Need heartburn relief? Here are your medication options.
Most of us have experienced heartburn at one point or another: the burning, painful sensation in your chest or throat; the bitter or sour taste in your mouth; the bloating and belching.
Heartburn is incredibly common. According to the American College of Gastroenterology:
- 60 million Americans report experiencing heartburn at least once a month.
- As many as 15 million Americans experience symptoms every day.
What is heartburn?
Heartburn is a burning sensation you feel in your chest when acid from your stomach travels back into your esophagus and throat. It can be triggered by eating certain types of foods or drinking certain types of beverages, or it can be a side effect of medication.
Frequent heartburn (occurring more than twice a week) can be a symptom of chronic acid reflux known as gastroesophageal reflux disease (GERD).
The good news is there are many ways to treat and manage heartburn.
They include lifestyle changes like:
- Eating smaller meals
- Avoiding trigger foods, like spicy or fatty foods, foods with a tomato base, citrus fruits, chocolate, and peppermint
- Avoiding alcohol, coffee, and caffeinated drinks
- Sleeping on your left side
- Not going to bed on a full stomach
- Quitting smoking
“While lifestyle modifications are the first-line therapy for controlling symptoms, over-the-counter medications and long-term prescription medications are very effective,” said Emily McDonald, a registered pharmacist with Express Scripts® Pharmacy.
Here are medication options — both prescription and over-the-counter — that can help give you the heartburn relief you need.
Over-the-counter heartburn medications
Over-the-counter (OTC) heartburn medications are meant to treat heartburn for a short period and are typically taken for no longer than 14 days. There are three classes of OTC heartburn medications:
- Antacids: These are medications like Mylanta®, Rolaids®, TUMS®, Pepto-Bismol®, and Maalox®. Antacids work by neutralizing stomach acid so that you can get quick relief.
- You typically take an antacid after a meal, and it starts working within about 10 minutes.
- Side effects can include constipation, diarrhea, changes in color of bowel movement, or stomach cramps.
- Histamine-2 agonists (H2 blockers): These are medications like Tagamet® HB, Pepcid® Complete, Pepcid AC®, and Zantac 360°®. H2 blockers help reduce and stop the secretion of stomach acid.
- They are used to treat frequent heartburn (heartburn that occurs more than twice a week), but can only be taken continuously for up to 2 weeks unless directed to continue by a doctor.
- You typically take H2 blockers 30 minutes before meals or at bedtime. They start working within 1 to 3 hours and last for up to 12 hours.
- Side effects can include headache, diarrhea, constipation, and dizziness.
- Proton pump inhibitors (PPIs): These are medications like Prevacid® 24HR, Nexium® 24HR, and Prilosec® OTC. Like H2 blockers, these reduce and stop the secretion of stomach acid and are used to treat frequent heartburn.
- Unlike H2 blockers, though, PPIs do not provide immediate heartburn relief and can take up to 4 days to feel the full effect. Relief can last up to 24 hours.
- You typically take a PPI about 30 minutes before your first meal.
- PPIs are only intended for a 14-day course of treatment and can be used up to 3 times a year, unless directed to continue by a doctor.
- Side effects can include headache, stomach pain, nausea, diarrhea, constipation, gas, and dizziness. If you are post-menopausal or on PPIs for a long time, they can reduce calcium absorption and increase your risk of osteoporosis.
“Patients should always speak with a pharmacist or doctor before taking heartburn medication, particularly if they are pregnant or breastfeeding, have liver or kidney disease, have high blood pressure or cirrhosis, or when looking for recommendations for children under 12 years of age,” said McDonald.
She recommends that patients always read the directions on their medication label, whether it’s prescription or OTC.
She also suggests that patients inform their doctor or pharmacist about any other medications they’re taking, including vitamins and supplements, because they may interact with heartburn medication. For example, the H2 blocker cimetidine can interact with other medications including warfarin (commonly used to prevent blood clotting) and certain antidepressants.
Prescription heartburn medications
Sometimes over-the-counter (OTC) medications aren’t enough to treat heartburn symptoms.
“If you’re experiencing heartburn symptoms two or more times a week, have chest pain that feels like it’s tightening or squeezing, your symptoms continue despite non-prescription medication, you’re having difficulty swallowing, or experiencing persistent nausea or vomiting, then it’s time to see a doctor about prescription options,” said McDonald.
Persistent heartburn may be a sign of a more serious condition like GERD or peptic ulcers, which only a doctor can diagnose. Additionally, heartburn symptoms can resemble signs of a heart attack, which requires immediate medical attention.
Prescription heartburn medications typically contain the same active ingredients as their OTC counterparts, but are available in a higher strength and can be taken for longer periods of time under the supervision of a doctor.
You can get a larger supply of heartburn medication with a prescription, such as a 30- or 90-day supply vs. the typical 14-day OTC supply. Some examples of these medications include prescription strength PPIs like Nexium, Prevacid, and Prilosec, and prescription strength H2 blockers like famotidine and nizatidine.
Our pharmacy is here to help
At Express Scripts® Pharmacy, we understand how important it is to get heartburn under control. You can contact our pharmacists 24/7 with any heartburn medication questions and concerns, whether it’s a prescription medication or an over-the-counter one. They can also help you figure out your best option for treatment at the lowest cost.
Learn more about Express Scripts® Pharmacy.
Posted date: October 26, 2023
