Two medicines, side by side
Esomeprazole vs omeprazole
Esomeprazole and omeprazole are both labeled for acid reflux and ulcers. Drugs@FDA records approvals of esomeprazole since 2001 and of omeprazole since 1989. Pharmacies paid $0.145 per esomeprazole mag DR 20 mg capsule and $0.0295 per omeprazole DR 20 mg capsule (NADAC, October 7, 2026). Omeprazole's other strengths are brand-only: $14.75 per pen (Prilosec DR 2.5 mg suspension).
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024); the omeprazole FDA label on DailyMed (effective April 22, 2024).
Highlights of the esomeprazole record
Esomeprazole (Nexium) · label of March 19, 2024
Used for
From the label: indicationstreats frequent heartburn (occurs 2 or more days a week) not intended for immediate relief of heartburn; this drug may take 1 to 4 days for full effect
On the market
- Earliest approval on file
- February 20, 2001
- Generic labelers
- 116 labelers
- Pharmacy cost
- $0.145 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 12
Highlights of the omeprazole record
Omeprazole (Prilosec) · label of April 22, 2024
Used for
From the label: indicationsOmeprazole is a proton pump inhibitor (PPI) indicated for the: Treatment of active duodenal ulcer in adults ( 1.1 ) Eradication of Helicobacter pylori to reduce the risk of duodenal ulcer recurrence in adults ( 1.2 ) Treatment of active benign gastric ulcer in adults ( 1.3 ) Treatment of symptomatic gastroesophageal reflux disease (GERD) in patients 1 year of age and older ( 1.4 ) Treatment of erosive esophagitis […]
On the market
- Earliest approval on file
- September 14, 1989
- Generic labelers
- 118 labelers
- Pharmacy cost
- $0.0295 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 7
Source: FDA drug labels via openFDA (Esomeprazole label of March 19, 2024, Omeprazole label of April 22, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do esomeprazole and omeprazole differ on the record?
Both are in FDA's class proton pump inhibitors.
Generics: esomeprazole since 2013; omeprazole since 2002 (Drugs@FDA).
| Esomeprazole | Omeprazole | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | Acid reflux and ulcers |
| Pharmacologic class | Proton Pump Inhibitor | Proton Pump Inhibitor |
| How it works (label) | n/a | Omeprazole belongs to a class of antisecretory compounds, the substituted benzimidazoles, that suppress gastric acid secretion by specific inhibition of the H + /K + ATPase enzyme system at the secretory surface of the gastric parietal … |
| Half-life (label) | n/a | disease classified as Child-Pugh Class A (n=3), B (n=4) and C (n=1), the bioavailability increased to approximately 100% compared to healthy subjects, reflecting decreased first-pass effect, and the plasma half-life of … |
| Earliest approval on file (Drugs@FDA) | February 20, 2001 | September 14, 1989 |
| First generic approved | March 18, 2013 | November 1, 2002 |
| Generic labelers (NDC) | 116 labelers | 118 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.145 per capsule (Esomeprazole mag DR 20 mg capsule) | $0.0295 per capsule (Omeprazole DR 20 mg capsule) |
| 12-month price change | -12% | -7% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 12 | 7 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 235,202 | 446,179 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Esomeprazole label, drug interactions (prescription label)Clinical Impact: Esomeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole is an enantiomer, in healthy subjects and in transplant patients receiving MMF has been reported to reduce the exposure …
Esomeprazole label, drug interactionsIncreased gastric pH during omeprazole treatment may change the absorption of the antiretroviral drug.
Source: FDA drug labels via openFDA
What next?
- Alternatives to esomeprazole
- every medicine labeled for the same conditions