Compare Aciphex vs. Nexium

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

Aciphex
(Rabeprazole)

Nexium
(Esomeprazole)

Treats heartburn and ulcers. Aciphex (Rabeprazole) is an effective medicine to treat heartburn and ulcers, but can be expensive.Treats heartburn and stomach ulcers. Nexium (Esomeprazole) gives you long-lasting heartburn relief. But this purple pill ain't cheap! The generic forms of alternative drugs work just as well, and are usually less expensive.
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Reviews & ratings
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Reviews for Nexium (Esomeprazole)
75%
25% vs. Aciphex (Rabeprazole)
59%
41% vs. Aciphex (Rabeprazole)
11%
11% vs. Aciphex (Rabeprazole)
Side effects
AciphexNexium
  • Passing gas 2%
  • Pain 2%
  • Constipaton 1%
  • Infection 1%
  • Sore throat 1%
More Aciphex side effects »

The Nexium FDA package insert doesn’t have numbers about how common side effects are.

More about Nexium side effects »
How it works
AciphexNexium
Aciphex (Rabeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.Nexium (Esomeprazole) is a proton pump inhibitor (PPI). It lowers the amount of acid in your stomach, treats heartburn, and heals ulcers.
Type of medication
AciphexNexium
Acid reducer
Proton pump inhibitor
Prescription only
Acid reducer
Proton pump inhibitor
Prescription or OTC
Available as
AciphexNexium
  • Extended release
  • Extended release
Used for (click to learn more)
AciphexNexium
Risk factors for serious side effects
AciphexNexium
    • Helicobacter pylori infection
    • Autoimmune disease
    • Being hospitalized
    • Antibiotic use
    • Osteoporosis
    • Age 50 or older
    • Using high medication doses
    • Long-term therapy (1 year or more)
    • Smoking
    • Use of other medications that weaken bones
      Detailed Aciphex (Rabeprazole) risks & warnings »
        • Helicobacter pylori infection
        • Autoimmune disease
        • Being hospitalized
        • Antibiotic use
        • Osteoporosis
        • Age 50 or older
        • Using high medication doses
        • Long-term therapy (1 year or more)
        • Smoking
        • Use of other medications that weaken bones
          Detailed Nexium (Esomeprazole) risks & warnings »
          Pregnancy category
          AciphexNexium
          CFDA pregnancy category (Weigh risks vs. benefits)

          Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

          See the FDA package insert
          BFDA pregnancy category (Probably safe)

          Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

          See the FDA package insert
          Alcohol
          No specific alcohol-related info.No specific alcohol-related info.
          Food
          • Take Aciphex (Rabeprazole) with or without food. It can work better for some people if it's taken 30 minutes before a meal.
          • Take 1 hour before a meal.
          Kidneys and liver
          No specific kidneys and liver-related info.No specific kidneys and liver-related info.
          Sex
          No specific sex-related info.No specific sex-related info.
          Sleep
          No specific sleep-related info.No specific sleep-related info.
          Weight
          No specific weight-related info.No specific weight-related info.
          Upsides and benefits
          AciphexNexium
          • Relieves heartburn symptoms and heals ulcers better than other stomach medicines, such as Pepcid, Tagamet, and Zantac.
          • Lasts longer than other similar stomach medicines. Most people take it once a day.
          • Your body won't develop a tolerance to Aciphex (Rabeprazole), so it'll work the same way as long as you need to keep taking it.
          • Once heartburn symptoms are treated, a low dose of Aciphex (Rabeprazole) can be taken daily.
          • Most people can take Nexium without any noticeable day-to-day side effects.
          • Nexium lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once or twice a day.
          • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
          • In studies it was better than a placebo (sugar pill) and as good as other proton pump inhibitors at treating heartburn.
          • Available as both a generic and over-the-counter option, so it's pretty affordable.
          Downsides and risks
          AciphexNexium
          • Taking Aciphex (Rabeprazole) in high doses or for longer than 1 year can increase the risk for bone fractures, especially if you already have osteoporosis (weak bones).
          • Many drugs can interact with Aciphex (Rabeprazole), so talk to your doctor or pharmacist before starting any new medicines.
          • There's no generic version available, so it can be expensive.
          • Doesn't start working as fast as some other antacids like Tums, Rolaids, or Maalox.
          • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
          • Can cause low levels of magnesium in the blood. You might need to take a magnesium supplement if you use Nexium long-term.
          • Can be expensive—especially the purple brand-name pill. Other alternatives are usually cheaper than Nexium and work just as well.
          • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Nexium.
          Tips from our pharmacists for people taking the medication
          AciphexNexium
          • Can take a few days to start working.
          • Take Aciphex (Rabeprazole) with or without food. It can work better for some people if it's taken 30 minutes before a meal.
          • Call your doctor if you have watery stools, stomach pain, or a fever because it could be a sign of a serious infection.
          • Aciphex (Rabeprazole) can lower the amount of magnesium in your body. Initial and follow-up blood tests may be needed before starting Aciphex (Rabeprazole).
          • Take 1 hour before a meal.
          • Don't chew or crush capsules; swallow them whole.
          • If you have trouble swallowing you can carefully open the capsules and sprinkle the inside pellets onto applesauce. Swallow the applesauce without chewing or crushing the pellets.
          • When using Nexium long-term, take a calcium citrate with vitamin D supplement daily to prevent bone loss. Be sure it's calcium citrate because it works the best when using a proton pump inhibitor.
          • Get a blood test for your magnesium level once a year; you may need a magnesium supplement while using Nexium.
          • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Nexium.
          Learn more
          More about AciphexSide effectsReviews & ratingsAlternativesFDA package insert
          More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert