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 | How do I choose an over-the-counter heartburn medicine?
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|  Your choice basically depends on whether you want to treat heartburn or prevent it. All over-the-counter heartburn treatments decrease the acid content of the stomach, but they do so in different ways. Antacids neutralize the acid that the stomach produces, while drugs called H2-blockers reduce the stomach’s output of acid. To prevent heartburn, choose an H2-blocker. Examples include ranitidine (Zantac 75), famotidine (Pepcid AC), cimetidine (Tagamet HB 200), and nizatadine (Axid). You can take these medicines at bedtime or 30 minutes before a meal. H2-blockers can prevent heartburn for four to eight hours following a dose.To treat heartburn that has already started, choose an antacid. Examples include Tums, Titralac, Maalox, or Mylanta. Antacid effects begin within five to 15 minutes and can last for as long as three hours.Pepcid Complete is a new product that combines the antacid, calcium carbonate and magnesium hydroxide with the H2-blocker famotidine. One tablet works to both 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.If you are taking other medicines, read product labels and talk to your doctor or pharmacist to prevent a drug interaction. For example, some antibiotics are not effective if they are taken with antacids.
See a doctor if your heartburn doesn't go away within two weeks, gets worse, or is accompanied by other symptoms.
Sources:
Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease. W. B. Saunders Company, 1998.
Handbook of Nonprescription Drugs. American Pharmaceutical Association, 2000.
Micromedex® Healthcare Series. Thomson Micromedex, 2006.
Pepcid Complete Product Information, Johnson & Johnson-Merck. http://www.pepcidac.com. Last accessed 11/15/2006.
Pharmacotherapy: A Pathophysiologic Approach. Appleton & Lange, 1999.
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
This reply prepared 6/25/2001.
This information updated 1/25/2007.
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