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WITHDRAWAL OF RANITIDINE
In 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. This recommendation was made because unacceptable levels of NDMA, a probable carcinogen (cancer-causing chemical), were found in some ranitidine products. If you’re prescribed ranitidine, talk with your doctor about safe alternative options before stopping the drug. If you’re taking OTC ranitidine, stop taking the drug and talk with your doctor about alternative options. Instead of taking unused ranitidine products to a drug take-back site, dispose of them according to the product’s instructions or by following the FDA’s guidance.
Ranitidine, brand name Zantac, is now marketed as Zantac 360, which contains a different active ingredient (famotidine). Famotidine is in the same class as ranitidine and works the same way but has not been found to contain unacceptable levels of NDMA.
Over-the-counter (OTC) medications are often among the first people use to treat symptoms of gastroesophageal reflux disease (GERD), such as heartburn and regurgitation.
Different types of OTC drugs for GERD help in different ways. Some offer immediate relief, while others help to prevent symptoms from returning.
In this article, we detail the different OTC treatments available for GERD, how they help, and when you should see a doctor.
Some people can treat their GERD symptoms with lifestyle changes, like eating fewer fatty and spicy foods. However these changes may not work for everyone.
If you make lifestyle changes and your symptoms don’t improve within a few weeks, your doctor may suggest you try OTC treatments.
Heartburn is the result of acid reflux, which occurs when stomach acid flows up into the esophagus.
Doctors often suggest antacids as a first treatment to help soothe minor heartburn. These drugs help reduce symptoms by neutralizing acid in your stomach.
Antacids typically work within minutes of taking them, offering more immediate relief than other treatments.
Antacids contain aluminum, magnesium, calcium, or some combination of these substances. They’re typically available as chewable or dissolving tablets. Some brands are available as liquids or gummies as well.
Common OTC antacids include:
Antacids sometimes cause
Other OTC medications help treat GERD symptoms by reducing the amount of acid your stomach makes. Stronger versions of these drugs are also available with a prescription.
H2 blockers reduce the amount of acid produced in your stomach to lower your risk of heartburn. Typically, they start to work within an 1 to 3 hours of when you take them. This means they act more slowly than antacids. However, they can provide longer symptom relief, lasting 8 to 12 hours.
H2 blockers are available OTC and by prescription. The OTC H2 blockers include:
- cimetidine (Tagamet HB)
- famotidine (Calmicid, Fluxid, Pepcid AC)
- nizatidine (Axid, Axid AR)
H2 blockers can cause side effects such as:
Proton pump inhibitors (PPIs)
PPIs come in pill form. Many are available by prescription only, but a few are available OTC:
- lansoprazole (Prevacid 24HR)
- omeprazole (Losec, Omesec, Prilosec OTC)
- omeprazole with sodium bicarbonate (Zegerid)
- esomeprazole (Nexium)
PPIs may cause several side effects, including:
- pain in your abdomen
- upset stomach
Side effects are less common when using PPIs than H2 blockers, but they tend to be more serious when they occur. These include an
Some people may use a combination of antacids, H2 blockers, and PPIs to manage acid reflux and prevent recurrences.
However, combining them can cause side effects such as diarrhea or constipation in some cases.
Be sure to talk with your doctor before combining any OTC treatments for GERD with other medications.
The severity of your GERD symptoms will help to indicate which OTC treatment is best for you.
Antacids are typically the first-choice treatment for relieving mild heartburn. By neutralizing the acid in your stomach, these drugs can provide relief of the immediate effects of heartburn.
H2 blockers and PPIs reduce the amount of stomach acid your body produces, so they’re more helpful if you’re experiencing heartburn frequently.
These drugs take longer to start working but can prevent heartburn for
In more severe or recurrent heartburn cases, PPIs are typically
You may wonder if an OTC or prescription GERD medication would be better for you.
The OTC forms of H2 blockers and PPIs have lower dosage levels than the prescription versions. They’re safe to use for short-term relief of minor discomfort.
However, if OTC medications do not resolve your symptoms, or symptoms frequently return, you should speak with a doctor.
Prescription medications can provide stronger relief from GERD symptoms. Certain prescription-strength medications, such as prescription PPIs, can also help heal damage to the esophagus caused by acid reflux.
If you have GERD symptoms and aren’t sure what kind of medication to take, talk with your doctor. They can confirm whether you have GERD and develop a treatment plan that will work for you.
Frequent, severe symptoms may be a sign of a more serious problem. And they could get worse over time if left untreated.
Be sure to ask your doctor any questions you may have. These might include:
- What lifestyle changes could reduce my symptoms?
- Which kind of OTC medication would be best for me?
- Would a prescription GERD medication work better for me?
- Am I taking any medications that might interact with an OTC medication?
- How and when should I take my GERD medication?
Changes in your daily habits may help reduce GERD symptoms. Your doctor can suggest changes that might work for you, such as:
- losing weight
- quitting smoking
- eating fewer fatty foods
- avoiding spicy or acidic foods
OTC medications are often the first line of action against GERD. These drugs typically fall into three categories, antacids, H2 blockers, and PPIs.
Antacids are fast-acting drugs that neutralize stomach acid and provide immediate relief for mild-to-moderate symptoms. You should not use antacids
Should you experience severe or recurrent GERD symptoms, you may wish to take either H2 blockers or PPIs. These work by reducing the amount of acid your stomach produces. As a result, they can prevent symptoms from coming back. However, they provide less immediate relief than antacids.
If you continue to experience GERD symptoms after taking OTC medications, you should consult your doctor, who may prescribe stronger versions of these drugs.
Continual acid reflux may also be a sign of a more serious condition and you should not ignore it. A doctor can carry out tests to find out what may be causing your persistent symptoms. They can then recommend a suitable course of action.