effective in treating symptoms of. Nexium and Prilosec are heartburn medications — more specifically Proton Pump Inhibitors (PPI) — manufactured by AstraZeneca Pharmaceuticals. Proton pumps are enzymes found in the parietal cells of your stomach. They make hydrochloric acid, the main ingredient of stomach acid. Your body needs stomach acid for digestion.