Heartburn Medications 101

From the Editors of Live Right Live Well

Antacids, acid reducers, proton pump inhibitors -- there’s a dizzying array of heartburn medications in the market. “Consumers have a very difficult time making sense of
heartburn medications,” says Dr. Cindy Yoshida, a gastroenterologist in Charlottesville, Va., and author of No More Digestive Problems. “Patients come into my office all the time wondering whether to take [one medication or another].” To help you sort things out, here’s a quick look at various heartburn medications:

1. Antacid

What it does: Neutralizes stomach acid in the esophagus.

What it’s best for: Immediate relief of heartburn, sour stomach or acid indigestion. “But the effects last a very short time and probably don’t do much to heal esophagitis [inflammation of the esophagus, which can result from frequent or severe heartburn],” says Yoshida.

Examples: Calcium, magnesium, sodium bicarbonate.

2. H2 Blocker (aka histamine receptor antagonist)

What it does: Partially blocks production of stomach acid by inhibiting the action of histamine, a substance that stimulates acid secretion.

What it’s best for: Quick relief of occasional or mild to moderate heartburn; also helps heal inflammation of the esophagus. Can prevent heartburn if you know you’ll be overindulging at a special occasion. Relief generally lasts for six to 10 hours.

Examples: Famotidine, cimetidine, nizatidine, ranitidine. Available over the counter and in prescription strength.

3. Proton Pump Inhibitor (PPI)

What it does: Inhibits the production of stomach acid by deactivating the acid pumps in stomach cells.

What it’s best for: Chronic, frequent or severe heartburn. Also heals esophagitis. PPIs take a few hours to start working, but once they do, relief can last for 24 hours. Taken once daily, PPIs can alleviate heartburn symptoms around the clock. For optimal effectiveness, take a PPI 30 minutes before a meal, advises Yoshida.

Examples: Omeprazole, lansoprazole, esomeprazole. Available over the counter and in prescription strength. 

4. Combination Products (antacid plus acid blocker)

What it does: Neutralizes stomach acid and blocks production of acid in the stomach.

What it’s best for: These drugs “can work quickly to neutralize stomach acid now and block acid for later,” says Yoshida. But don’t use this or any other heartburn medication continuously for more than two weeks. “If your symptoms persist beyond that point,” says Yoshida, “you should see your doctor.”