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Are there any prescription treatments for heartburn?

Heartburn is described as a burning or painful sensation in the chest behind the breastbone. It occurs when the acid in your stomach travels backward into your esophagus (acid reflux). Your throat can also become irritated when exposed to stomach acid over time. Other symptoms include a sour taste in the mouth, belching, coughing, and wheezing.

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). Prescription treatments for heartburn reduce stomach acid to relieve symptoms and allow the throat to heal.

H2-blockers such as ranitidine (brand name Zantac), >famotidine (Pepcid), >cimetidine (Tagamet), and >nizatadine (Axid) all lower the amount of acid the stomach produces. They're also available in lower strengths over the counter. Prescription strength H2-blockers are the main treatment for heartburn that doesn't respond to nonprescription treatment, or for more serious conditions. Your doctor will prescribe H2-blockers to be taken either on a regular basis or only as needed.

Proton pump inhibitors (PPIs) such as >omeprazole (Prilosec), >lansoprazole (Prevacid), >rabeprazole (Aciphex), esomeprazole (Nexium) and pantroprazole (>Protonix) have the same effect as H2-blockers, but they're stronger. Doctors usually prescribe PPIs if H2-blockers don't work. You take them once or twice daily on a regular basis.

>Metoclopramide (Reglan) is a drug that helps food move through your stomach and intestines faster, which prevents a backup of food and acid into the throat. Doctors prescribe metoclopramide when acid reducer medicines aren't enough to control heartburn. You often take it in combination with H2-blockers or PPIs.

Sources:
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
Mayo Clinic Family Health Book. William Morrow & Co., 1996.
Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease. W. B. Saunders Company,1998.
Tytgat GN. “Medical Therapy of Gastroesophageal Reflux Disease in Secondary and Tertiary Care Settings’” Yale Journal of Biology and Medicine. 72 (1999).
Micromedex® Healthcare Series. Thomson Micromedex,, 2006.
Medline Plus. Medline, 2006.
http://www.nih.gov. Last accessed 11/15/2006.

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

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•	What are proton pump inhibitors ?
•	What are the side effects of proton pump inhibitors ?
•	Are there any interactions with proton pump inhibitors ?
•	Are there any over-the-counter treatments for heartburn?
•	Are there any prescription treatments for heartburn?
•	What are proton pump inhibitors ?
•	What are the side effects of proton pump inhibitor drugs ?
•	Are there any interactions with proton pump inhibitors ?
•	How do I choose an over-the-counter heartburn medicine?
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