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Nexium vs. Dexilant

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

Key takeaways

Esomeprazole (Nexium) and dexlansoprazole (Dexilant) are both proton pump inhibitors (PPIs) used to treat conditions caused by too much stomach acid, such as GERD and heartburn. Esomeprazole (Nexium) is available both over-the-counter and by prescription, while dexlansoprazole (Dexilant) is only available by prescription. You can take esomeprazole (Nexium) an hour before meals, but dexlansoprazole (Dexilant) can be taken at any time of the day, with or without food. Esomeprazole (Nexium) is approved for use in both adults and children, and dexlansoprazole (Dexilant) is approved for adults and children aged 12 and older. Both medications can cause side effects like diarrhea and stomach pain, but esomeprazole (Nexium) has a broader range of common side effects, including headache and nausea. Long-term use of either medication can lead to bone fractures and low magnesium levels. Both medications might also cause a false-positive urine drug test for THC, but Dexilant typically isn't used in people with severe liver problems.

Esomeprazole

(Nexium)

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Dexlansoprazole

(Dexilant)

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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

Summary for Dexilant

Prescription only

Dexlansoprazole (Dexilant) is a prescription medication used to treat conditions caused by too much stomach acid, such as heartburn or gastroesophageal reflux disease (GERD). It's a proton pump inhibitor (PPI), which means it blocks acid from "getting pumped" into the stomach. Dexlansoprazole (Dexilant) can be taken by adults and children ages 12 years and older. It's typically taken once daily, with or without food. Dexlansoprazole (Dexilant) doesn't cause many side effects, but some of the more common ones include diarrhea, nausea, and stomach pain.

Indications for Dexilant

Pros and Cons for Dexilant

Pros

  • Can take with or without food
  • Only taken once a day
  • Granules inside the capsules can be mixed with water or applesauce, so convenient for people with difficulty swallowing pills
  • FDA-approved for children age 12 and older

Cons

  • Long-term use might weaken bones and raise the risk of bone fracture(s)
  • Might cause a false-positive urine drug test
  • Not safe for people with severe liver problems
  • Can lower magnesium and vitamin B12 levels

Common Side Effects for Dexilant

Adults

  • Diarrhea (5%)
  • Belly pain (4%)
  • Nausea (3%)

Children

  • Headache (more than 5%)
  • Belly pain (more than 5%)
  • Diarrhea (more than 5%)
  • Common cold (more than 5%)
  • Mouth and throat pain (more than 5%)

Warnings for Dexilant

  • Risk of hiding symptoms of a more serious condition
  • 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 Nexium vs. Dexilant

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Esomeprazole30 capsules / 40mg
$13.25$19.78
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Price Card Drug Icon
Dexlansoprazole30 capsules / 60mg
$88.71$95.95
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