Medications for Gastroesophageal Reflux Disease (GERD)/Heartburn

by Rick Alan

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 doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

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.

Proton Pump Inhibitors

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

H-2 Blockers

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

Antacids

  • Alka-Seltzer
  • Maalox Advanced Regular Strength
  • Pepto-Bismol
  • Tums
  • Rolaids
  • Mylanta

Prokinetics

  • Bethanechol (Urecholine)
  • Metoclopramide (Reglan)

Proton Pump Inhibitors

Common brand names include:

  • Omeprazole (Prilosec)
  • Lansoprazole (Prevacid)
  • Pantoprazole (Prontoix)
  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)
  • Dexlansoprazole (Dexilant)

Proton pump inhibitors block stomach acid production created by the stomach’s acid-making cells. By greatly decreasing the amount of stomach acid, proton pump inhibitors reduce the symptoms of GERD and help prevent damage that occurs from acid reflux into the esophagus.

Side effects may include:

  • Diarrhea
  • Constipation
  • Stomach pain
  • Nausea or vomiting
  • Headache
  • Increased risk of fracture in older adults, especially in people who take proton pump inhibitors in high doses for longer than a year

H-2 Blockers

Common brand names include:

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

H-2 blockers decrease the amount of acid secreted by the stomach by blocking histamine release. This decrease in stomach acid reduces the symptoms of GERD and helps prevent damage to the esophagus that acid reflux can cause.

Side effects may include:

  • Headache
  • Diarrhea
  • Nausea
  • Drowsiness
  • Confusion

Antacids

Common brand names include:

  • Alka-Seltzer
  • Maalox Advanced Regular Strength
  • 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.

Side effects may include:

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

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. This shortens the time during which reflux can occur. Prokinetics are usually given along with other GERD/heartburn medications.

Side effects may include:

  • Drowsiness
  • Restlessness
  • Diarrhea
  • Nausea

Special Considerations

  • Take your medications as directed. Do not change the amount or the schedule.
  • Know what side effects could occur. Discuss them with your doctor.
  • Talk to your doctor before you stop taking the medication.
  • Plan ahead for refills if you need them.
  • Do not share your medication with anyone.
  • Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.

References:

Gastroesophageal reflux disease (GERD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated April 29, 2013. Accessed April 30, 2013.
Gastroesophageal reflux disease (GERD). Merck Manual for Health Care Professionals. Available at: http://www.merckma.... Updated May 2012. Accessed April 30, 2013.
Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/. Updated April 30, 2012. Accessed April 30, 2013.
Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108(3):302-328.
Understanding heartburn and reflux disease. American Gastroenterological Association website. Available at: http://www.gastro..... Published April 25, 2010. Accessed April 30, 2010.
3/1/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov.... Published February 17, 2010. Accessed April 30, 2013.
3/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: FDA approves name change for heartburn drug Kapidex. US Food and Drug Administration website. Available at: http://www.fda.gov.... Published March 4, 2010. Accessed April 30, 2013.
5/28/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: FDA: possible fracture risk with high-dose, long-term use of proton pump inhibitors. US Food and Drug Administration website. Available at: http://www.fda.gov.... Published May 25, 2010. Accessed April 30, 2013.
Last reviewed April 2013 by Daus Mahnke, MD; Brian Randall, MD
Last Updated: 4/30/2013
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