Over-the-counter (OTC) medicines are drugs you can buy without a doctor’s prescription. There are 3 types of OTC medicines that treat heartburn and acid reflux.
- Antacids reduce the effects of acid in your stomach. They do this by neutralizing the acid. Antacids can provide fast, short-term relief. There are many different brands of antacids. They come in the forms of chewable tablets, dissolving tablets, and liquid.
- H2 blockers reduce the amount of acid your stomach makes. While they don’t relieve symptoms as quick as antacids, they do last longer. H2 blockers usually start to work within an hour. An OTC example is famotidine (brand name: Pepcid).
- Proton pump inhibitors (PPIs) reduce your body’s production of acid. They work well for heartburn that isn’t resolved by antacids or H2 blockers. It may take a little longer for a PPI to help your symptoms, but relief will last longer. Most forms start working in a few days. PPIs are most helpful for people who have chronic heartburn (more than 2 days a week). Omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid 24HR) are examples of OTC PPIs.
Path to improved health
To find out which medicine is right for you, talk to your family doctor. They can tell you about the benefits and risks. Antacids and acid reducers rarely cause side effects. If they do, the side effects usually are minor and go away on their own. These may include headaches, nausea, constipation, or diarrhea.
Talk to your doctor before taking antacids if you have kidney disease. You should avoid any antacid that contains calcium carbonate or aluminum hydroxide and magnesium carbonate unless your doctor recommends it.
Talk to your doctor before taking a proton pump inhibitor if:
- You are elderly or have immune system problems. PPIs can increase your risk for pneumonia.
- You are a postmenopausal woman. PPIs reduce calcium absorption and increase your risk for osteoporosis.
- You have been treated for a Clostridium difficile (C. diff.) infection in the past. PPIs may increase the risk that your infection returns.
If you are over the age of 55 and require long-term PPI treatment, your doctor may refer you for an EGD (esophagogastroduodenoscopy). This procedure examines the lining of the esophagus, stomach, and upper small intestine. If you have significant reflux, your doctor also may test you for a bacteria called H. pylori prior to trying you on PPIs.
Things to consider
Do not use more than 1 antacid or acid reducer at a time unless your doctor says it’s okay. Store all medicines up and away, out of reach and sight of young children. Keep medicines in a cool, dry place. This helps prevent them from becoming less effective before they expire. Do not store medicines in bathrooms, which often are hot and humid.
When to see the doctor
Let your doctor know how the OTC medicines work for you. If your symptoms do not improve or get worse, the doctor may suggest a prescription medicine. If possible, try not to take PPIs long-term. These can increase your risk of certain health conditions, such as osteoporosis, kidney disease, and dementia.
Tell your doctor if you have any of the following symptoms. They may be signs of a more serious problem.
- Bloody or black stools
- Bloody vomit
- Heartburn that has not improved after 2 weeks of treatment with OTC medicines
- Trouble swallowing or pain when you swallow
- Unplanned weight loss
If you have chest pain, shortness of breath, dizziness, and pain in your arms, you may be having a heart attack. Call 911 or go to the emergency room right away.
Questions to ask your doctor
- What type of OTC medicine is best for me to relieve heartburn and acid reflux?
- How much medicine can I take and how often?
- What are the side effects and risks of these OTC medicines?
- Are there any health conditions that prevent me from taking OTC medicines?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.