Dexilant is dexlansoprazole, a proton pump inhibitor in 30 mg and 60 mg capsules, used for reflux, heartburn and healing inflammation of the oesophagus. Its distinguishing feature is a dual-release capsule that gives two separate peaks of acid suppression from one daily dose — which means, unusually for this class, it can be taken at any time of day.
What is Dexilant?
The South African Medicine Price Registry lists Dexilant 30 mg and Dexilant 60 mg as Schedule 4 capsules containing dexlansoprazole.
Dexlansoprazole is a proton pump inhibitor (PPI). The cells lining the stomach have a molecular pump that moves acid into the stomach; a PPI switches those pumps off, and production only resumes as new pumps are made over a day or two.
Two things make Dexilant different from the other PPIs.
It is the single active half of lansoprazole — the more active of two mirror-image forms, isolated. This gives more predictable levels and longer duration.
It uses dual delayed release. The capsule contains two kinds of granule that dissolve at different points in the gut — one releasing at one to two hours, the second at four to five. The result is two separate peaks of drug from one capsule, extending acid suppression well into the evening and overnight.
That is why Dexilant can be taken at any time of day, with or without food. This is a genuine and unusual advantage. Every other PPI — omeprazole, pantoprazole, esomeprazole, lansoprazole — must be taken 30 to 60 minutes before breakfast, and taking it at the wrong time is the commonest reason a PPI seems not to work. Dexilant removes that problem entirely.
Where the strengths are used: 60 mg is typical for healing erosive oesophagitis — where acid has actually damaged the lining — while 30 mg is used for maintenance and for reflux without erosion.
If you cannot swallow the capsule, open it, sprinkle the granules on soft food and swallow immediately. Do not chew or crush them — that destroys the release system that is the point of the product.
What is Dexilant commonly used for?
- Gastro-oesophageal reflux disease (GORD) — heartburn, acid rising into the throat, burning behind the breastbone after meals or at night.
- Healing erosive oesophagitis, where the reflux has inflamed or eroded the lining of the oesophagus. This is the 60 mg indication.
- Maintaining healing, and keeping symptoms controlled long term at 30 mg.
- Night-time and evening reflux, where the extended action is particularly useful.
- Reflux not controlled on another PPI, as a step across.
- Protecting the stomach lining in people at risk from anti-inflammatories.
Worth knowing:
It is not an antacid and does not work in minutes. It reduces acid being made, taking a day or two for full effect. For breakthrough symptoms while it settles in, an antacid such as Gaviscon is what actually helps.
Reflux treatment is often meant to be finite. Courses of four to eight weeks, then a step down or stop, are common. PPIs get repeated for years without review far more often than they should be. If you have been on one over a year without discussion, ask whether it is still needed.
Stopping suddenly after long use causes rebound acid. The stomach compensates by making extra pumps, so stopping dead causes a week or two of worse symptoms. That is rebound, not the original problem returning — which is why long-term users should step down gradually.
Lifestyle measures genuinely work: smaller meals, not lying down within three hours of eating, raising the head of the bed, losing excess weight, and cutting back alcohol, smoking and trigger foods.
How Dexilant fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Proton pump inhibitors | Dexlansoprazole (Dexilant), omeprazole, pantoprazole, esomeprazole | Strongest acid suppression; slow onset |
| Dual-release PPI | Dexilant | Two peaks per capsule; any time of day |
| H2 blockers | Famotidine | Weaker but faster; useful at night |
| Antacids | Gaviscon, Rennies | Neutralise acid present; act in minutes |
| Antispasmodics | Hyoscine (Hyospasmol) | Cramping, not acid |
| Anti-nausea | Metoclopramide (Adco-Contromet) | Nausea and stomach emptying |
Dexilant is generally a second choice rather than a first — not because it works less well, but because it costs considerably more than generic omeprazole or pantoprazole. Its value is in the timing flexibility and the extended evening cover, which matter most to people whose reflux is nocturnal or who cannot reliably take a tablet before breakfast.
See the digestive and stomach medicines hub.
What to check before using Dexilant
Tell your doctor or pharmacist if you:
- Have liver disease, where the dose may need limiting.
- Take HIV medicines, particularly atazanavir, rilpivirine or nelfinavir. Reduced stomach acid substantially lowers their absorption — this interaction matters clinically.
- Take warfarin, methotrexate, digoxin, clopidogrel, tacrolimus, or antifungals such as ketoconazole or itraconazole.
- Take iron supplements or vitamin B12 — long-term acid suppression reduces absorption of both.
- Have osteoporosis or fracture risk.
- Are due for a gastroscopy or an H. pylori breath test. PPIs cause false negatives and are usually stopped around two weeks beforehand.
- Are pregnant or breastfeeding.
Do not treat alarm symptoms with acid suppression. See a doctor promptly rather than starting or continuing a PPI if you have difficulty or pain swallowing, unintentional weight loss, persistent vomiting, vomiting blood, black tarry stools, or anaemia, or if new indigestion starts over the age of 45 to 50. A PPI can quieten the symptom while something more serious continues underneath.
Practical points:
- Take it once daily, at any time, with or without food.
- Swallow the capsule whole, or open it onto soft food and swallow immediately without chewing.
- Complete the course even once symptoms settle — the lining takes weeks to heal.
Possible cautions and when to ask a pharmacist or doctor
Dexlansoprazole is generally well tolerated. The commonest effects are diarrhoea, wind, abdominal pain, nausea and headache, usually mild.
Longer-term use carries modest risks shared across the class: low magnesium, reduced vitamin B12 and iron absorption, a small increase in fracture risk, and more gut infections including C. difficile, since stomach acid is part of the body’s defence. Reasons to review the need periodically, not to abandon a PPI that is required.
Seek medical advice promptly for:
- Severe or persistent diarrhoea, especially watery or bloody, or with fever — during or after treatment.
- Muscle cramps, twitching, palpitations, weakness or unsteadiness — possible low magnesium, which develops over months to years.
- A rash, particularly on sun-exposed skin, or a rash with joint pain.
- Reduced urine output, swelling or unusual tiredness — possible kidney inflammation.
- Any alarm symptom listed above.
Get emergency help for vomiting blood, black tarry stools, severe chest pain, or swelling of the face, lips or tongue with difficulty breathing.
Chest pain deserves a separate word. Reflux and heart pain feel similar. Do not assume new or severe chest pain is heartburn — particularly with breathlessness, sweating, nausea, pain spreading to the arm, neck or jaw, or onset with exertion. Get it assessed.
Contact your doctor if symptoms do not improve within two to four weeks, if they return quickly after a course, if you have been taking a PPI over a year without review, or if you want to stop after long use — so it can be reduced gradually.
Related medicine guides
Frequently asked questions
What is Dexilant 60 mg used for? Healing erosive oesophagitis — reflux that has inflamed or eroded the lining of the oesophagus — and reflux symptoms generally.
What is Dexilant 30 mg used for? Maintaining healing and controlling reflux symptoms long term, and reflux without erosion.
When should I take it? Any time of day, with or without food. This is its main practical advantage — other PPIs must be taken before breakfast.
How is it different from omeprazole or pantoprazole? It is the single active half of lansoprazole in a dual-release capsule that gives two peaks from one dose, extending cover into the evening. It also costs considerably more.
How long before it works? A day or two for full effect. An antacid helps in the meantime.
Can I open the capsule? Yes — sprinkle the granules on soft food and swallow immediately. Do not chew or crush them.
Can I stop when I feel better? Complete the prescribed course. After long-term use, step down gradually rather than stopping dead, or you will get a rebound of extra acid.
Is long-term use safe? For people who need it, generally yes, but it should be reviewed periodically. Long-term use is linked to low magnesium, reduced B12 and iron absorption, and small increases in fracture and gut infection risk.