Prilosec vs. Dexilant

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

Key Takeaways

  • Prilosec and Dexilant are both proton pump inhibitors that reduce stomach acid to treat GERD and erosive esophagitis, but Prilosec also covers ulcers and H. pylori infection while Dexilant does not.

  • Dexilant's dual-release formula allows once-daily dosing without regard to meal timing, while Prilosec generally works best taken before breakfast on an empty stomach.

  • Prilosec is available over the counter and typically costs far less per month than Dexilant, which is prescription-only.

Prilosec vs. Dexilant Drug Summary

Prilosec

Prilosec (omeprazole) is a proton pump inhibitor that lowers stomach acid to treat GERD, erosive esophagitis, ulcers, and H. pylori infection. It comes as a delayed-release capsule, tablet, or oral suspension and is taken once or twice daily depending on the condition. Prilosec is available both by prescription and over the counter.

Dexilant

Dexilant (dexlansoprazole) is a proton pump inhibitor used to heal erosive esophagitis, maintain that healing, and relieve symptoms of non-erosive GERD. It is a delayed-release capsule with a dual-release design that can be taken once daily regardless of meal timing. Dexilant is available by prescription only.

Prilosec vs. Dexilant Side Effects

Prilosec

Most common
abdominal pain (up to 5.2%)
nausea (up to 4%)
diarrhea (up to 4%)
headache (up to 6.9%)

Dexilant

Most common
abdominal pain (≥2%)
nausea (≥2%)
diarrhea (≥2%)
vomiting (≥2%)

Prilosec vs. Dexilant Dosage

Prilosec

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 20 mg once daily At the start
Maximum dose 120 mg three times daily If needed
Dose changes 4 increases As tolerated

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

Prilosec vs. Dexilant Indications

Prilosec

Prilosec treats a broad range of acid-related conditions, from everyday heartburn to ulcers and rare hypersecretory disorders. It is also used as part of combination therapy to eradicate H. pylori infection.

  • Duodenal and gastric ulcers

  • Erosive esophagitis from GERD

  • Maintenance of healed erosive esophagitis

Dexilant

Dexilant is approved to heal erosive esophagitis at any severity grade and to maintain that healing over time. It is also approved for symptomatic non-erosive GERD, but it does not treat ulcers or H. pylori infection.

  • Healing of erosive esophagitis (all grades)

  • Maintenance of healed erosive esophagitis

  • Symptomatic non-erosive GERD

Prilosec vs. Dexilant Pros and Cons

Prilosec

Prilosec has decades of use, treats the widest range of acid-related conditions, and is available both over the counter and by prescription. It generally costs far less per month than Dexilant, though it usually needs to be taken before a meal for full effect.

Pros

  • Available over the counter and by prescription

  • Broader FDA-approved uses, including ulcers and H. pylori

  • Roughly $15 to $95 per month without insurance

Cons

  • Best taken 30 to 60 minutes before a meal

  • Twice-daily dosing needed for the H. pylori regimen

  • Dose adjustment recommended for Asian patients

  • No dual-release technology for extended coverage

Dexilant

Dexilant's dual-release design keeps acid suppression going longer and lets it be taken without regard to food. It is a newer PPI with a narrower set of approved uses and a noticeably higher monthly cost than Prilosec.

Pros

  • Can be taken regardless of meal timing

  • Dual-release formula extends acid suppression

  • Simple once-daily dosing for every approved use

Cons

  • Roughly $270 to $470 per month without insurance

  • Not approved for ulcers or H. pylori eradication

  • Only available as a capsule, no other forms

  • Shorter track record than Prilosec (approved 2009)

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