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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Coupons for Nexium
Best available price for 30 (40mg) capsules of esomeprazole
Reviews & ratings
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Reviews for Aciphex (rabeprazole)
Not enough review data. Review it!
of people (All ages) say Aciphex (rabeprazole) is worth it
Not enough review data. Review it!
say it works well
Not enough review data. Review it!
say it's a big hassle
Have you used Aciphex (rabeprazole)?
Worth itNot sureNot worth it
Reviews for Nexium (esomeprazole)
75%
-25% worse vs. Aciphex (rabeprazole)
59%
-30% worse vs. Aciphex (rabeprazole)
11%
-11% worse vs. Aciphex (rabeprazole)
1239 reviews
Have you used Nexium (esomeprazole)?
Worth itNot sureNot worth it
Side effects
AciphexNexium
  • Headache 10%
  • Diarrhea 5%
  • Nausea 5%
  • Abdominal pain 5%
  • Vomiting 4%
  • Sore throat 1%
  • Passing gas 2%
  • Pain 2%
More Aciphex side effects »
  • Diarrhea 3%
  • Headache 2%
  • Drowsiness 2%
  • Change in taste 7%
  • Abdominal pain 4%
  • Nausea 2%
  • Irritability 5%
  • Vomiting 5%
More 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
Prescription only
Prescription or OTC
Available as
AciphexNexium
  • Extended release
  • Extended release
Used for
AciphexNexium
Risk factors for serious side effects
AciphexNexium
  • Helicobacter pylori infection
  • Autoimmune disease
  • Being hospitalized
  • Antibiotic use
  • Osteoporosis
Detailed Aciphex (rabeprazole) risks & warnings »
  • Helicobacter pylori infection
  • Autoimmune disease
  • Being hospitalized
  • Antibiotic use
  • Osteoporosis
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.

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

Interactions
AciphexNexium
  • Many drugs can interact with Aciphex (Rabeprazole), so talk to your doctor or pharmacist before starting any new medicines.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Nexium.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Nexium.
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.
  • Take 1 hour before a meal.
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 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
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