Dexilant vs. Omeprazole

See how Dexilant and Omeprazole compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Dexilant's dual-release capsule spreads acid suppression across two waves and can be taken any time of day, while omeprazole works best taken before a meal.

  • Both are proton pump inhibitors for GERD and erosive esophagitis, but omeprazole also treats ulcers and H. pylori infection and costs far less out of pocket.

  • Omeprazole is sold over-the-counter for frequent heartburn, while Dexilant requires a prescription and carries a much higher price even as a generic.

Dexilant vs. Omeprazole Drug Summary

Dexilant

Dexilant (dexlansoprazole) is a proton pump inhibitor used to heal erosive esophagitis, maintain that healing, and relieve heartburn from non-erosive GERD. Its dual delayed-release capsule releases medication in two separate waves, so it is taken once daily at any time, regardless of meals.

Omeprazole

Omeprazole is a proton pump inhibitor used to treat GERD, heal erosive esophagitis, and treat duodenal and gastric ulcers. It is taken once daily before a meal, usually for 4 to 8 weeks depending on the condition, and can also be paired with antibiotics to clear H. pylori infection.

Dexilant vs. Omeprazole Side Effects

Dexilant

Most common
Abdominal pain (up to 2%)
Nausea (up to 2%)
Diarrhea (up to 2%)
Cold symptoms (up to 2%)

Omeprazole

Most common
Abdominal pain (up to 5%)
Nausea (up to 4%)
Diarrhea (up to 4%)
Headache (up to 7%)

Dexilant vs. Omeprazole 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

Omeprazole

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 40 mg once daily If needed
Dose changes 1 increase As tolerated

Dexilant vs. Omeprazole Indications

Dexilant

Dexilant is FDA-approved to heal all grades of erosive esophagitis, maintain that healing over time, and relieve heartburn from non-erosive GERD. It is not approved for children under 12 years old.

  • Healing of all grades of erosive esophagitis (EE)

  • Maintenance of healed erosive esophagitis

  • Relief of heartburn from non-erosive GERD

  • Treatment of symptomatic non-erosive GERD

Omeprazole

Omeprazole is FDA-approved to treat symptomatic GERD, heal erosive esophagitis, and treat duodenal and gastric ulcers. It is also used with antibiotics to eradicate H. pylori infection.

  • Healing of erosive esophagitis (EE)

  • Treatment of duodenal and gastric ulcers

  • Eradication of H. pylori (with antibiotics)

  • Treatment of symptomatic GERD

Dexilant vs. Omeprazole Pros and Cons

Dexilant

Dexilant's dual-release delivery gives it steady acid suppression that does not depend on meal timing, a real convenience edge over standard PPIs. That flexibility comes at a much higher price, even now that a generic dexlansoprazole is on the market.

Pros

  • Dual delayed-release formula spreads acid suppression across two release phases

  • Can be taken at any time of day, with or without food

  • Approved for healing of all grades of erosive esophagitis, including severe cases

Cons

  • Roughly $270 to $470 per month without insurance, even as a generic

  • Not approved for children under 12

  • Does not treat ulcers or H. pylori infection like omeprazole does

Omeprazole

Omeprazole covers a broader range of acid-related conditions, including ulcers and H. pylori infection, and has decades of real-world use behind it. It generally needs to be taken before a meal, and its single-release formula does not sustain acid control as evenly as Dexilant's dual-release design.

Pros

  • Roughly $5 to $25 per month as a generic, without insurance

  • Available over-the-counter as well as by prescription

  • Treats a wider range of conditions, including ulcers and H. pylori infection

Cons

  • Must be taken before eating, usually in the morning, for full effect

  • Single-release formula may not control acid as evenly through the day

  • Higher reported rate of headache than Dexilant's label

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