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Nexium vs Dexilant

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Nexium Details

Dexilant Details

Comparative Analysis

Nexium Prescription Information

Dexilant Prescription Information

Nexium Side Effects

Dexilant Side Effects

Safety Information

Cost Analysis

Market Analysis



For patients dealing with gastroesophageal reflux disease (GERD) or other types of stomach acid-related conditions, certain drugs that reduce the production of stomach acid can help in alleviating symptoms and promoting healing. Nexium and Dexilant are two such medications often prescribed for these conditions. Both belong to a class of drugs known as proton pump inhibitors (PPIs), but they operate slightly differently within this category.

Nexium, also referred to by its generic name Esomeprazole, helps decrease the amount of acid produced in the stomach. It's typically used for treating GERD, preventing ulcers, and helping heal erosive esophagitis—a condition caused by damage to the lining of the esophagus from stomach acid.

On another hand, Dexilant contains dexlansoprazole as an active ingredient which works similarly to Nexium but has been shown in some studies to provide 24-hour relief from heartburn due to GERD with just one daily dose. This could be particularly helpful for patients seeking longer-lasting effects throughout their day.

Nexium vs Dexilant Side By Side

Brand NameNexiumDexilant
ContraindicationsShould not be taken with rilpivirine-containing products. Risk of bone fractures, vitamin B12 deficiency, and low magnesium levels with long-term use.Should not be taken with rilpivirine-containing products. Risk of bone fractures, vitamin B12 deficiency, and low magnesium levels with long-term use.
CostAround $248 for 30 capsules of 20 mgAround $281 for 30 capsules of 60 mg
Generic NameEsomeprazoleDexlansoprazole
Most Serious Side EffectKidney problems, low magnesium levels, new or worsening symptoms of lupus, stomach growths (fundic gland polyps)Allergic reactions, severe skin reactions, vitamin B12 deficiency, low magnesium levels
Severe Drug InteractionsRilpivirine-containing productsRilpivirine-containing products
Typical Dose20–40 mg/day30mg/day, can be increased to 60mg/day

What is Nexium?

Esomeprazole (the generic name for Nexium) was a significant advancement within the proton pump inhibitor (PPI) class of drugs, which marked substantial progress from earlier classes of acid reflux medications. Esomeprazole received approval by the FDA in 2001. Nexium works by decreasing the amount of acid produced in the stomach, providing an effective remedy for conditions such as gastroesophageal reflux disease (GERD), peptic ulcer disease and Zollinger-Ellison syndrome.

On the other hand, Dexlansoprazole (brand name Dexilant) is another drug from the PPI class that also reduces stomach acid production but with a unique dual delayed release formulation; it releases medication at two different times to provide longer-lasting relief throughout the day compared to traditional PPIs like Nexium. Both medications have similar side effects including risk of bone fracture, low magnesium levels and clostridium difficile infection but they are generally well tolerated.

What conditions is Nexium approved to treat?

Nexium is approved for the treatment of several digestive disorders:

  • Gastroesophageal reflux disease (GERD)
  • Erosive esophagitis, a condition that causes inflammation and damage to the tube connecting your mouth and stomach
  • Zollinger-Ellison syndrome, a disorder where tumors in pancreas or duodenum cause increased production of gastric acid
  • Prevention of gastric ulcers caused by nonsteroidal anti-inflammatory drugs.

How does Nexium help with these illnesses?

Nexium is a medication that helps manage gastroesophageal reflux disease (GERD) and other conditions caused by excessive stomach acid. It does this by reducing the amount of gastric acid produced in the stomach, allowing for healing of damage to your esophagus and relief from symptoms like heartburn. Nexium belongs to a class of drugs known as proton pump inhibitors (PPIs), which work by blocking enzymes in the wall of the stomach that produce acid.

Similarly, Dexilant also manages GERD and excessive stomach acid-related conditions but operates slightly differently. Aside from inhibiting the action of proton pumps like Nexium does, Dexilant has a dual delayed release formulation: it releases one part immediately after ingestion while reserving another portion for later release. This two-step process provides initial relief and maintains consistent control over gastric acid production throughout the day.

In essence, both Nexium and Dexilant are effective at limiting effects associated with excess gastric acidity such as heartburn or ulceration, helping patients manage their condition more effectively.

What is Dexilant?

Dexilant is a brand name for dexlansoprazole, which is a proton pump inhibitor (PPI), meaning it decreases the amount of acid produced in the stomach. Apart from treating symptoms of gastroesophageal reflux disease (GERD), such as heartburn, difficulty swallowing, and persistent cough, Dexilant can also repair esophagus damage caused by acid over time. It was first approved by the FDA in 2009.

As dexlansoprazole isn't an H2 antagonist (a type of antihistamine that inhibits the action of histamine at H2 receptors), its mechanism differs significantly from medications like Tagamet or Zantac. Unlike these drugs, Dexilant does not block histamine but instead directly reduces gastric acid production by inhibiting the enzyme on gastric parietal cells responsible for secretion. This unique function means that its side-effect profile also varies: while generally well-tolerated with few side effects, some patients may experience diarrhea or abdominal pain. The reduction in stomach acidity provided by dexlansoprazole can be beneficial particularly to those who don't respond favorably to treatment involving antacids or H2 antagonists.

What conditions is Dexilant approved to treat?

Dexilant is a medication that has been approved by the FDA for treating several acid-related conditions, such as:

  • Gastroesophageal reflux disease (GERD), a chronic condition where stomach acid frequently flows back into the esophagus.
  • Erosive esophagitis (EE), which is inflammation and damage to the lining of your esophagus caused by stomach acid.
  • Maintaining healing of EE and relief from heartburn.

How does Dexilant help with these illnesses?

Dexlansoprazole, or Dexilant, is a proton pump inhibitor (PPI) similar to esomeprazole (Nexium). It works by blocking the enzyme in the wall of the stomach that produces acid. This reduces the amount of gastric acid produced and alleviates symptoms associated with conditions like gastroesophageal reflux disease (GERD), which can cause heartburn and other uncomfortable symptoms. Dexilant has a unique delivery system allowing for two separate releases of medication in one capsule, providing extended relief over time. Moreover, it is metabolized slower than Nexium which could lead to longer-lasting effects on reducing stomach acid production. Therefore, Dexilant might be used when patients do not respond well to Nexium or need more prolonged symptom relief.

How effective are both Nexium and Dexilant?

Both esomeprazole (Nexium) and dexlansoprazole (Dexilant) are proton pump inhibitors with a proven track record for treating conditions caused by excess stomach acid, such as gastroesophageal reflux disease (GERD), erosive esophagitis, and Zollinger-Ellison syndrome. They were both approved by the FDA within a decade of each other, with Nexium in 2001 and Dexilant in 2009. Given that they inhibit different enzymes involved in gastric acid secretion, their prescribing patterns might differ based on specific patient needs.

A direct comparison study conducted during clinical development demonstrated comparable efficacy between these two drugs at managing GERD symptoms over an eight-week period. The safety profiles of both drugs were also promising; most adverse effects reported were mild to moderate in severity and transient.

In terms of meta-analysis reports, one review from 2013 suggested that esomeprazole is effective at healing erosive esophagitis starting from the first week of treatment. This study also pointed out its good tolerability profile compared to other proton pump inhibitors making it a popular choice among prescribers worldwide.

On the other hand, dexlansoprazole has been shown to be highly effective against placebo in treating symptoms related to GERD according to a 2015 meta-analysis. While typically not considered as the initial treatment option due to its cost-effectiveness ratio compared with omeprazole or lansoprazole - common first-line treatments - there's still significant research supporting its use especially when co-prescribed alongside H2 blockers like ranitidine for better symptom control.

Overall, either drug could serve as an optimal solution depending on individual patients' tolerance levels or need to avoid certain side effects associated with proton pump inhibitors such as abdominal pain or diarrhea.

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At what dose is Nexium typically prescribed?

Oral dosages of Nexium range from 20–40 mg/day, with most adults finding that a daily dose of 20 mg is sufficient for treating gastroesophageal reflux disease (GERD). Children aged 1-11 years may be started on a lower dosage depending on their body weight and the severity of their condition. In either population, dosage can be adjusted after a few weeks if there is no response. The maximum recommended dose for adults is Nexium 40mg per day.

On the other hand, Dexilant comes in two strengths: 30mg and 60mg capsules. For healing erosive esophagitis (EE), the recommended adult dose is one Dexilant 60 mg capsule once daily for up to eight weeks. If needed, an additional eight-week course may be considered. For maintaining healed EE and relief of heartburn, it's suggested to take one Dexilant 30 mg capsule once daily when required.

In all cases never exceed the prescribed dosage; always consult your healthcare provider before making any changes to your medication routine.

At what dose is Dexilant typically prescribed?

Dexilant therapy typically begins with a dosage of 30mg/day. The dose can then be increased to 60mg/day, taken once daily. For severe conditions like erosive esophagitis, the maximum recommended dose is 60 mg per day which may be administered if there is no response to treatment at 30 mg/day after several weeks. It's worth noting that Dexilant comes in two forms: delayed-release capsules and sprinkle capsules (which can be opened and sprinkled onto soft food for those who have difficulty swallowing pills). Always remember that it’s essential to follow your doctor's instructions regarding medication administration.

What are the most common side effects for Nexium?

Common side effects of Nexium and Dexilant may include:

  • Headache
  • Nausea, vomiting
  • Diarrhea or constipation
  • Gas, stomach pain, indigestion
  • Dizziness
  • Dry mouth
  • Sleepiness/drowsiness or insomnia (trouble sleeping)
  • Increased sweating
  • Mild rash or itching on the skin

In rare cases, both medications can lead to a decrease in magnesium levels in your blood which may result in tremors (uncontrollable shaking), feeling jittery or nervousness. If these symptoms persist after medication use, it is advisable to reach out to a healthcare provider for assistance.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Nexium?

Although Nexium and Dexilant are both proton pump inhibitors used to treat acid reflux, they can occasionally cause severe side effects. Here are some you should watch out for:

  • Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
  • Kidney problems - urinating less than usual, blood in your urine, swelling in your feet or ankles
  • Low magnesium levels - dizziness with a fast heartbeat; jitteriness; muscle cramps or weakness; coughing up blood
  • New or worsening symptoms of lupus - joint pain and rash on cheeks or arms that worsens in sunlight
  • Symptoms related to stomach growths (fundic gland polyps)

It's important to note that these medications may also interact negatively with other drugs, leading to further complications such as:

  • Increased risk for bone fractures if taken long term (over one year)
  • Vitamin B12 deficiency after long-term use

If you experience any of the above adverse effects while taking either Nexium or Dexilant immediately seek medical attention.

What are the most common side effects for Dexilant?

When comparing Nexium to Dexilant, it's important to highlight some of the potential side effects that can occur with Dexilant. These may include:

  • Dry mouth or a sore throat
  • Abdominal pain and gas, which might lead to a loss of appetite
  • Diarrhea or constipation
  • Nausea or vomiting
  • Dizziness and headaches
  • Possible sleep disturbances such as insomnia
  • Rash on your skin In rare cases, there might be confusion and agitation. Furthermore, long-term use could potentially cause weight changes due to changes in digestion. It's essential for patients taking Dexilant to monitor their symptoms closely and report any concerns immediately. It's also worth mentioning that everyone reacts differently to medications; therefore what one person experiences may not be the same for another person.

Are there any potential serious side effects for Dexilant?

When taking Dexilant, it's important to be aware of any adverse reactions which may signify a serious problem. Be watchful for the following symptoms:

  • Signs of an allergic or severe skin reaction: hives, itching sensation, fever, swollen glands, difficulty breathing.
  • Swelling in your face or throat
  • Soreness in throat
  • Burning eyes sensation
  • Skin pain accompanied by red or purple skin rash with blistering and peeling
  • Unusual changes in mood or behavior
  • Blurred vision issues including tunnel vision, eye pain or swelling, seeing halos around lights
  • Fast-paced and irregular heartbeats

If you experience any of these symptoms while on Dexilant medication course immediately seek medical attention.

Contraindications for Nexium and Dexilant?

Both Nexium and Dexilant, like most proton pump inhibitors (PPIs), can increase the risk of bone fractures if used for long periods or in high doses. If you notice any unexplained fracture or bone pain, please seek immediate medical attention.

Neither Nexium nor Dexilant should be taken if you are taking rilpivirine-containing products commonly used to treat HIV-1 infection, such as Complera/Eviplera and Odefsey. Always inform your physician about all medications you take; these drugs may require a period of discontinuation to prevent dangerous interactions with Nexium and Dexilant.

Furthermore, prolonged use of PPIs like Nexium and Dexilant may lead to vitamin B12 deficiency especially in elderly patients or those on a vegetarian diet. Long-term use can also result in low magnesium levels which could cause serious side effects including muscle spasms, irregular heartbeat, seizures among others.

How much do Nexium and Dexilant cost?

For the brand name versions of these drugs:

  • The price for 30 capsules of Nexium (20 mg) averages around $248, which works out to approximately $8.27/day.
  • The price for 30 capsules of Dexilant (60 mg) averages about $281, working out to roughly $9.37/day.

Therefore, if you are taking a standard dose, then brand-name Nexium tends to be less expensive on a per-day treatment basis compared with Dexilant. However, remember that cost should not be your primary consideration in determining which drug is right for you - efficacy and side effects should also play significant roles in your decision.

As far as generic versions go:

  • Esomeprazole (the generic version of Nexium), available in packs from 15 up to 500 tablets (20 mg), can cost between $0.17 and $1 per day depending on the pack size and dosage.
  • Dexlansoprazole (generic Dexilant) isn't widely available yet due to patent restrictions; however once it becomes more accessible the prices will likely decrease significantly similar to other generics.

Popularity of Nexium and Dexilant

Esomeprazole, known by its brand name Nexium, was estimated to have been prescribed about 15.9 million times in the US in 2020. Esomeprazole accounted for over 45% of prescriptions among proton pump inhibitors (PPIs), a class of drugs which reduce stomach acid production and are used primarily in the treatment of gastroesophageal reflux disease (GERD) and peptic ulcers. The prevalence of esomeprazole has generally remained steady since it was first introduced.

On the other hand, dexlansoprazole, also referred to as Dexilant, was prescribed around 2.1 million times within the same period. In comparison with esomeprazole's dominant market share among PPIs, dexlansoprazole accounts for just under 6%. It has seen a moderate increase in prescription rate since its introduction but remains less frequently chosen compared to esomeprazole due to higher cost and similar efficacy profiles on most counts.


Both Nexium (esomeprazole) and Dexilant (dexlansoprazole) are proton pump inhibitors commonly used to treat conditions such as gastroesophageal reflux disease (GERD), stomach ulcers, and heartburn. They work by reducing the production of stomach acid, thereby relieving symptoms associated with these conditions. Both drugs have been proven effective in clinical studies, but they may not be combined due to potential interactions.

Nexium typically acts faster than Dexilant but it's effect lasts for a shorter duration while Dexilant has a unique dual release mechanism that provides two separate releases of medication which offers longer-lasting relief from symptoms. Therefore, Nexium is often prescribed when immediate relief is needed whereas Dexilant might be chosen for ongoing management of chronic conditions.

Both medications are available in generic form now which can save cost especially for those paying out-of-pocket. An adjustment period may also occur where full effects aren't noticeable right away.

The side effect profiles are similar between the two drugs - common ones being headache, nausea, diarrhea and flatulence; however both medications are generally well-tolerated. Patients must monitor their responses to these medications closely and should seek medical help immediately if they notice severe diarrhoea or signs of an allergic reaction such as difficulty breathing or swelling of the face or throat.