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).

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.

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.

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)

Side effects are rare, but they can include:

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

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

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 

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.

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.

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.

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.