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Pantoprazole vs. omeprazole: which should you take?

Updated on October 13th, 2022

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Written and medically reviewed by Dorcas Morak, Pharm.D

You frequently inquire as to which medication (omeprazole (Prilosec) or pantoprazole (Protonix))is superior for treating your digestive issues. Even if they appear to be the same, they nonetheless differ in key ways. So, after reading this post, you will be confident in your ability to choose which one to purchase the next time you visit a pharmacy.

What are Pantoprazole and Omeprazole?

Both pantoprazole and omeprazole are Proton Pump Inhibitors (PPIs) and work by lowering stomach acid production. They are prescribed for a brief period (four to eight weeks) due to their higher risk of causing lupus erythematosus and osteoporosis following their long-term use.

Pantoprazole is the generic name of Protonix and it is usually prescribed for adults and children older than 5 years. It is available as a delayed released tablet, oral suspension, and injection-ready powder. The typical dosage is 40 milligrams once daily.

Furthermore, omeprazole, the generic of Prilosec, is commonly prescribed for adults and children aged one and older. Its common dosage forms are tablet, capsule, oral suspension, and injectable powder. Its typical dose is 20mg once daily.

Is Pantoprazole Different from Omeprazole in its Use?

FDA has approved both pantoprazole and omeprazole for the treatment of GERD, erosive esophagitis, and Zollinger-Ellison syndrome but only Omeprazole is approved for the treatment of gastric ulcers, duodenal ulcers, and H. pylori. Though, Pantoprazole is used off-label for these other indications.

Does Protonix relieve your symptoms faster than Prilosec?

Pantoprazole relieves your symptoms within 24 hours after the initial dose. Additionally, it continues to act for roughly 7 days after the last dose. Omeprazole however begins to work about one to two hours after the first dose, although you might not feel much better until about five complete days of treatment. Contrary to pantoprazole, its impact only lasts for about three days following the final dose.

What is the difference between Pantoprazole and Omeprazole Side Effects?

The common side effects of pantoprazole and omeprazole include the following:

  • Headache
  • Diarrhea
  • Abdominal pain
  • Nausea and vomiting
  • Flatulence
  • Constipation
  • Rashes
  • Stevens-Johnson syndrome
  • Osteoporosis (long-term use)

However, Pantoprazole may cause

  • Facial and generalized edema
  • Hyperglycemia
  • Photosensitivity
  • Clostridium associated diarrhea

While Omeprazole may cause:

  • Cough
  • Alopecia
  • Anorexia
  • Upper respiratory tract infection

Note that the list is not all-inclusive; ask your pharmacist for more details

Do pantoprazole and omeprazole interact differently with other drugs?

Your choice depends on the medications you are taking for co-morbidity. While pantoprazole and omeprazole similarly interact with some medicines, they interact differently with others.

Both pantoprazole and omeprazole interact with:

Omeprazole specific interaction:

The consequence of interaction may be fatal. Talk to your Doctor or Pharmacist about other drugs you are taking.

Does Pantoprazole Work Better Than Omeprazole?

A study that compares the efficacy of PPIs in short-term use concludes that all PPIs are equally effective. Contrarily, another study proved that pantoprazole relieves gastrointestinal symptoms more rapidly and can keep patients in remission for a longer time. Additionally, the studies proved that there was a low rate of relapse on 40mg daily than on 20mg daily dose of pantoprazole

Does pantoprazole cost more than omeprazole?

Omeprazole typically costs less than pantoprazole. The cost varies depending on where it is purchased. Without health insurance, omeprazole costs about $46 for a month's supply, whereas pantoprazole costs about $69. But with a RxLess prescription discount card or coupon, you can get pantoprazole for as low as $7 and omeprazole for as low as $6.43. The coupon is acceptable in over 70,000 pharmacies including CVS, Walgreens, and Rite Aids.

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