milder medications such as antacids
before switching to stronger medications
that block stomach acid release.
For example, antacids are a good first
choice, as they have minimal side effects
and offer immediate, short-term relief.
The next step up would be stronger
medications called histamine- 2 receptor
agonists, or H2RAs, which inhibit
stomach acid release.
Proton pump inhibitors are the
last resort for severe or uncontrolled
heartburn. Your pharmacist or doctor
can help you figure out the best medication for you.
Feeling no pain is definitely a gain
when it comes to heartburn, and the
chart above can help you get started.
Frieda Wiley is a freelance journalist and
licensed pharmacist.
Charting the ’burn
©
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0
X
/
S
H
U
T
T
E
R
S
T
O
C
K
CLASS
Antacids
H2RAs
Proton
pump
inhibitors
Famotidine
(Pepcid AC),
cimetidine,
nizatidine (Axid),
ranitidine
(Zantac)
Esomeprazole
(Nexium),
dexlansoprazole
(Dexilant),
lansoprazole
(Prevacid),
omeprazole
(Prilosec,
Zegerid),
pantoprazole
(Protonix)
Over the
counter
(OTC)
Rx and
OTC
Rx and
OTC
Mild
Moderate,
nighttime
symptoms
Severe
symptoms
not fully
relieved by
antacid or
H2RAs
30 minutes before
meals or at bedtime for
nighttime symptoms or
as needed.
Best if taken 30 minutes
before meals. Take for
2 to 4 weeks; see
doctor afterward if
symptoms don’t
improve or long-term
use is needed.
Antacid effects
don’t last very
long but are
often the
fastest-acting.
Takes 30 to 90
minutes to notice
effect.
12 to 24 hours;
may take a while
or a few doses
to notice relief.
Cimetidine can interact
with other medications;
discuss with your
doctor or pharmacist.
Long-term use may
decrease magnesium
levels, increase risk for
severe diarrhea caused
by bacterial infection,
increase risk for or
worsen osteoporosis.
Discuss with your
doctor or pharmacist.
SYMPTOM
SEVERITY HOW TO TAKE
EFFECTS
LAST …
SIDE EFFECTS/
PRECAUTIONS
OTCNAMES
Alka-Seltzer,
Alterna-Gel,
Amphogel, milk
of magnesia,
Gaviscon, Gelusil,
Maaolx, Mylanta,
Rolaid, Tums
Instructions vary, so
read label or ask
pharmacist for help.
Some antacids are
OK to take with food.
Others should be taken
1 hour after meals.
Some antacids are high
in sodium. Use caution
if you have high blood
pressure, kidney disease
and kidney stones. Take
1 hour before or 4 hours
after other medications.
