Compare Aciphex vs. Nexium

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

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Aciphex (rabeprazole)

Prescription only

Nexium (esomeprazole)

Over-the-counter
Treats heartburn and ulcers.

Aciphex (rabeprazole) is good for treating heartburn and ulcers, but should not be used long-term.

Treats heartburn and stomach ulcers.

Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term.

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4.0/ 5 average rating with 1239 reviewsforNexium
Upsides
  • Aciphex (rabeprazole) works better than over-the-counter medications that have not relieved your acid reflux.
  • The delayed-release pill provides relief over 24 hours.
  • Aciphex (rabeprazole) can be taken with or without food.
  • The capsule can be safely used by children as young as 1 year old.
  • 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
  • Using Aciphex (rabeprazole) for a long time can can weaken your bones or increase your risk for infectious diarrhea.
  • Lowers magnesium and vitamin B12 in your body so you may need to take supplements.
  • Aciphex (rabeprazole) interferes with how many medications work.
  • 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.
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Used for
  • GERD
  • H. Pylori bacterial infection
  • Prevention and treatment of NSAID-induced gastric ulcers
Dosage forms
  • Delayed release pill
  • Pill
  • Injection
  • Packet
Price
Lowest price
$19.60
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Lowest price
$33.78
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Reviews
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1239 reviews so far
75%
saidit'sworth it
59%
saiditworked well
11%
saidit'sa big hassle

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Side effects
5possible side effects
  • Headache
    10%
  • Diarrhea
    5%
  • Nausea
    5%
  • Vomiting
    4%
  • Abdominal pain
    4%
See more detailed side effects
The Nexium (esomeprazole) FDA package insert doesn’t have numbers about how common side effects are.
Risks and risk factors
  • Stomach cancer
  • Kidney inflammation
  • Severe diarrhea
    • Being hospitalized
    • Antibiotic use
  • Bone fractures
    • High dose Aciphex (rabeprazole)
    • Taking Aciphex (rabeprazole) for longer than one year
    • Low bone mineral density
    • Age 50 years or older
    • Alcohol
    • Smoking
    • Taking steroids or anti-seizure medicines
  • Low levels of magnesium and vitamin B12
  • Lupus
See more detailed risks and warnings
  • Stomach cancer
  • Kidney injury
  • Severe diarrhea
    • Being treated at a hospital
  • Bone fractures
    • High dose Nexium (esomeprazole)
    • Long-term treatment with Nexium (esomeprazole)
    • Low bone mineral density
    • Aged 65 years or older
  • Lupus
See more detailed risks and warnings
Learn more about Aciphex (rabeprazole)
Learn more about Nexium (esomeprazole)