Which Acid Reflux Medicine Should I Use?

Acid reflux happens when what you ate comes back up through your esophagus into your throat and mouth. It’s normal to experience it now and again, but you need to talk to your healthcare provider if you have chronic acid reflux, which is also known as gastroesophageal reflux disease (GERD).

Research estimates that about 20% of people in the United States have GERD.

If you have symptoms of acid reflux, you may be able to manage it with lifestyle changes and over-the-counter medications. However, some cases of acid reflux require prescription or other remedies.

Man with indigestion at breakfast table

Image Source / Getty Images

Over-the-Counter (OTC) Medications

A wide variety of OTC medications are available to help with your acid reflux symptoms. However, if you have symptoms that will not go away with these medications, your healthcare provider may prescribe medicines for your condition.

Symptoms of acid reflux can be uncomfortable, and they may include:

  • Heartburn
  • Nausea
  • Chest pain
  • Problems or pain while swallowing
  • Complications in the mouth, throat, or lungs, such as a chronic cough or hoarseness

Antacids

Antacids are OTC medications that neutralize stomach acid from indigestion. They are the first line of defense against acid reflux. You can consume antacids by chewing tablets, dissolving the remedy in water, or swallowing a liquid that helps coat the stomach. 

Common brands include: 

  • Gaviscon (aluminum hydroxide magnesium)
  • Pepto Bismol (bismuth subsalicylate)
  • Tums or Rolaids (calcium carbonate)
  • Alka-Seltzer (sodium bicarbonate)

Antacids can help, but you shouldn’t use them every day or for severe symptoms, except after discussing it with your healthcare provider. Potential side effects of antacids include:

  • Magnesium-containing brands may cause diarrhea.
  • Calcium or aluminum may cause constipation.
  • Rarely, brands with calcium may cause kidney stones.

Antacid Warnings

You should tell your healthcare provider if you’re taking antacids daily or most days.

  • If you take large amounts of antacids that contain aluminum, you may be at risk of calcium loss, which can lead to osteoporosis.
  • Antacids can interrupt the absorption of other medications. It’s recommended that you take other medications one hour before or four hours after taking antacids. 

H2 Receptor Blockers

Histamine-2 (H2) receptor blockers are stomach acid production blockers. They may work in the short or long term for indigestion and a stomach or peptic ulcer.

They also help heal the esophagus from GERD. It takes 30 to 90 minutes for these medications to work, and symptoms may improve up to 24 hours later.

The best times to take H2 receptor blockers are:

  • Generally with the first meal of the day
  • Before the evening meal, if necessary
  • Before bedtime

Common brands of H2 receptor blockers include:

  • Tagamet HB (cimetidine)
  • Pepcid AC (famotidine)
  • Axid AR (nizatidine)
  • Zantac 75 (ranitidine)

FDA Warnings

The Food and Drug Administration (FDA) announced the recall of all medications containing the ingredient ranitidine. They also advised against taking OTC ranitidine, and suggested speaking with a medical professional if you've been taking prescription ranitidine and before stopping medication.

Side effects are rare, but they can include:

  • Headache
  • Diarrhea
  • Dizziness
  • Rashes
  • Enlargement of breast tissue in men

When to See a Healthcare Provider

People with kidney problems should not use famotidine before consulting a healthcare provider.

It is also not recommended for people who:

  • Are pregnant or breastfeeding
  • Take medications that may interact with it
  • Have symptoms that are worsening or not improving
  • Are experiencing side effects
  • Have any other underlying conditions that are worsening

Proton Pump Inhibitors (PPIs)

Proton pump inhibitors (PPIs) prevent specific cells from pumping stomach acid into the stomach. They are better at treating GERD symptoms than H2 receptor blockers, and they work to heal the esophageal lining in most people with GERD.

Common brands of PPIs include:

  • Prilosec (omeprazole)
  • Prevacid (lansoprazole)
  • Protonix (pantoprazole) 
  • Aciphex (rabeprazole) 
  • Nexium (esomeprazole) 
  • Dexilant (dexlansoprazole) 

Side effects of PPIs can include:

  • Increased risk of cirrhosis and liver cancer
  • Nutritional deficiencies
  • Compounding effects with continued use

PPI Warnings

OTC PPIs should not be used for longer than 14 days to treat acid reflux heartburn. Also, no more than three 14-day treatments should be used within one year. PPI use is associated with increased risk of vitamin and mineral deficiencies, mainly vitamin B12, vitamin C, calcium, iron, and magnesium metabolism. However, the risk is low in the general population.

Prescription Medications

If you have symptoms that are not resolving with OTC medications, you may need prescriptions from your healthcare provider.

Prokinetics

Prokinetics are prescription acid reflux remedies that can help control acid reflux while strengthening the lower esophageal sphincter, where your esophagus meets your stomach, while also causing the stomach contents to empty faster. Due to their side effects and adverse reactions, though, these medications are used less often than other remedies. 

Common brands of prokinetics include:

  • Propulsid (cisapride)
  • Reglan (metoclopramide)
  • Urecholine (bethanechol)
  • Motilium (domperidone)

Side effects of these medications can include:

  • Headache
  • Nausea
  • Diarrhea
  • Abdominal pain
  • Cramps 

FDA Warnings

This class of medication has several serious warnings. Metoclopramide-containing drugs may cause:

  • Tardive dyskinesia (which causes involuntary movements of the tongue, lips, face, trunk, and extremities)
  • Parkinson's symptoms
  • Restlessness
  • Neuroleptic malignant syndrome
  • Depression 
  • Hypertension (high blood pressure)
  • Fluid retention
  • Sexual dysfunction 

Discontinued and reserved options of prokinetics include:

  • Cisapride-containing prokinetics were removed from the market in 2000 for severe adverse cardiac side effects like irregular heartbeat (arrhythmia).
  • Urecholine (bethanechol) was also discontinued in 2000.
  • Motilium (domperidone) is available only for those with GERD who have not responded to standard treatments.

H2 Receptor Blockers

A prescription H2 receptor blocker provides a higher dose of active medication. This may be recommended if you haven't found relief with the OTC options or if you are taking OTC H2 receptor blockers on a regular basis, such as most days for two weeks or more. They may also be prescribed for people with peptic ulcer. 

Proton Pump Inhibitors (PPIs)

Prescription PPIs are also stronger than their OTC counterparts, and are generally considered for chronic cases or longer-term usage like a year or more. Talk to your healthcare provider to weigh the risks and benefits.

Acid Reflux Medications Options
Drug How they work Relieve symptoms? Heal esophagus? Prevent GERD?  
Antacids Neutralize acid  
H2 Blockers (OTC) Mildly suppress acid  
H2 Blockers (Prescription) Moderately suppress acid  
PPIs Significantly suppress acid
Prokinetics Promote emptying of stomach contents  

Home Remedies

Some herbal ingredients in many teas may help with digestive issues, including heartburn. There is not enough scientific evidence to confirm their effectiveness, though. They include:

  • Catnip (mint family)
  • Fennel
  • Marshmallow root
  • Papaya tea 

The following ingredients, however, do have some research supporting their use for acid reflux and other digestive issues.

Peppermint oil may actually make acid reflux worse. It has a relaxing effect on your lower esophageal sphincter and may encourage digestive backup.

Licorice

Licorice has long been used in herbal medicine for gastric inflammation. Research indicates that using licorice (tea and chews) increases the mucous coating of the esophagus lining, which helps reduce stomach irritation.

Ginger

Ginger root in chews or teas is traditionally used for acid reflux, and it has shown prokinetic effects in animal studies. It helps with gastric emptying and digestive tract movement.

Recommended doses range from 1 gram to 1.5 grams of the dried herb per day (tea, chews, or spice), given 30 minutes to one hour before a meal. Start with the lowest dose and adjust as needed.

Exceeding the recommended dose of ginger can lead to adverse reactions. Research shows that 5 grams a day can cause gastric upset, such as heartburn, abdominal discomfort, and diarrhea. People with blood disorders should not use this home remedy without first talking to their healthcare provider due to its association with blood platelet count reduction.

Kudzu

Kudzu has many esteemed properties, some of which are anti-inflammatory. Its roots are found in dietary supplements, and its leaves contain properties useful for digestive disorders.

Melatonin

Research shows that melatonin is beneficial for more than a good night’s sleep. It has protective properties that can help support the upper GI tract mucosa, and may be useful for regulating digestive mobility, such as stomach emptying. It has also shown anti-inflammatory effects.

Self-Care

Making lifestyle changes that will help you prevent acid reflux and reduce the need for medication is a form of self-care. Get to know your body’s reaction to certain foods by keeping a journal.

Heartburn and Acid Reflux Food Triggers

While everyone is different, there are certain foods that tend to trigger acid reflux. These include acidic or spicy foods.

Other potential irritating foods include:

  • Coffee and tea
  • Chocolate
  • Beer, wine, and other forms of alcohol
  • Fried or greasy foods
  • Mint
  • Tomatoes and tomato-based foods

Lifestyle Changes

Research has shown that some behavioral changes may be helpful in reducing acid reflux. They include:

  • Avoiding eating before lying down for bed or a nap
  • Sleeping in a position that allows for head elevation
  • Losing weight, if necessary 
  • Avoiding secondhand smoke or quitting smoking

Summary

Acid reflux is quite common, and there are many remedies you can try to alleviate the uncomfortable symptoms. However, if you have chronic acid reflux or OTC medications are not helping, talk to your healthcare provider.

A Word From Verywell

No one likes having acid reflux. While we can deal with it every once in a while, when it becomes chronic, it changes our relationship with food. The associated symptoms hurt and take some pleasure out of enjoying certain foods. This is why you need to find the right acid reflux remedy not only to relieve the burn but also to heal the lining of your throat and esophagus and prevent it from happening again.

If you're taking antacids or other OTC medications on a regular or frequent basis, reach out to a healthcare provider to discuss other options like prescription medications and lifestyle changes that may benefit you.

Was this page helpful?
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014 Jun;63(6):871-80. doi:10.1136/gutjnl-2012-304269

  2. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Treatment for GER & GERD. Updated July 2020.

  3. MedlinePlus. Taking antacids. Updated November 1, 2018.

  4. MedlinePlus. H2 blockers. Updated March 3, 2019.

  5. U.S. Food and Drug Administration. FDA requests removal of all ranitidine products (Zantac) from the market. Published April 1, 2020.

  6. Song HJ, Jiang X, Henry L, Nguyen MH, Park H. Proton pump inhibitors and risk of liver cancer and mortality in patients with chronic liver disease: a systematic review and meta-analysis. Eur J Clin Pharmacol. 2020 Jun;76(6):851-866. doi:10.1007/s00228-020-02854-8

  7. Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Ther Adv Drug Saf. 2013 Jun;4(3):125-133. doi:10.1177/2042098613482484

  8. Food and Drug Administration. FDA Drug Safety Communication: Possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors. Updated Match 8, 2017.

  9. Quigley EM. Prokinetics in the management of functional gastrointestinal disorders. J Neurogastroenterol Motil. 2015 Jul 3;21(3):330-336. doi:10.5056/jnm15094

  10. Food and Drug Administration. REGLAN (metoclopramide) tablets. Updated August 2017. 

  11. Miller JL. Cisapride to be taken off market, placed in controlled-access plan. American Journal of Health-System Pharmacy. 2000 May 1;57(9):834-834. doi:10.1093/ajhp/57.9.834

  12. Food and Drug Administration. How to request domperidone for expanded access use. Updated February 2, 2021.

  13. Food and Drug Administration. FDA Drug Safety Communication: Possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors. Updated Match 8, 2017.

  14. Harvard Health. Herbal remedies for heartburn. Updated February 15, 2021.

  15. Yeh AM, Golianu B. Integrative treatment of reflux and functional dyspepsia in children. Children (Basel). 2014 Aug 18;1(2):119-133. doi:10.3390/children1020119

  16. Son E, Yoon JM, An BJ, Lee YM, Cha J, Chi GY, Kim DS. Comparison among activities and isoflavonoids from pueraria thunbergiana aerial parts and root. Molecules. 2019 Mar 5;24(5):912. doi:10.3390/molecules24050912Melatonin

  17. Siah KT, Wong RK, Ho KY. Melatonin for the treatment of irritable bowel syndrome. World J Gastroenterol. 2014 Mar 14;20(10):2492-2498. doi:10.3748/wjg.v20.i10.2492

  18. Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014 Aug 6;5(3):105-12. doi:10.4292/wjgpt.v5.i3.105