Pepcid vs. Dexilant
See how Pepcid and Dexilant compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Pepcid is an H2 blocker that starts working within about an hour and costs far less, while Dexilant is a stronger proton pump inhibitor built to heal erosive esophagitis.
Both drugs relieve GERD symptoms, but Dexilant only needs one dose a day and works no matter when you eat, while Pepcid is often taken twice daily.
Pepcid is sold over the counter and as a generic, while Dexilant is prescription-only and carries a much higher price tag without insurance.
Pepcid vs. Dexilant Drug Summary
Pepcid
Pepcid (famotidine) is an H2 blocker that reduces the amount of acid the stomach produces. It treats active duodenal and gastric ulcers, GERD, erosive esophagitis, and hypersecretory conditions like Zollinger-Ellison syndrome. It comes as a tablet taken once or twice daily depending on the condition being treated.
Dexilant
Dexilant (dexlansoprazole) is a proton pump inhibitor that blocks acid production at its source using a dual delayed-release capsule. It treats erosive esophagitis, helps keep it healed once it clears, and relieves symptoms of non-erosive GERD. It is taken once daily and works regardless of meal timing.
Pepcid vs. Dexilant Side Effects
Pepcid
Dexilant
Pepcid vs. Dexilant Dosage
Pepcid
Dexilant
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | At the start |
| Maximum dose | 20 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| 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 |
Pepcid
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | At the start |
| Maximum dose | 20 mg once daily | If needed |
| Dose changes | 3 increases | 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 |
Pepcid vs. Dexilant Indications
Pepcid
Pepcid is FDA-approved to treat active duodenal and gastric ulcers, symptomatic non-erosive GERD, and erosive esophagitis confirmed by biopsy. It is also used for pathological hypersecretory conditions such as Zollinger-Ellison syndrome and to reduce the risk of ulcer recurrence.
Active duodenal ulcer
Active gastric ulcer
Symptomatic non-erosive GERD
Erosive esophagitis due to GERD
Dexilant
Dexilant is FDA-approved to heal all grades of erosive esophagitis and to maintain that healing over time. It also treats symptomatic non-erosive GERD in adults and adolescents 12 and older.
Healing of erosive esophagitis (all grades)
Maintenance of healed erosive esophagitis
Relief of heartburn
Symptomatic non-erosive GERD
Pepcid vs. Dexilant Pros and Cons
Pepcid
Pepcid works within about an hour, making it a practical option for occasional or mild symptoms, though it is not as strong as a PPI for healing erosive esophagitis. It is sold both over the counter and by prescription, and generic versions keep the cost low.
Pros
Available over the counter and generic
Starts working within about an hour
Roughly $10 to $100 per month without insurance, before savings programs
No food restrictions for timing
Cons
Less potent for healing erosive esophagitis
Often needs twice-daily dosing
Effect can wear off with regular use (tachyphylaxis)
Not approved for maintenance of healed erosive esophagitis
Dexilant
Dexilant's dual delayed-release formulation gives stronger, longer-lasting acid suppression, making it a better fit for healing erosive esophagitis. It costs significantly more than Pepcid and is not available as a generic or over the counter.
Pros
Stronger acid suppression for healing erosive esophagitis
Once-daily dosing regardless of meal timing
Approved for long-term maintenance of healed EE
Dual-release formula extends acid control
Cons
Roughly $270 to $470 per month without insurance, before savings programs
Not available over the counter
Long-term use linked to bone fracture risk
Small risk of C. difficile-associated diarrhea
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