There are a variety ofheartburnmedicines available over the counter to ease symptoms. If these don't help enough, talk to your doctor about what else might help -- in addition to lifestyle changes. Your doctor may want to see if gastroesophageal reflux disease, or GERD, is the cause of your symptoms.
Nonprescription medications used to treat heartburn include:
Antacids for Heartburn
Antacids neutralize stomach acid to cut down on heartburn, sour stomach, acid indigestion, and stomach upset. Some antacids also contain simethicone, an ingredient that helps your body get rid of gas. Some antacids contain ingredients that can cause diarrhea, such as magnesium, or constipation, such as aluminum.
Examples of antacids include:
- Aluminum hydroxide gel
- Calcium carbonate(Alka-Seltzer,Tums)
- Magnesium hydroxide (Milk of Magnesia)
- Gaviscon, Gelusil, Maalox, Mylanta, Rolaids
- Pepto-Bismol
You should take antacids exactly as directed by your doctor or according to the package label. If you use the tablets, chew them well before swallowing for faster relief.
Be sure to follow the directions on the label so you don't overdose or overuse antacids. Side effects include constipation, diarrhea, changes in the color of bowel movements, and stomach cramps.
Acid Reducers for Heartburn
There are two types of drugs that cut down on the production of acid in the stomach: histamine antagonists (H2 antagonists or H2 blockers) and proton pump inhibitors (PPIs).
Examples of H2 blockers available over the counter include:
- Cimetidine (Tagamet HB)
- Famotidine (Pepcid AC, Zantac 360)
- Nizatidine (Axid, Axid AR)
Note: The H2 blocker ranitidine,which was in older Zantac products,was removed from the market in 2020 after it wasfound to contain a cancer-causing agent.
The proton-pump inhibitors esomeprazole (Nexium 24HR), lansoprazole (Prevacid 24HR), and omeprazole (Prilosec OTC) are sold over-the-counter to treat frequent heartburn (two or more times per week) for 14 days. These types ofmedicines are also available as higher-strength prescriptions. Take them according to the directions on the package or as advised by your doctor.
If these medications don't relieve your symptoms, or if your heartburn symptoms get worse or last for longer than 2 weeks, you should see your doctor.
Combination Antacid/Acid Reducer for Heartburn
Pepcid Complete combines the acid-neutralizing capability of an antacid and the acid-reducing actions of an H2 blocker. Zegerid OTC combines a proton-pump inhibitor with sodium bicarbonate.
Prescription Medication for Acid Reflux
H2 blockers. In prescription form (usually higher dosesthan the over-the-counter versions), H2 blockers can generally relieve heartburn and treat reflux, especially if you’ve never had treatment before. These drugs are particularly useful at alleviating heartburn but may not be as good for treatingesophagitis (inflammation that occurs in theesophagus) that is the result of GERD.
Histamine stimulates acid production, especially after meals, so H2 blockers are best taken 30 minutes before meals. They can also be taken atbedtime to suppress nighttime production of acid. Examples of prescription H2 blockers:
- Cimetidine (Tagamet HB)
- Famotidine (Pepcid AC, Zantac 360)
- Nizatidine (Axid, Axid AR)
Side effects can includeheadache,abdominal pain,diarrhea,nausea, gas,sore throat,runny nose, anddizziness.
Proton pump inhibitors. Depending on the source of your heartburn or reflux, your doctor can prescribe drugs that block acid production more effectively and for a longer period of time than the H2 blockers, namely the family ofmedications doctors call proton pump inhibitors. PPIs are best taken an hour before meals. They include:
- Dexlansoprazole (Dexilant)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Omeprazole (Prilosec, Zegerid)
- Pantoprazole (Protonix)
- Rabeprazole (Aciphex)
Most doctors do not believe that one drug is significantly more effective than the others inmanaging GERD. These medications are also good for protecting the esophagus from acid so that esophagealinflammation can heal.
Side effects can includeheadache, diarrhea, abdominal pain,bloating,constipation,nausea, and gas.
Promotility agents. These work by stimulating the muscles of the gastrointestinal tract, which may help prevent acids from staying in thestomach too long, and strengthening the lower esophageal sphincter, reducing reflux into the esophagus.Metoclopramide(Reglan) is a promotility agent occasionally used to treat heartburn associated with GERD. The side effects of Reglan can be serious and may include drowsiness,fatigue, diarrhea, restlessness, and movement problems.
So Which Works Best for Heartburn?
All of these over-the-counter medicines, to a varying degree, can relieve the symptoms of heartburn. If you have more severe heartburn symptoms that these medications don't relieve, or if you've been using these medicines for more than 2 weeks, call your doctor. You may need a stronger prescription medicine and tests to see what's causing your symptoms.
