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 has some risks if used long term.
Reviews & ratings
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Have you used Aciphex (Rabeprazole)?
Worth itNot sureNot worth it
Reviews for Nexium
75%
+25% better vs. Aciphex
59%
+30% better vs. Aciphex
11%
+11% better vs. Aciphex
1239 reviews
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
Side effects
AciphexNexium
  • Infection 1%
  • Constipaton 1%
  • Pain 2%
  • Pharyngitis 1%
  • Flatulence 2%
  • Vomiting 4%
  • Abdominal pain 4%
  • Diarrhea 5%
  • Nausea 5%
  • Headache 5%
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 treats heartburn and heals ulcers by lowering the amount of acid in your stomach.
Type of medication
AciphexNexium
Prescription onlyLower-cost generic availableOver-the-counterLower-cost generic available
Available as
AciphexNexium
  • Extended release
  • Pill
  • Injection
  • Packet
Used for
AciphexNexium
  • GERD
  • H Pylori Bacterial Infection
Risk factors for serious side effects
AciphexNexium
  • Helicobacter pylori infection
  • Autoimmune disease
  • Being hospitalized
  • Antibiotic use
  • Osteoporosis
Detailed Aciphex (Rabeprazole) risks & warnings »
  • Being treated at a hospital
  • High dose Nexium (esomeprazole)
  • Long-term treatment with Nexium (esomeprazole)
  • Low bone mineral density
  • Aged 65 years or older
Detailed Nexium (esomeprazole) risks & warnings »
Pregnancy

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.

Interactions
AciphexNexium
  • Many drugs can interact with Aciphex (Rabeprazole), so talk to your doctor or pharmacist before starting any new medicines.
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
Food
AciphexNexium
  • Take Aciphex (Rabeprazole) with or without food. It can work better for some people if it's taken 30 minutes before a meal.
No food related info.
Kidneys and liver
AciphexNexium
No kidneys and liver related info.
  • Nexium (esomeprazole) can cause acute kidney damage that can occur at any time during treatment. If you notice blood in the urine, changes in urine output, swelling of the body, weight gain, fever, or confusion, stop taking Nexium (esomeprazole) and speak to your doctor immediately.
Pain
AciphexNexium
  • Call your doctor if you have watery stools, stomach pain, or a fever because it could be a sign of a serious infection.
No pain 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 (esomeprazole) without any noticeable day-to-day side effects.
  • Nexium (esomeprazole) lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need quicker relief.
  • Nexium (esomeprazole) is inexpensive, with over-the-counter and generic options.
  • Coupons are available for the brand name - speak to your doctor or pharmacist.
  • The packet form is a good option if you have trouble swallowing pills.They can be mixed with water for easier swallowing.
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 right away like antacids (Tums, Rolaids, or Maalox).
  • It can take several days or weeks to start feeling benefits.
  • May not be the best choice for patients 65 years of age and older due to risk of bone fractures and severe diarrhea.
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 Nexium (esomeprazole) with a full glass of water 1 hour before eating.
  • Starts working in as little as an hour.
  • It can take 1 to 4 days to take full effect.
  • Since some prescription drugs can interact with Nexium (esomeprazole), talk to your doctor about all the medicines that you're taking.
  • Do not take Nexium (esomeprazole) for more than 14 days, unless directed by your doctor. Speak to your doctor if your symptoms don't go away after 2 weeks.
  • Nexium (esomeprazole) capsules can be opened and sprinkled on 1 tablespoon of applesauce, cottage cheese, or yogurt. Swallow immediately after.
Learn more
More about AciphexSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Aciphex (Rabeprazole)?
Worth itNot sureNot worth it
More about NexiumSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it