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Aciphex vs. Nexium

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Rabeprazole (Aciphex) and Esomeprazole (Nexium) are both proton pump inhibitors (PPIs) used to treat conditions caused by too much stomach acid, such as GERD and ulcers. Rabeprazole is available only by prescription, while Esomeprazole can be bought over-the-counter or with a prescription. You should take Rabeprazole with or without food, depending on your condition, but Esomeprazole should be taken an hour before meals. Rabeprazole is typically taken once a day, but Esomeprazole can be taken once or twice a day. Both medications can cause side effects like constipation, passing gas, headaches, and belly pain. Long-term use of either medication can increase the risk of bone fractures and lower vitamin B12 and magnesium levels. However, Esomeprazole has a significant interaction with clopidogrel (Plavix), which can raise the risk of blood clots, while Rabeprazole interacts with warfarin (Coumadin), increasing the risk of bleeding.

Rabeprazole

(Aciphex)

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Esomeprazole

(Nexium)

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Summary for Aciphex

Prescription only

Rabeprazole (Aciphex) is a medication used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving too much stomach acid. The dosage is typically once a day for most conditions. Rabeprazole (Aciphex) isn't know to cause many side effects, but some of the more common ones include constipation and passing gas. Long-term use of rabeprazole (Aciphex) raise the risk for more serious warnings, such as the risk of bone fractures.

Indications for Aciphex

For adults only:

For adults and children 12 years and older:

  • Gastroesophageal reflux disease (GERD)

Pros and Cons for Aciphex

Pros

  • Can continue to use with antacids, such as calcium carbonate
  • Available as a lower-cost generic medication
  • People with GERD can take this without regard to food
  • Can be taken once or twice a day

Cons

  • Interacts with warfarin (Coumadin), which can raise the risk of bleeding
  • Long-term use might weaken bones and raise the risk of bone fracture
  • Might cause or worsen lupus
  • Tablets can't be crushed or chewed, which is inconvenient for people with trouble swallowing

Common Side Effects for Aciphex

  • Pain (3%)
  • Sore throat (3%)
  • Passing gas (3%)
  • Infections (2%)
  • Constipation (2%)

Warnings for Aciphex

  • Risk of hiding symptoms of a more serious problem
  • Sudden kidney problems
  • Severe infectious diarrhea
  • Risk of bone fractures
  • Skin reactions
  • Lupus
  • Low vitamin B12 and magnesium levels
  • Interaction with other medications

Summary for Nexium

Prescription or over-the-counter

Esomeprazole (Nexium) is a medication used to treat conditions that are caused by too much stomach acid, such as heartburn or acid reflux. It's available both with a prescription and over the counter (OTC). Take esomeprazole (Nexium) an hour before a meal so that it can start working before you eat. It can take a couple days for you to feel its full effects, so consider taking other quick-acting antacids in the meantime until the medication effect kicks in.

Indications for Nexium

For adults only:

  • Heartburn — OTC only
  • Lower the risk of stomach ulcer due to nonsteroidal anti-inflammatory drugs (NSAID)
  • Lower the risk of duodenal ulcer caused by Helicobacter pylori (H. pylori) infection
  • Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)

For adults and children:

  • Gastroesophageal reflux disease (GERD)
  • Inflamed esophagus due to GERD

Pros and Cons for Nexium

Pros

  • Can continue to use with antacids, such as calcium carbonate
  • Provides longer-lasting relief than some other heartburn medications
  • Available as over-the-counter and lower-cost generic options
  • Granules or pellets inside the capsules can be mixed with water or applesauce, so convenient for people with difficulty swallowing pills

Cons

  • Takes 1 to 4 days for the medication to fully kick in, so not the best choice for immediate heartburn relief
  • Significant interaction with clopidogrel (Plavix), which can raise the risk of blood clot
  • Long-term use might weaken bones and raise the risk of bone fracture
  • Can lower magnesium and vitamin B12 levels

Common Side Effects for Nexium

  • Headache (4-8%)
  • Belly pain (3-4%)
  • Diarrhea (2-4%)
  • Nausea (2%)
  • Passing gas (more than 1%)
  • Constipation (more than 1%)
  • Dry mouth (more than 1%)

Warnings for Nexium

  • Risk of hiding symptoms of a more serious problem
  • Sudden kidney problems
  • Severe infectious diarrhea
  • Bone fractures
  • Skin reactions
  • Lupus
  • Low vitamin B12 and magnesium levels
  • Interaction with other medications

Prices with our coupons for Aciphex vs. Nexium

Price Card Drug Icon
Rabeprazole DR30 tablets / 20mg
$17.00$89.96
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Price Card Drug Icon
Esomeprazole30 capsules / 40mg
$13.25$19.78
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