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Are there any over-the-counter treatments for heartburn?

Heartburn can be mild and temporary, but can also be chronic and a symptom of a more serious gastrointestinal condition. Heartburn is often caused by a condition called gastroesophageal reflux disease (GERD). Over-the-counter treatments for heartburn include antacids and H2-blockers. Antacids act by neutralizing stomach acid. Examples are products containing calcium (brand names Tums or >Titralac), magnesium (>Maalox or >Mylanta), or aluminum (>AlternaGel). Antacids relieve heartburn symptoms in 5 to 15 minutes. They work well to relieve occasional mild heartburn but aren't as helpful in preventing it. The benefits of antacids don't last as long as other over-the-counter heartburn remedies, and you need to take them more often.

H2-blockers such as randitidine (>Zantac 75), famotidine (>Pepcid AC), cimetidine (>Tagamet HB), and nizantidine (>Axid AR) lower the amount of acid produced in the stomach. They're available in lower strengths over the counter and in higher strengths with a prescription from your doctor. H2-blockers take from 15 to 30 minutes to provide heartburn relief. When taken before meals and at bedtime, H2-blockers help to prevent heartburn.

>Pepcid Complete is a new product that combines the antacid, calcium carbonate with the H2-blocker famotidine. Pepcid Complete works quickly to neutralize and reduce stomach acid.

The proton pump inhibitor (PPI) omeprazole (Prilosec OTC) is also available in a lower strength over-the-counter. This type of drug can be used when H2-blockers do not work.

You shouldn't use over-the-counter antacids and H2-blockers to treat heartburn that lasts more than a couple of weeks. Also, these medicines don't help irritated throat tissue to heal. Prescription drugs are usually preferred if over-the-counter treatments don't work.

Sources:
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
Micromedex® Healthcare Series. Thomson Micromedex, 2006.
Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease. W. B. Saunders Company, 1998.
Pepcid Complete Product Information, Johnson & Johnson-Merck. http://www.pepcidac.com. Last accessed 11/15/2006.
Handbook of Nonprescription Drugs. American Pharmaceutical Association, 2000.
Drug Facts and Comparisons. Facts & Comparisons, 2006.

This answer prepared 1/18/2001.
This information updated 11/15/2006.

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