My insurance no longer covers Nexium (esomeprazole magnesium). How do I save money on Nexium?

Written by Shivam Patel, PharmD, BSPS, RPh | Posted June 12, 2020 | Updated January 25, 2022

After a large meal or eating certain trigger foods, some unfortunate folks tend to feel a burning sensation in the chest called heartburn. Acid from your stomach found its way to rise into your esophagus, which normally has a barrier muscle that contracts to avoid any escape of acid. However, this acid reflux occurs when that muscle -- called the lower esophageal sphincter -- is weakened, causing us to have that painful dragon breath after our favorite Italian dish paired with wine.

Fortunately, heartburn relief is just a local pharmacy visit away. Nexium (generic name: esomeprazole magnesium) is a Proton Pump Inhibitor (PPI) that works by lowering the amount of acid present in the stomach. Nexium helps treat acid reflux and ulcers which alleviates symptoms like heartburn, persistent cough and difficulty swallowing. Nexium is available over-the-counter and with a prescription.

What is the difference between prescription and OTC Nexium?

Nexium 20mg with a prescription and Nexium 20 mg available over the counter (OTC or without a prescription) have the exact same active ingredient (called esomeprazole).

This means both OTC and prescription Nexium work the same exact way in your body.

The difference is that OTC Nexium is used primarily for heartburn. The prescription version is written by your provider so it can be used for additional indications, such as gastroesophageal reflux disease (GERD) or for the treatment of certain ulcers. This means directions on how you take prescription Nexium can vary from person to person, but OTC Nexium directions remain the same for everyone as listed on the back of the packaging.

Nexium 40mg remains available as a prescription-only medication.

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How do I save money on Nexium?

You can lower your costs on brand name Nexium 40mg by ordering it online from PharmacyChecker-accredited pharmacies. Currently, the lowest price is $29.25 for 30 tablets compared to the average retail U.S. Pharmacy price of $296.72. That’s a savings of 90%!

Compare Nexium Prices

But the cheapest option is actually to “go local, and go generic!” You can save up to 95% at your local pharmacy using the PharmacyChecker U.S. Discount Card.

With regards to Nexium 20mg sold over-the-counter (OTC Nexium), you can save the most by opting for a generic version like Equate at your local pharmacy. However, brand name OTC Nexium is available at local pharmacies for about $7 dollars more if you prefer that option.

Comparing Prices for Brand and Generic Nexium (esomeprazole magnesium)

Drug (generic) Strength Quantity U.S. Average Retail Price PharmacyChecker U.S. Discount Card Price Lowest International Accredited Pharmacy Price Greatest Percentage Savings
Brand Nexium (esomeprazole magnesium) 40mg 30 capsules $296.72 $253.93 $29.25 90%
Generic Nexium (esomeprazole magnesium) 40 mg 30 capsules $294.16 $15.70 $29.40 90%
Brand Nexium (esomeprazole magnesium) 20mg 30 capsules $304.20 $21.51 $26.93 91%
Generic Nexium (esomeprazole magnesium) 20 mg 30 capsules $290.13 $18.70 $26.99 94%
OTC Brand Nexium (esomeprazole magnesium) 20mg 30 capsules $21.87 (average $10.21 for 14 capsules) N/A $26.71 Cheaper locally
OTC Generic Nexium (esomeprazole magnesium) 20mg 30 capsules $14.90 (equate brand $6.98 for 14 capsules) N/A $25.33 Cheaper locally

Sources: Average U.S. Retail Price calculated based on pricing on GoodRx.com. PharmacyChecker U.S. Discount Card Price based on availability at pharmacies near White Plains, NY Zip: 10605. Lowest Accredited International Pharmacy Price based on prices listed on PharmacyChecker.com. OTC = over-the-counter. OTC brand Nexium price calculated using average price of CVS, Walmart and Target. OTC Generic Nexium price from Walmart.

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What triggers heartburn?

The causes of heartburn vary widely. Here are some common triggers with tips to help you prevent it.

  • Smoking - Not only is smoking bad for your lungs and overall health, but it can increase the risk of heartburn.

  • Catching Z’s on your right side - Research has shown that sleeping turned to your right may worsen acid reflux, so try sleeping on your right and make sure you keep your head elevated.

  • Wearing tight clothing - Skinny jeans may look amazing, but tight clothes and belts put additional pressure on your stomach, so try to loosen it up a little.

  • Stress - Stress can disturb the digestive process by increasing our sensitivity to acid. This often results in worse heartburn pain. Find ways to cope with stress like meditation, yoga, or talking with loved ones.

  • Overeating - We all get tempted to indulge in late night snacks, but you really are best to avoid them. Also, eating smaller meals throughout the day can reduce risk of heartburn.

  • Certain foods - Food triggers vary between individuals, but the following are common culprits:

    • Any food that is fried, spicy, fatty or rich
    • Caffeine
    • Coffee
    • Chocolate
    • Mints
    • Alcohol
    • Carbonated beverages
    • Tomato and citrus juices
    • Mustard and ketchup
    • Vinegar
    • Any other acidic juices or fruits
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How do I know I have heartburn?

Common symptoms of heartburn include:

  • Burning pain or sensation in your chest that rises to your throat

  • Burning pain or sensation that worsens when lying down or bending over

  • An awful acidic taste in your mouth (that feels like dragon breath) or bad breath

Sometimes people confuse heartburn symptoms with a heart attack. So here are some signs of a heart attack:

  • Chest discomfort
  • Discomfort or pain in one or both arms, neck, jaw, or stomach
  • Shortness of breath
  • Lightheadedness
  • Cold sweats
  • Nausea

Those that experience a heart attack may feel pain or discomfort in their chest that lasts longer than a few minutes or may go away and come back. This usually feels like a squeezing, fullness, or an uncomfortable pressure.

Pharmacist TIP: If your heartburn symptoms seem worse or different than usual, get medical attention immediately. Do not wait for any reason. Call 911 and get emergency medical help.

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What are common side effects of Nexium?

Watch out for the following possible side effects:

  • Nausea
  • Diarrhea
  • Gas
  • Constipation
  • Headache
  • Drowsiness
  • Dry Mouth
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Where is Nexium manufactured?

We found packaging of OTC Nexium sold in the U.S. showing that it is made in France.

Packaging of U.S.-sold prescription Nexium shows it is manufactured by AstraZeneca in Sweden.

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Comments
I only need 20mg Esomeprazole which Anthem just stopped covering. What's the best way to purchase this in bulk to save money?
I need 20 mg esomeprazole since Anthem stopped covering my dosage. What's the best way to purchase this in amounts that will help me save the most.
If you need brand name nexium your best bet is Sams club. You need the $100/year membership card to get the discount. If you use the astra zeneca discount card with the purchase ( a lot of the time the pharmacist will find it and apply it for you) you can get 30 pills for 70 dollars. Brand name nexium at the other pharmacies run about $160 for 30 pills. Other wise the generic or over the counter will run you $30 a month.
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