Dexilant vs. Famotidine
See how Dexilant and Famotidine compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Dexilant is a proton pump inhibitor that suppresses acid all day with one dose, while famotidine is an H2 blocker that works faster but for a shorter time.
Dexilant is FDA-approved for erosive esophagitis and GERD, while famotidine covers a wider range of conditions including duodenal and gastric ulcers.
Famotidine typically costs far less than Dexilant, but Dexilant generally provides stronger, longer-lasting acid control.
Dexilant vs. Famotidine Drug Summary
Dexilant
Dexilant (dexlansoprazole) is a proton pump inhibitor used to heal erosive esophagitis and treat GERD. It uses a dual delayed-release capsule that releases medication in two waves, so it works once daily regardless of when you eat.
Famotidine
Famotidine is an H2-receptor antagonist used to treat GERD, ulcers, and erosive esophagitis. It comes as a tablet, liquid, or injection, and is taken once or twice daily depending on the condition being treated.
Dexilant vs. Famotidine Side Effects
Dexilant
Famotidine
Dexilant vs. Famotidine Dosage
Dexilant
Famotidine
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg once daily | At the start |
| Maximum dose | 60 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg twice daily | Weeks 1-6 |
| Maximum dose | 40 mg once daily | Weeks 1-8 |
| Dose changes | 1 increase | As tolerated |
Dexilant
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg once daily | At the start |
| Maximum dose | 60 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Famotidine
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg twice daily | Weeks 1-6 |
| Maximum dose | 40 mg once daily | Weeks 1-8 |
| Dose changes | 1 increase | As tolerated |
Dexilant vs. Famotidine Indications
Dexilant
Dexilant treats acid-related damage to the esophagus, including all grades of erosive esophagitis and non-erosive GERD. It is also used to keep esophagitis healed once it clears and to relieve ongoing heartburn.
Healing of erosive esophagitis, all grades
Maintenance of healed erosive esophagitis
Relief of heartburn from GERD
Treatment of non-erosive GERD symptoms
Famotidine
Famotidine treats several acid-related conditions, including duodenal and gastric ulcers, GERD, erosive esophagitis, and rare hypersecretory disorders. It is also used off-label to prevent stress ulcers in critically ill patients.
Treatment of duodenal and gastric ulcers
Maintenance therapy for duodenal ulcers
Treatment of GERD and erosive esophagitis
Treatment of hypersecretory conditions
Dexilant vs. Famotidine Pros and Cons
Dexilant
Dexilant offers extended, two-phase acid suppression that works whether or not you eat beforehand, and it is approved for the full range of erosive esophagitis severity. It costs more than older acid reducers and carries the class-wide risks of long-term PPI use.
Pros
Once-daily dosing regardless of meal timing
Dual-release formula gives longer acid suppression
Approved for all grades of erosive esophagitis
Cons
Costs roughly $270 to $470 per month without insurance
Long-term use linked to higher fracture risk
Not approved for children under 12
Famotidine
Famotidine works faster than a PPI and costs far less, with both prescription and over-the-counter options. It has a broader label covering ulcers and hypersecretory conditions but generally provides milder acid suppression than Dexilant.
Pros
Available over the counter as well as by prescription
Costs roughly $10 to $90 per month without insurance
No boxed warning associated with the drug class
Cons
Needs dose adjustment with kidney impairment
Often requires multiple doses per day
Risk of confusion or hallucinations in elderly patients
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