Nexium generic availability, cost, and dosage

In this article:

• Is there a generic for Nexium?
• What are the differences between brand-name and generic Nexium?
• How much is generic Nexium?
• Is Nexium covered by insurance?
• How do you get Nexium covered by insurance?
• Generic alternatives to Nexium
• Expert takeaway

In this article

• Is there a generic for Nexium?
• What are the differences between brand-name and generic Nexium?
• How much is generic Nexium?
• Is Nexium covered by insurance?
• How do you get Nexium covered by insurance?
• Generic alternatives to Nexium
• Expert takeaway

Acid reflux, with symptoms of heartburn, is also known as gastroesophageal reflux disease (GERD; a more serious form of acid reflux). One may have heard of or taken a medication called Nexium to help relieve this condition. Nexium is part of the proton pump inhibitor (PPI) class of drugs, and the generic name of Nexium is esomeprazole. PPIs work by decreasing the amount of acid produced by the stomach. Nexium was approved by the U.S. Food and Drug Administration (FDA) in 2001. Nexium is chemically similar to Prilosec (omeprazole), the first PPI approved by the FDA in 1989.

Now, Nexium is available in brand and generic, prescription, and over-the-counter forms. As of 2023, almost 1.1 million people in the U.S. filled over 3.8 million prescriptions for generic Nexium. Although many refer to this medicine as Nexium, generic esomeprazole can offer significant cost savings. Continue reading to learn more about Nexium and its generic esomeprazole. 

RELATED: Nexium vs. Prilosec: Differences, similarities, and which is better for you

Is there a generic for Nexium?

The FDA approved the first generic of prescription Nexium, esomeprazole, in January 2015. Nexium is still a brand-name product, but it is more commonly dispensed by pharmacies as generic esomeprazole. Generic esomeprazole is manufactured by numerous pharmaceutical companies. If a healthcare provider prescribes Nexium, the pharmacist will likely dispense esomeprazole unless a patient or the healthcare provider specifically requests the brand name. 

Nexium and esomeprazole can also be purchased over the counter. 

What are the differences between brand-name and generic Nexium?

The following table summarizes important information about the difference between brand and generic Nexium. 

Drug information	Nexium (esomeprazole)
Uses (Rx form)	Heals acid damage and maintains healing of erosive esophagitis (inflammation of the lining of the esophagus, which is the tube that runs from the throat to the stomach) Treats heartburn and other GERD symptoms Lowers the risk of ulcers due to nonsteroidal anti-inflammatory drugs (NSAIDs) Treats stomach ulcers (gastric ulcers) due to H. pylori infection (in combination with antibiotics) Treatment of pathological hypersecretory conditions (conditions where too much acid is made) such as Zollinger-Ellison Syndrome
Uses (OTC form)	Treats frequent heartburn that occurs 2 or more days per week
Standard dosage	Varies by indication A common adult prescription dosage is 20-40 mg once daily OTC: 20 mg once daily for 14 days
Common side effects	Headache Dry mouth Stomach side effects (nausea, gas, abdominal pain, constipation or diarrhea) Less common adverse reactions may include back or chest pain, weakness, swelling, hot flashes, flulike symptoms Serious side effects may occur, such as severe allergic reactions or skin reactions that require emergency medical help Consult a provider for a complete list of possible side effects.
Contraindications	People with allergies to esomeprazole, omeprazole, any other PPI, or any ingredient in the medication should not take Nexium
Other considerations	Nexium may cause new or worsening lupus (systemic lupus erythematosus). Be alert to symptoms like joint pain and skin rash, especially on the cheeks, and notify a doctor right away if symptoms occur.  Taking a PPI for a long time and/or higher doses can cause complications like bone fractures, polyps, low magnesium levels, and vitamin B12 deficiency. Consult a healthcare provider for medical advice. They will prescribe or recommend the lowest effective dose for the shortest length of treatment to minimize the risk of complications. Read the Medication Guide and Patient Information Leaflet with the prescription for more information about this medication.

How much is generic Nexium?

The cost of generic Nexium is significantly lower than brand Nexium. The table below shows the significant cost savings from brand-name Nexium to generic esomeprazole. A prescription of 90, 40 mg capsules of brand-name Nexium without insurance would cost about $1,060. However, if you use a free SingleCare card the cost of generic Nexium can be as low as $21 for 90, 40 mg capsules of esomeprazole.

Note: If purchasing OTC strength Nexium, a prescription will be needed from a healthcare provider to apply the SingleCare discount.

Brand vs. generic Nexium prices
Cost information	Brand-name prescription Nexium	Nexium generic (esomeprazole)
Average cost without insurance	$1,060 for 90, 40 mg capsules of Nexium	$780 for 90, 40 mg capsules of esomeprazole
SingleCare’s lowest price	$810 for 90, 40 mg capsules of Nexium at Kroger	$21 for 90, 40 mg capsules of esomeprazole at Kroger
Free coupons	Nexium coupons	Esomeprazole coupons

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of December 15, 2025. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available.

Is Nexium covered by insurance?

Brand-name Nexium typically isn’t covered by insurance, but generic Nexium is usually covered by most insurance plans. However, coverage can vary by plan, and there may be instances when your insurance plan requires prior authorization or step therapy before it will cover Nexium. To learn more about Nexium coverage, contact your health insurance provider. 

How do you get Nexium covered by insurance?

Although most insurance plans cover Nexium, some may require prior authorization or step therapy before it will cover the drug. If your insurance plan does not cover Nexium, you can use a SingleCare prescription discount card to help lower the price of a Nexium prescription. 

Generic alternatives to Nexium

Although Nexium is a safe and effective medication, it may not be right for everyone. Whether you are looking for a Nexium alternative because of side effects, contraindications, drug interactions, cost, or lack of efficacy, there are several generic alternatives available. These may include:

• Omeprazole
• Lansoprazole
• Pantoprazole
• Rabeprazole
• Dexlansoprazole
• Famotidine
• Cimetidine

Keep in mind that each alternative has its own risks, warnings, drug interactions, and side effects. Always consult a healthcare provider for medical advice before switching to an alternative. They can discuss which alternative is right for you. 

Long-term use of Nexium

Because of the risk of side effects that may occur with long-term use, healthcare providers prescribe Nexium at the lowest effective dose for the shortest time. Some of the risks associated with long-term PPI use include:

• Increased risk of osteoporosis and related bone fractures of the hip, spine, or wrist
• Cyanocobalamin (vitamin B12) deficiency
• Low magnesium levels 
• Fundic gland polyps (a type of stomach polyp that occurs in the upper stomach)

Consult a healthcare provider for more information about Nexium use and its benefits and risks. Ensure the provider is aware of any medical conditions and your family’s medical history.

How to switch from Nexium to esomeprazole

When issuing a prescription for this PPI, a healthcare provider will generally write the prescription as “Nexium.” State laws allow pharmacists to dispense generics of brand-name drugs, even if the prescription is written for the brand-name drug—unless a person or a healthcare provider specifically indicates not to substitute the brand with a generic. 

If taking brand-name Nexium and want to switch to the generic, check with the healthcare provider or pharmacist. The brand-name and generic products contain the same ingredients and dosage, making switching to a generic product an easy transition. Always consult a healthcare provider for medical advice, for medication questions or concerns. 

Expert takeaway

Ashley Wong, Pharm.D., and a member of the SingleCare Medical Board, says, “Always talk to a healthcare professional before stopping brand-name or generic Nexium. Abruptly stopping PPIs like Nexium can result in rebound—or increased—acid secretion. To minimize this risk, healthcare providers may recommend slowly lowering your dosage of Nexium over time until it is safe for you to stop the drug completely. If you’re looking to switch to a Nexium alternative, talk to your healthcare provider. They can tell you the safest way to stop taking Nexium.”