Many Americans use over-the-counter (OTC) drugs to treat minor gastrointestinal problems. In fact, OTC medicines are often among the initial treatments for:
- other symptoms of gastroesophageal reflux disease (GERD)
Some people have success treating their GERD symptoms with lifestyle changes including:
- losing weight
- stopping smoking
- eating fewer fatty foods
- avoiding spicy or acidic foods
These changes can sometimes be hard to maintain. They also may not be effective for everyone. Your doctor may recommend incorporating OTC treatments if your symptoms don’t improve within a few weeks. In many cases, a combination of lifestyle modifications and OTC medicines can effectively manage heartburn.
Three types of OTC medicines can help control GERD symptoms:
- H2 blockers
- proton pump inhibitors (PPIs)
Some people may use a combination of these medications to control acid reflux. However, you should talk to you doctor before combining antacids with other medications in order to prevent potentially negative side effects or complications.
Heartburn occurs when acid backs up from the stomach into the esophagus. This is called acid reflux. Antacids are often recommended as initial treatment to help soothe minor heartburn. They can help reduce acid reflux symptoms by neutralizing stomach acid. OTC medicines often combine different antacids using three basic salts—aluminum, magnesium, and calcium—with bicarbonate or hydroxide ions. Antacids are typically available as chewable or dissolving tablets. Some brands are available as liquids or gums as well.
Some common OTC antacids include:
Antacids sometimes cause side effects like diarrhea and constipation. These side effects are more common when antacids are used too frequently.
These medicines reduce acid production in your stomach. This lowers your chance of getting heartburn. H2 blockers act less quickly than antacids. However, they can provide relief from symptoms for a longer time period. H2 blockers usually start to work within an hour.
H2 blockers are available both as OTC products and by prescription. Some OTC H2 blockers include:
- cimetidine (Tagamet HB)
- famotidine (Calmicid, Fluxid, Pepcid AC)
- nizatidine (Axid, Axid AR)
- ranitidine (Tritec, Wal-Zan, Zantac 25, Zantac 75, Zantac 150)
According to the Temple University Digestive Diseases Center (TUDDC), these drugs are effective for about half of those with GERD symptoms. However, H2 blockers can sometimes cause side effects like:
PPIs block acid production. They’re the most powerful drugs for reducing stomach acid production. They’re usually the most effective treatment for GERD.
Many PPIs are available by prescription only. However, a few PPIs are available OTC. These include:
- lansoprazole (Prevacid 24HR)
- omeprazole (Losec, Omesec, Prilosec OTC)
- omeprazole with sodium bicarbonate (Zegerid)
PPIs are taken in pill form. They’re most appropriate for people with more frequent heartburn. PPIs have been associated with several side effects, including:
- abdominal pain
- upset stomach
Less common but more serious side effects have also been linked to PPI usage. These include an increased chance of pneumonia and bone fracture.
Any type of OTC medicine may cause harmful interactions with others. Talk to your doctor before starting any OTC drug.
The OTC forms of H2 blockers and PPIs have lower dosage levels than those available by prescription. These reduced-strength formulations have only been approved for temporary relief of minor discomfort. More severe or long-term symptoms should be treated by a physician.
OTCs have not been proven to heal esophageal damage caused by acid reflux. Only certain prescription-strength medicines, like PPIs, can make that claim.
Talk to your doctor if you have frequent symptoms and OTC treatments and lifestyle changes aren’t helping. A physician can help confirm your diagnosis and help develop an appropriate treatment plan. Treatment may include the use of prescription medicines. Surgery may be necessary in severe cases.
Frequent episodes of heartburn may be signs of a more serious problem. Such problems could worsen over time, if not effectively treated. Contact your doctor if you use an OTC medicine for GERD more than twice a week. You should also talk to a doctor if symptoms don’t improve with treatment.