Lansoprazole vs. Omeprazole: Similarities and Differences

Medically reviewed by Lindsay Cook, PharmD

Lansoprazole (brand name: Prevacid) and omeprazole (brand name: Prilosec) belong to a class of medications known as proton pump inhibitors (PPIs). PPIs are the most commonly prescribed class of drugs for heartburn.

Both medications are approved by the Food and Drug Administration (FDA) to treat several digestive conditions, such as gastroesophageal reflux disease (GERD). GERD is a common chronic health condition that affects the digestive system.

While their uses are similar, lansoprazole and omeprazole contain different active ingredients and are administered at different doses.

Furthermore, while they have similar effectiveness rates, their onset and duration of action may vary. Finally, the conditions they are FDA-approved to treat differ slightly.

Understanding the differences between these drugs is crucial in making strides to correctly address the digestive conditions you or a loved one may face.

This article will provide an overview of lansoprazole and omeprazole, highlighting their similarities and differences, guidance on using them safely, potential side effects, storage requirements, and more.

Understanding Proton Pump Inhibitors (PPIs)

PPIs are a class of drugs used to treat various conditions related to the digestive system and acid-reflux disorders.

They work by reducing the amount of stomach acid produced in the stomach.

Commonly Used PPIs

Examples of commonly used PPIs include:

• Prevacid (lansoprazole)

• Prilosec (omeprazole)

• Nexium (esomeprazole)

• Protonix (pantoprazole)

Of the available PPIs, lansoprazole and omeprazole have been on the market for the longest period.

Of the six PPIs approved for use in the United States, only three are available via prescription.

What They Treat

PPIs are commonly used to relieve symptoms of GERD or acid reflux.

Other conditions PPIs treat include the following:

• Stomach ulcers

• Esophagitis

• Nonerosive reflux disease (NERD)

• Peptic ulcer disease (PUD)

• Zollinger-Ellison syndrome (ZES)

How GERD Occurs

GERD occurs when substances in the stomach back up into the esophagus and often results in symptoms such as heartburn and acid reflux.

The muscle that allows food to pass into the stomach and typically prevents this from happening is called the lower esophageal sphincter.

If this muscle isn't functioning correctly, GERD may occur.

Factors that can affect muscle function and lead to GERD include:

• Carrying excess weight

• Pregnancy

• Smoking

GERD impacts at least 20% of adults in the United States.

Symptoms of GERD

GERD-related symptoms can vary but may include the following:

• Heartburn

• Acid reflux

• Angina (chest pain)

• Nausea

• Pain or difficulty swallowing
  

Inform your healthcare provider if you are experiencing severe GERD symptoms. These include chest pain, chronic cough, or asthma.

How Is GERD Treated?

Lifestyle changes such as weight loss, quitting smoking, and adjusting eating habits can help minimize symptoms.

The following prescription and over-the-counter (OTC) medication classes are also commonly used to manage GERD:

• Antacids

• Histamine H2-receptor antagonists (H2 blockers)

• PPIs
  

What Is Lansoprazole?

Lansoprazole has many FDA-approved uses, including the following:

• Symptomatic GERD in adults and children 1 year and older

• Treatment and maintenance of several types of ulcers

• Treatment and maintenance of erosive esophagitis (EE) in adults and children 1 year and older

• Zollinger-Ellison syndrome in adults

Forms of Administration

Lansoprazole is available as a delayed-release (DR) capsule and as an orally disintegrating tablet (ODT) powder for suspension (to be mixed with liquid).

It is available as a prescription and OTC under Prevacid, SoluTab, and Prevacid 24HR.

Off-Label Uses

A medication is off-label when prescribed for a purpose or at a dose other than its FDA-approved and intended use.

PPIs may be used off-label before endoscopic procedures in high-risk individuals who are also on antiplatelet therapy and to prevent nonsteroidal anti-inflammatory drugs (NSAIDs)-induced ulcers.

PPIs may also help treat certain types of cancer, but research in this area is ongoing.

Lansoprazole is not an active ingredient in any other medications.

How It Works

All PPIs work similarly and promote gastrointestinal (GI) healing by decreasing the production of stomach acid.

What Is Omeprazole?

Omeprazole is FDA-approved to treat the following conditions:

• Treatment of duodenal and gastric ulcers in adults

• Treatment of GERD in adults and children

• Maintenance of erosive esophagitis in adults and children

• Treatment of pathological hypersecretory conditions in adults

Children as young as 1 year old can take omeprazole.

Forms of Administration

Omeprazole is available for administration as a DR capsule and tablet and as granules for suspension.

It is available as a prescription and OTC under the brand names Prilosec and Prilosec OTC.

Use In Other Products

Omeprazole is found as an active ingredient in the brand-name drugs Talicia (amoxicillin/omeprazole/rifabutin) and Zegerid (omeprazole/sodium bicarbonate) for the treatment of Helicobacter pylori (H. pylori).

Omeprazole is also present in Konvomep (omeprazole/sodium bicarbonate) as a liquid suspension, a drug used to treat benign gastric ulcers.

How It Works

Omeprazole promotes GI healing by decreasing the production of stomach acid.

Dosing Guidelines

The following outlines basic dosing guidelines for the use of lansoprazole versus omeprazole:

Note that an asterisk symbol indicates weight-based dosing.

How Quickly Does Each Drug Work?

Neither medication should be taken for the immediate relief of heartburn-related symptoms.

It may take up to four days for lansoprazole and omeprazole to begin to work, and they should be taken daily as directed to maintain their desired effect.

Both medications are expelled through the bowels.

Side Effects and Safety

There are no significant differences in side effects among varying types of PPIs.

While side effects are similar among PPIs overall, switching to another PPI may be a helpful strategy in side effect management should they occur.

Common Side Effects

The most common side effects of lansoprazole and omeprazole include:

• Diarrhea

• Abdominal pain

• Nausea

• Constipation

• Headache

• GI upset

Severe Side Effects

More severe, long-term side effects include:

• Increased risk of bone fractures (hip, wrist, and spine)

• Pneumonia

• Clostridioides difficile (C. diff )–associated diarrhea (CDAD)

• Osteoporosis (loss of bone mineral density and bone mass)

• Low levels of magnesium

• Vitamin B12 deficiency

Safely Taking Lansoprazole or Omeprazole

Lansoprazole and omeprazole should be taken once daily in the morning before eating, as food can delay PPI absorption.

They should not be taken on an as-needed basis.

Swallow the capsules and tablets whole and avoid crushing or chewing them. Only the capsules can be opened, and contents are poured into food or juice, such as applesauce, for people with trouble swallowing.

You should never double your dose, but taking a missed dose as soon as you remember is OK. If it's almost time for your next dose, skip the missed dose and continue your usual schedule.

The medication may not work how it should if you frequently miss doses or stop taking it as directed.

Both medications are intended for short-term use only. When used to treat symptomatic GERD, both medications can be used for up to eight weeks.

Only take lansoprazole and omeprazole as directed or as instructed by a healthcare provider. Long-term use may increase your risk of developing side effects.

These medications should be avoided in pregnant and breastfeeding people. Consult with a healthcare provider before using.

Potential for Interaction

Due to the mechanism of action of this group of medications, it is crucial to make your healthcare provider aware of any OTC medications, prescription drugs, or herbal vitamins and supplements you are taking.

Avoid taking PPIs with the following medications due to their potential to affect absorption and effectiveness:

• Medications for the treatment of human immunodeficiency virus (HIV), such as Reyataz (atazanavir), Endurant (rilpivirine), and Invirase (saquinavir)

• Blood thinning medications, such as Jantoven (warfarin)

• Drugs used for blood pressure support, such as Digox (digoxin)

• Chemotherapy treatment options, such as Otrexup (PF, methotrexate)

• Medications used to prevent organ rejection after transplant, such as Envarsus XR (tacrolimus)

• Drugs used for the treatment of tuberculosis (TB), such as Rifadin (rifampin)

• Plants used for the treatment of depression, such as Saint- John's-wort

Review of Efficacy

There are no significant differences in safety and efficacy among PPIs, and they have been proven effective at safely managing gastrointestinal and acid-related conditions.

One study found that lansoprazole helped lessen GERD symptoms more quickly and effectively than omeprazole and concluded that both medications were safe, effective, and well-tolerated.

Another study yielded similar results and found that while the two medications had a similar effect on gastric acidity, lansoprazole was more effective.

An analysis of PPI clinical trials found that the PPI esomeprazole was more effective in GERD treatment than omeprazole. Otherwise, no significant differences were identified among the PPIs tested.

Alternative Treatment Options

Lifestyle changes can help manage symptoms of GERD.

Non-drug options for minimizing symptoms include: inclining your body and elevating your head while you sleep (especially if nighttime symptoms are present), avoiding eating meals within three hours of going to sleep, and stopping smoking.

Certain foods or drinks can trigger GERD symptoms.

Avoiding the following triggers is a way to improve or even prevent GERD symptoms:

• Acidic foods

• Alcohol

• Chocolate

• Caffeine

• Spicy foods

Surgery is also an option to manage GERD that does not improve with lifestyle changes or medications but may be considered a high-risk option.

Summary

PPIs are the most commonly prescribed class of drugs for heartburn. They work to heal the GI tract by reducing stomach acid production. They treat a variety of conditions, including stomach ulcers and GERD.

Lansoprazole and omeprazole are both approved by the FDA to treat several digestive conditions, including symptomatic GERD.

They are both available as prescription medications and OTC. They have different active ingredients and are effectively used at different doses.

They work similarly and are both effective medications. The conditions they are approved to treat differ, but there is some crossover.

Understanding the differences between these drugs is an important step in choosing the best and most appropriate therapy.

Neither medication is intended for long-term use. If symptoms have not improved after taking either medication as directed, consult your healthcare provider.

Frequently Asked Questions

How do I store lansoprazole or omeprazole?

PPIs should be stored in a secure, dry area at room temperature (68–77 degrees F). Do not store PPIs in bathrooms or other areas susceptible to high heat, light, or moisture.

They should be kept out of the sight and reach of children and pets.

How can I deal with the side effects associated with using PPIs?

PPIs are typically well-tolerated. Side effects are more likely to occur with long-term use of the medication, so use it as directed.

Read the original article on Verywell Health.