MEDICATIONS FOR GASTROESOPHAGEAL REFLUX DISEASE (GERD)/HEARTBURN

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your pharmacist/ health care provider if you need to take any special precautions. Use each of these medications as recommended by your health care provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your health care provider.

Different medications for GERD/heartburn work in different ways. Your doctor may prescribe a combination of over-the-counter and prescription medications to help treat and control your GERD/heartburn.

PRESCRIPTION MEDICATIONS

Proton pump inhibitors

  • Omeprazole (Prilosec)
  • Lansoprazole (Prevacid)
  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)

Prokinetics

  • Bethanechol (Urecholine)
  • Metoclopramide (Reglan)

Mucosal protectors

  • Sucralfate (Carafate)

OVER-THE-COUNTER MEDICATIONS

Antacids

  • Alka-Seltzer
  • Maalox
  • Pepto-Bismol
  • Tums
  • Rolaids
  • Mylanta
  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

PRESCRIPTION MEDICATIONS

PROTON PUMP INHIBITORS

Common brand names include:

  • Omeprazole (Prilosec)
  • Iansoprazole (Prevacid)
  • Pantoprazole (Prontoix)
  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)

Proton pump inhibitors block stomach acid production by blocking mechanisms in the stomach’s acid-making cells. By greatly decreasing the amount of stomach acid, proton pump inhibitors reduce the symptoms of GERD, especially heartburn, and help prevent damage that occurs from acid reflux into the esophagus. In general, proton pump inhibitors are prescribed for severe cases of GERD and for patients whose symptoms are not controlled by H2 blockers and antacids.

Proton pump inhibitors are available as tablets or delayed release capsules. They are usually taken just before meals. You should consult with your doctor before taking proton pump inhibitors if you have a history of liver disease.
The most common side effects include:

  • Diarrhea
  • Stomach pain
  • Nausea
  • Headache

PROKINETICS

Common brand names include:

  • Bethanechol (Urecholine)
  • Metoclopramide (Reglan)

Prokinetics help control acid reflux by strengthening the lower esophageal sphincter muscle, and/or emptying the contents of the stomach faster, thus shortening the time during which reflux can occur.
Prokinetics are usually given in conjunction with other GERD/heartburn medications. Bethanechol is available in tablet form. It is generally taken 1 hour before or 2 hours after meals to avoid nausea and vomiting. Metoclopramide is available in tablet and liquid form. It is usually taken before meals.
Common side effects of metoclopramide include:

  • Drowsiness
  • Restlessness
  • Muscle spasms or involuntary movements

Exercise caution when driving or operating equipment while taking metoclopramide.

MUSCOSAL PROTECTORS

Common brand names include:

  • Sucralfate (Carafate)

Muscosal protectors coat and soothe an esophageal lining irritated by GERD. They are usually given as a tablet or liquid and taken on an empty stomach. Consult with your doctor before taking sucralfate if you have a history of gastrointestinal or kidney disease.

Possible side effects include:

  • Constipation
  • Nausea
  • Dizziness

PRESCRIPTION OR OVER-THE-COUNTER MEDICATIONS

ANTACIDS (OTC)

Common brand names include:

  • Alka-Seltzer
  • Maalox
  • Pepto-Bismol
  • Tums
  • Rolaids
  • Mylanta

Antacids are a combination of three basic salts—magnesium, calcium, and aluminum—combined with hydroxide or bicarbonate ions. Antacids come in chewable tablet and liquid forms. Antacids help control the symptoms of GERD by neutralizing stomach acid.

Antacids are usually taken 1 to 3 hours after meals, or as needed or directed. They should not be taken at the same time as you take other medications, because they decrease the absorption of many other drugs.

Possible side effects include:

  • Diarrhea or constipation
  • High blood levels of calcium (if the antacid you take has calcium)
  • Kidney stones or kidney problems

Avoid antacids with calcium if you have high blood levels of calcium, and check with your doctor to see if you need follow-up tests of kidney function, and calcium and/or potassium levels.

H2 BLOCKERS(ALSO AVAILABLE IN PRESCRIPTION STRENGTH)

Common brand names include:

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

H2 blockers decrease the amount of acid secreted by the stomach by blocking histimine release. This decrease in stomach acid reduces the symptoms of GERD, especially heartburn, and helps prevent damage to the esophagus that acid reflux can cause. H2 blockers can be taken as tablets, capsules, chewable tablets, or liquids. They should be taken at the same time each day. A dose is often given before bedtime to prevent acid reflux while sleeping.

Possible side effects include:

  • Headache
  • Diarrhea
  • Nausea
  • Drowsiness
  • Confusion

SPECIAL CONSIDERATIONS

Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed, not more, not less, not at a different time.
  • Do not stop taking them without consulting your health care provider.
  • Don’t share them with anyone else.
  • Know what effects and side effects to expect, and report them to your health care provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don’t run out.

WHEN TO CONTACT YOUR HEALTH CARE PROVIDER

If you take other prescription or over-the-counter medications or supplements, check with your health care provider before taking medications for GERD/heartburn. Contact your health care provider if side effects occur or you have any questions about your medicine.

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