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

Most common
diarrhea (up to 2%)
abdominal pain (up to 2%)
nausea (up to 2%)
upper respiratory tract infection (up to 2%)

Famotidine

Most common
diarrhea (up to 1%)
headache (up to 1%)
dizziness (up to 1%)
constipation (up to 1%)

Dexilant vs. Famotidine Dosage

Dexilant

Dosage
Dosage Table
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

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

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