Most people have experienced acid reflux or heartburn at least once – likely after a large meal. But what is the best heartburn medicine? There are three primary types for acid reflux and heartburn: antacid medication, H2 blockers, and proton pump inhibitors (PPIs). All of these work differently and either aim to prevent acid reflux or to provide quick relief. If you suffer from acid reflux and want to find out which are the safest acid reflux medicines, here’s everything you should know about the best treatments.
What Is Acid Reflux?
Acid reflux is quite a common and irritating medical condition. Also called heartburn, it occurs when stomach acid and other stomach contents back up into the esophagus through the lower esophageal sphincter (LES). It is estimated to affect up to 20% of Americans. Frequent acid reflux may be an indication of gastroesophageal reflux disease (GERD) – a more severe type of acid reflux that, if left untreated, may lead to serious health implications.
Common Acid Reflux Symptoms
Depending on which organs are most affected by stomach acid, a person suffering from acid reflux may experience any number of symptoms, including:
- Heartburn
- Sour taste
- Regurgitation
- Indigestion
- Difficulty swallowing
- Sore throat
- Dry cough
- Asthma symptoms
Related Read: Stomach Flu vs Food Poisoning: How to Tell the Difference
The Best Heartburn Medicine for Acid Reflux Relief
For Instant Relief – Antacids
While preventative treatments such as H2 blockers and PPIs are more effective, antacid medication is just what you need if you want fast heartburn relief. These inexpensive, over-the-counter (OTC) tablets can be used on demand for symptom relief, but it must be noted that antacids don’t do anything to prevent acid reflux or GERD.
The common ingredients contained in antacids like calcium carbonate – found in Tums and Rolaids – and/or magnesium – found in Mylanta and Maalox – provide heartburn relief within 5 minutes and only work temporarily for 30 to 60 minutes at most. Antacids are typically available as chewable or dissolving tablets, but some brands come in liquid or gum form.
Common OTC Antacids
- Alka-Seltzer
- Gelusil
- Maalox
- Mylanta
- Pepto-Bismol
- Rolaids
- Tums
Antacid Side Effects
Side effects are mostly mild and include:
- Constipation
- Nausea
- Diarrhea
Be careful not to overuse antacids since some brands contain calcium, and excessive calcium intake can lead to kidney stones. If your symptoms persist for more than 2 weeks with an antacid, you might need stronger acid reflux medication.
For Stronger Relief – H2 Blockers
H2 blockers work by decreasing stomach acid and blocking histamine – one of the body’s inflammatory agents – from causing the stomach to produce acid. H2 blockers act more slowly compared to antacids and typically kick in within an hour of taking them. However, this also means they provide long-lasting symptom relief for up to 8 to 12 hours.
H2 blockers are available both over the counter and by prescription. They usually work better when taken 10 to 60 minutes before eating food or drinking beverages that cause reflux. If your symptoms still aren’t alleviated, you can take another dose within 24 hours.
Common H2 Blockers
- Cimetidine (Tagamet HB)
- Famotidine (Calmicid, Fluxid, Pepcid AC)
- Nizatidine (Axid, Axid AR)
H2 Blocker Side Effects
The side effects of H2 blockers are usually mild and include:
- Headache
- Fatigue and drowsiness
- Diarrhea
- Constipation
- Muscle aches and abdominal pain
As with antacids, H2 blockers are only suitable for short-term use. Unless directed by a medical professional, it’s not advised to take the maximum daily dose for more than 2 weeks. It’s also important to note that over time, the effectiveness of any H2 blocker will wear off due to the stomach adjusting to the medication.
If your acid reflux symptoms occur more than twice a week, or if the severity of your symptoms increases, you might have GERD – a severe form of acid reflux. In this case, your doctor may increase your H2 blocker dosage or will suggest a proton pump inhibitor (PPI).
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For When H2 Blockers Don’t Help – Proton Pump Inhibitors (PPI)
If you’ve been taking H2 blockers for a few weeks and your acid reflux symptoms aren’t letting up or haven’t lessened, then you might need a proton pump inhibitor (PPI). PPIs are the most powerful drug for reducing acid production and typically the most effective treatment for GERD. PPIs work by blocking an enzyme that produces stomach acid, causing them to make less acid and soothe heartburn symptoms.
PPIs come in pill form, and while many are available by prescription only, some are available over-the-counter. Unless otherwise prescribed by a doctor, PPIs should be taken on an empty stomach 30 to 60 minutes before eating breakfast, once daily for 14 days. While it may take between 1 to 4 days for the full effects to kick in, people may experience complete relief from their symptoms within 24 hours.
Common Proton Pump Inhibitors (PPIs)
- Lansoprazole (Prevacid 24HR)
- Omeprazole (Losec, Omesec, Prilosec OTC)
- Omeprazole with sodium bicarbonate (Zegerid)
- Esomeprazole (Nexium)
A meta-analysis of 41 studies comparing PPIs found no differences among the various kinds of PPIs in treating GERD.
Proton Pump Inhibitors (PPIs) Side Effects
Mild symptoms include:
- Flatulence
- Headache
- Abdominal pain
- Nausea
- Diarrhea
However, long term use of PPIs has raised concerns with potential associated side effects, including:
- Vitamin B12 deficiency
- Increased risk of fractures
- Increased risk of pneumonia and dementia
- Hypomagnesemia — low level of magnesium in the blood that can lead to convulsions, fatigue, and muscle weakness
- Increased risk of Clostridium difficile bacteria infections
If you need to take PPIs for more than 14 days, you should consult with your doctor to determine how long you should be taking them and whether the risks outweigh the benefits.
Healthy lifestyle changes must also accompany any treatment being taken for acid reflux. Avoid late-night eating, make sure you eat a healthy diet, elevate your head in bed, and get enough rest.
You should consider consulting with a medical professional if you find yourself taking antacids every day, experience acid reflux more than twice a week, and have symptoms that significantly affect your quality of life.
