Prevacid vs. Aciphex
See how Prevacid and Aciphex compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Prevacid and Aciphex are both proton pump inhibitors that reduce stomach acid to treat GERD, ulcers, and related conditions.
Prevacid comes in a capsule, an orally disintegrating tablet, an IV version, and an over-the-counter option, while Aciphex is only a single-strength tablet.
Aciphex has a much higher typical list price than Prevacid, while Prevacid has broader FDA approval for younger pediatric patients.
Prevacid vs. Aciphex Drug Summary
Prevacid
Prevacid (lansoprazole) is a proton pump inhibitor that reduces stomach acid production to treat GERD, ulcers, and erosive esophagitis. It comes as a delayed-release capsule, an orally disintegrating tablet, or an IV injection, and is also sold over-the-counter for frequent heartburn. Prescription doses range from 15 mg to 60 mg daily depending on the condition being treated.
Aciphex
Aciphex (rabeprazole) is a proton pump inhibitor that lowers stomach acid to heal and manage GERD, duodenal ulcers, and hypersecretory conditions. It's taken as a delayed-release tablet available in a single 20 mg strength, with higher doses used for conditions like Zollinger-Ellison syndrome. It's approved for adults and adolescents 12 and older, but not for younger children.
Prevacid vs. Aciphex Side Effects
Prevacid
Aciphex
Prevacid vs. Aciphex Dosage
Prevacid
Aciphex
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 60 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | At the start |
| Maximum dose | 60 mg twice daily | If needed |
| Dose changes | 3 increases | As tolerated |
Prevacid
| STAGE | DOSE | WHEN |
| Starting dose | 15 mg once daily | At the start |
| Maximum dose | 60 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Aciphex
| STAGE | DOSE | WHEN |
| Starting dose | 20 mg once daily | At the start |
| Maximum dose | 60 mg twice daily | If needed |
| Dose changes | 3 increases | As tolerated |
Prevacid vs. Aciphex Indications
Prevacid
Prevacid is FDA approved for a wide range of acid-related conditions, including GERD, duodenal and gastric ulcers, and erosive esophagitis. It's also used for H. pylori eradication and for rare hypersecretory conditions like Zollinger-Ellison syndrome. It is not approved for infants under 1 year old.
Duodenal and gastric ulcer healing
Erosive esophagitis healing and maintenance
GERD treatment
H. pylori eradication (triple therapy)
Zollinger-Ellison syndrome and hypersecretory conditions
Aciphex
Aciphex is FDA approved for healing and maintaining GERD, duodenal ulcer healing, and H. pylori eradication when combined with antibiotics. It's also approved for hypersecretory conditions such as Zollinger-Ellison syndrome, using doses up to 100 mg daily. It is not approved for GERD treatment in children under 12.
Healing of erosive or ulcerative GERD
Maintenance of GERD healing
Duodenal ulcer healing
H. pylori eradication (with antibiotics)
Zollinger-Ellison syndrome and hypersecretory conditions
Prevacid vs. Aciphex Pros and Cons
Prevacid
Prevacid's availability in capsule, orally disintegrating tablet, and IV forms gives patients and clinicians more flexibility than a single-tablet option. It also carries a broader pediatric approval and a much lower typical list price, though its label includes a specific long-term polyp risk.
Pros
Available as a capsule, orally disintegrating tablet, and IV injection
Also approved for gastric ulcer healing, which Aciphex is not
Available over-the-counter as well as by prescription
Cons
Long-term use linked to increased risk of fundic gland polyps
Not approved for symptomatic GERD in infants under 1 year old
More formulation options can mean more variation in insurance coverage
Aciphex
Aciphex offers a simple single-strength tablet and a specific label for Zollinger-Ellison syndrome at doses up to 100 mg daily. It lacks the formulation variety of Prevacid and carries its own distinct warnings, along with a significantly higher typical list price.
Pros
Specifically labeled for Zollinger-Ellison syndrome at doses up to 100 mg daily
Approved for symptomatic GERD treatment in adolescents 12 and older
Only one tablet strength (20 mg), which can simplify prescribing
Cons
Available only as a delayed-release tablet, with no liquid, ODT, or IV option
Contraindicated with rilpivirine-containing HIV medications
Carries a specific warning for cutaneous and systemic lupus erythematosus
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