Ask a Pharmacist

Pantoprazole or Omeprazole?

pantoprazole vs. omeprazole - wellrx blog image

By Rosanna Sutherby, PharmD

What is the difference between pantoprazole and omeprazole? Is one better than the other? We often hear these questions in the pharmacy. Pantoprazole (Protonix) and omeprazole (Prilosec) are both medications used to treat heartburn and other stomach conditions. They are in the same category of drugs and work similarly; however, there are a few differences between the two. Before you head to a pharmacy near you for stomach acid relief, read the following comparison of pantoprazole and omeprazole.

What Type of Medication Are Pantoprazole and Omeprazole?

Pantoprazole and omeprazole both fall in the category of drugs known as proton pump inhibitors (PPIs). PPIs help reduce stomach acid by working directly in the stomach to decrease acid production.

What Do Pantoprazole and Omeprazole Treat?

Pantoprazole can be used in patients 5 years and older and is indicated for the following conditions:

  • Treatment of gastroesophageal reflux disease (GERD), a condition in which the muscle in the lower esophagus (the tube that connects your throat to your stomach) is weakened, allowing stomach acid to pass into the esophagus. The stomach acid causes heartburn and irritation in the esophagus
  • To help heal erosive esophagitis (inflammation and irritation of the esophagus) in patients with GERD
  • Treatment of Zollinger-Ellison syndrome, a condition in which the stomach secretes too much acid

Omeprazole can be used in patients 1 year and older and is indicated for the following conditions:

  • Treatment of GERD
  • To help heal erosive esophagitis in patients with GERD
  • Treatment of Zollinger-Ellison syndrome and other conditions in which your stomach secretes too much acid
  • Part of a treatment regimen to treat stomach or intestinal ulcers caused by the bacterium Helicobacter pylori (H. pylori)

How Fast Do Pantoprazole and Omeprazole Work?

  • Pantoprazole: You may start to see the effects of pantoprazole about two and a half hours after taking your first dose; however, it may take about seven days to feel the full impact of the medication. The effects of pantoprazole can last for up to seven days after you stop the medicine.
  • Omeprazole: You may start to feel the effects of omeprazole one to two hours after taking the medication, but you may not feel full relief until you have been taking omeprazole for about four consecutive days. The effects of omeprazole can last for up to five days after you stop the medicine.

What Are the Side Effects of Pantoprazole and Omeprazole?

Pantoprazole and omeprazole generally have similar side effects. The most common side effects of both drugs include the following:

  • headache
  • diarrhea
  • stomach pain
  • nausea
  • vomiting
  • gas

In addition, osteoporosis-related bone fractures have been associated with long-term use of all PPIs.

Pantoprazole can cause dizziness, joint pain, dry mouth, and blurred vision.

Omeprazole has been associated with diarrhea related to Clostridium difficile (C. diff), an infection that causes watery diarrhea accompanied by fever and stomach cramping.

This list does not represent all possible side effects. A conversation with your pharmacist will help you understand the side effects of your medications.

What Medications Interact with Pantoprazole and Omeprazole?

The choice between pantoprazole and omeprazole may be affected by drug interactions with other medications that you are taking. Some medicines interact with both pantoprazole and omeprazole, and others interact with one and not the other.

Both pantoprazole and omeprazole interact with the following medications:

  • antifungals, such as ketoconazole (Nizoral), itraconazole (Sporanox), and voriconazole (Vfend)
  • atazanavir (Reyataz, Evotaz)
  • iron supplements
  • methotrexate
  • nelfinavir (Viracept)
  • warfarin (Coumadin)

In addition, pantoprazole can produce false-positive results in urine tests for tetrahydrocannabinol (THC).

Omeprazole can also interact with the following medications:

  • anxiety medications, such as diazepam (Valium)
  • citalopram (Celexa)
  • clopidogrel (Plavix)
  • cyclosporine (Neoral, Gengraf, Sandimmune)
  • diuretics (water pills)
  • rifampin (Rifadin, Rifamate)
  • St. John’s wort
  • tacrolimus (Prograf)

The above is not a complete list of drug interactions. Talk with your pharmacist or a health care provider for more information about drugs that may interact with your medication.

Does Pantoprazole Work Better Than Omeprazole?

Generally, pantoprazole and omeprazole are equally effective. Studies comparing pantoprazole and omeprazole have found pantoprazole as effective as omeprazole in treating GERD as well as treating stomach ulcers.

How Much Do Pantoprazole and Omeprazole Cost?

The cost of pantoprazole and omeprazole varies based on your insurance coverage, where you live, and where you shop. Some insurance plans may not cover omeprazole because it is available over the counter. When you compare prescription prices, the average retail cost for thirty pantoprazole 40-mg tablets is about $69. The average retail cost for thirty omeprazole 20-mg capsules is about $46. If your insurance does not cover your medication, you can use a prescription discount card to get the lowest prescription price at a pharmacy near you.

How Do Prescription Discount Cards Work?

Prescription discount cards, or prescription savings cards, help you obtain the lowest prescription price for your medication. If your insurance does not cover your medication or the cost is too high on insurance, a free Rx savings card may save you up to 80% or more off the retail price. You can use the ScriptSave® WellRx discount card for the best prescription savings at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.


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