Gastroesophageal reflux disease (GERD) requires ongoing treatment. A doctor may prescribe medications to manage symptoms or recommend over-the-counter (OTC) options like antacids, H2 blockers, or proton pump inhibitors.

OTC drugs for GERD may help in different ways. Some offer immediate relief if you have severe symptoms of heartburn, while others help to prevent those symptoms from returning.

Lifestyle changes, like eating fewer fatty and spicy foods, are often a general recommendation for heartburn symptoms. However, they may not work for everyone, especially if you have severe GERD.

If lifestyle changes don’t improve your symptoms within a few weeks, OTC medications may help.

Learn more about treatments for GERD.

Heartburn is a symptom of acid reflux, which occurs when stomach acid flows up into the esophagus (food pipe).

Doctors often suggest antacids as the first line of treatment for minor heartburn. Antacids can reduce heartburn by neutralizing acid in your stomach. They typically work within minutes of taking them, offering more immediate relief than other GERD treatments.

Antacids have different ingredients. They may contain aluminum, magnesium, calcium, or some combination of these substances.

You can find antacids as chewable or dissolving tablets. Some brands are available as liquids or gummies.

Common OTC antacids in the United States include:

  • Alka-Seltzer
  • Gelusil
  • Maalox
  • Mylanta
  • Pepto-Bismol
  • Rolaids
  • Tums

Antacids may cause side effects such as diarrhea and constipation, which are more common if you use them frequently. It is important to follow the dosage instructions on the package and a doctor’s recommendation.

Using antacids daily or to treat severe symptoms is not recommended.

Read more about heartburn relief.

Other OTC medications can treat GERD symptoms, like heartburn, by reducing the amount of acid your stomach produces. These types of drugs are also available as prescriptions for more severe cases of GERD.

H2 blockers

H2 blockers reduce the amount of acid produced in your stomach to lower the chance of recurring heartburn. Typically, they start to work within 1–3 hours of taking them and they can provide symptom relief for 8–12 hours.

Over-the-counter H2 blockers include:

  • cimetidine (Tagamet HB)
  • famotidine (Pepcid AC)
  • nizatidine (Axid, Axid AR)

H2 blockers may lead to side effects such as:

  • headache
  • constipation
  • diarrhea
  • nausea
  • vomiting

Proton pump inhibitors (PPIs)

Proton pump inhibitors (PPIs) are the most potent drugs for reducing acid production, particularly if you have frequent heartburn.

Most PPIs come in pill form. Many are available by prescription only, but a few are available OTC, including:

PPIs may cause:

  • diarrhea
  • nausea
  • vomiting
  • pain in your abdomen
  • upset stomach
  • headache

Severe PPI side effects are less common and may include an increased risk of pneumonia, bone fracture, and, rarely, hypomagnesemia (low magnesium levels), which may be life threatening.

Some people may use a combination of antacids, H2 blockers, and PPIs to manage acid reflux and prevent recurrences.

Combination therapy may increase the chance of side effects, such as diarrhea or constipation.

A prescribing doctor can explain the potential side effects and benefits of using more than one OTC medication for GERD.

The severity of your GERD symptoms will help a doctor determine if and which OTC treatment is best for you.

Antacids are often indicated for mild heartburn. H2 blockers and PPIs may be preferred for frequent heartburn.

PPIs are typically more effective than H2 blockers in treating GERD and severe heartburn.

OTC H2 blockers and PPIs are effective but may not be enough for some cases of GERD. They have lower drug concentrations (dosage) than their prescription versions. OTC H2 blockers and PPIs are safe for short-term relief of minor to moderate discomfort.

If these OTC medications do not improve your GERD symptoms, a doctor can explore other management options, including lifestyle changes and natural strategies for indigestion, ulcers, and heartburn like:

If OTC drugs and natural strategies don’t work, prescription medications may provide relief from GERD symptoms. Certain prescription-strength medications, such as prescription PPIs, can also help heal damage to the esophagus caused by acid reflux.

Talking with a healthcare professional may help clarify what’s the best GERD treatment for your needs.

Frequent, severe symptoms may be a sign of a more serious problem, that could worsen over time if left untreated.

You may want to ask the medical professional these questions:

  • What lifestyle changes could reduce my symptoms?
  • How long will it take for a natural strategy to offer relief?
  • Which OTC medications should I consider?
  • If I have other chronic conditions or risk factors, which OTC medications should I avoid?
  • Would a prescription GERD medication work better for me?
  • Would I need to take it regularly or just as needed?
  • Would OTC GERD medications interact with any of the other medications or supplements I take?
  • How and when should I take my GERD medication?
  • What red flags and side effects should I be aware of that may require medical care?

OTC medications may help relieve mild to moderate symptoms of GERD, particularly heartburn. Antacids, H2 blockers, and PPIs are all available over the counter.

Antacids are fast-acting drugs that neutralize stomach acid and provide immediate relief for mild-to-moderate symptoms. H2 blockers or PPIs may help with recurrent and more severe symptoms. These work by reducing the amount of acid your stomach produces. They can prevent symptoms from coming back.

If you continue to experience GERD symptoms after taking OTC medications, a doctor may recommend switching to prescription medications.