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

Most common
headache (up to 7%)
abdominal pain (up to 5%)
diarrhea (up to 3.8%)
nausea (up to 3%)

Aciphex

Most common
headache (up to 9.9%)
pain (up to 3%)
pharyngitis (up to 3%)
flatulence (up to 3%)

Prevacid vs. Aciphex Dosage

Prevacid

Dosage
Dosage Table
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

Dosage
Dosage Table
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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