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Heartburn occurs when stomach contents flow back up into the esophagus—the muscular tube that carries food and liquids from the mouth to the stomach. Also called acid indigestion, heartburn is an uncomfortable, burning feeling in the mid-chest, behind the breastbone, or in the upper part of the abdomen—the area between the chest and the hips. This feeling occurs because the stomach’s digestive juices contain acid. Sometimes people with this problem can taste food or acidic fluid in the back of the mouth. What are my OTC treatment options?There are three classes of OTC medications for the treatment of heartburn. AntacidsAntacids relieve heartburn (indigestion). They work by changing the stomach acid that causes heartburn. Common OTC antacids include: Histamine-2 (H2) blockersH2 blockers relieve and prevent heartburn and work by reducing the amount of acid produced by the stomach. Typically, they start to work within one to three hours and provide acid-suppression for several hours. Because acid reducers may interact with certain other medicines, ask your doctor or pharmacist before use if you are taking a prescription drug. Common OTC H2-blockers include:
Proton pump inhibitors (PPIs)OTC PPIs treat frequent heartburn (occurs 2 or more days a week) and are not intended for immediate relief of heartburn, as they may take one to four days for full effect. In contrast, prescription PPIs are used to treat conditions like gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. PPIs work by reducing the amount of acid produced by the stomach. Because acid reducers may interact with certain other medicines, ask your doctor or pharmacist before use if you are taking a prescription drug. OTC PPIs are only intended for a 14-day course of treatment and can be used up to three times per year.
How do I use these drugs safely and effectively?
More Safety InformationAntacids
Proton Pump Inhibitors (PPIs)GeneralIf you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online or by phone (1-800-332-1088). More Consumer InformationAntacids
Proton Pump Inhibitors (PPIs)H2-Blockers
Regulatory InformationIn April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with their doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with their healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA’s guidance. To treat acid reflux, a person has several over-the-counter (OTC) and prescription options to choose from. Medications for acid reflux offer either fast acting or long-term relief to the pain. In some cases, a doctor may recommend using combinations of medication. This article looks at the different types of medicine for acid reflux, how to take them, and when to see a doctor.
According to the American College of Gastroenterology (ACG), acid reflux or gastroesophageal reflux (GER) occurs when acid from the stomach flows into the esophagus. The result is a burning sensation in the middle of the chest. It may also cause an acidic taste in the mouth and burning in the throat. A person may experience these symptoms for a few hours. People may know this sensation as heartburn. Although many people experience heartburn occasionally, if it occurs two or more times a week, they may have gastroesophageal reflux disease (GERD). A person experiences heartburn when stomach fluids remain in the esophagus long enough to damage its lining. Find out more about the differences between heartburn and acid reflux here. When treating acid reflux, doctors attempt to:
Some lifestyle changes the ACG recommend include:
There are a few different types of OTC medications for acid reflux: AntacidsAccording to one 2020 article, antacids work by neutralizing the acid present in a person’s stomach. According to the United Kingdom’s National Health Service (NHS), antacids can provide relief from symptoms for a couple of hours. However, they do not treat the underlying cause of acid reflux, and the NHS do not recommend long-term use. Some examples of antacids include:
A pregnant person can safely take antacids that contain aluminum salts. Though they are generally safe for short-term use, there are some risks associated with taking antacids continually. Chronic use of aluminum hydroxide antacids may increase the risk of toxicity in infants and those experiencing renal failure. Symptoms may include:
Chronic use of calcium carbonate may result in:
H2 receptor blockersH2 receptor blockers are a type of medication that researchers initially developed for treating peptic ulcers. The body can rapidly absorb H2 blockers, providing acid-suppression that can last several hours. According to a 2018 article in the journal, LiverTox, H2 receptors block histamine type 2 receptors in the stomach. By blocking the receptors, the medication slows or reduces the amount of acid the stomach produces. The ACG state that H2 blockers improve heartburn symptoms and help the esophagus lining to heal. However, this may require a higher dosage. According to the International Foundation for Gastrointestinal Disorders, H2 receptor blockers include:
RanitidineSince April 2020, the FDA have requested the removal of ranitidine from the market in the United States due to the unacceptable levels of NDMA, which is a potential carcinogen. Those who are taking ranitidine should stop taking it and talk to a healthcare provider about an alternative medication. They should dispose of the product as per the product’s instructions. Some potential side effects of H2 blockers include:
Proton pump inhibitorsProton pump inhibitors (PPI) are a type of medication that reduces the amount of acid a person’s stomach makes. The state that PPIs are more effective than H2 blockers. They can also heal the esophageal lining. The Food and Drug Administration (FDA) state that a person can take OTC PPIs for 14 days, up to three times a year. Two OTC examples of PPIs include:
Though generally safe and effective for long term use, there are potential side effects from using a PPI. According to the International Foundation for Gastrointestinal Disorders, some potential side effects include:
If OTC medications are not effective, a person may consider talking to their doctor about prescription options. Some prescription medications include: ProkineticsProkinetics are medications that help the stomach process food faster. According to the NIDDK, some examples include:
Though generally safe, prokinetics do not mix well with all medication. They can also cause side effects such as:
PPIsLike the OTC versions, prescription-strength PPIs reduce the amount of acid the stomach produces. The difference tends to be in the strength of the dose and offering of approved medications. Some examples of prescription-strength PPIs include:
H2 receptor blockersSimilar to the OTC versions, H2 receptor blockers block histamine receptors in the stomach. This causes a reduction in the production of stomach acid. The main differences in the prescription forms are an increase in the dose and strength. The higher dose can help the esophageal lining to heal. According to the ACG, 50% of people who take prescription-strength H2 blockers twice a day stop experiencing symptoms. They can also help maintain remission in 25% of those with GERD. A person may need to use a combination of medications to treat their acid reflux effectively. Antacids, PPIs, and H2 blockers all work in slightly different ways, and according to the NIDDK, a person may need to try a combination of medication to help control symptoms. A person should use caution when combining or taking multiple medications. A doctor can advise people on the safety of using acid reflux medications based on their health conditions and other medications. Sometimes, certain medications may not create the desired effects. According to an older study, researchers found that taking H2 inhibitors with PPIs did not produce any greater effect in reducing symptoms. The main difference between OTC and prescription-strength medication is the size of the doses. A person should talk to their doctor about prescription medications if OTC medication is not working for them. According to the ACG, different medications can provide different results: A person should talk to their doctor if they have persistent or frequent acid reflux. Frequent or intense heartburn may be a sign a person has gastroesophageal reflux disease (GERD). According to the NIDDK, GERD is a more severe form of GER. A person may need additional treatment, such as surgery, if medications and lifestyle changes do not work. There are several medication options for people seeking to control their acid reflux. Options include both OTC and prescription medications. A person should talk to a doctor if they have frequent acid reflux that OTC and lifestyle changes do not appear to help. A person should also talk to their doctor about taking new medication. Last medically reviewed on September 4, 2020 |
What is the medicine for acid reflux?
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