Heartburn Medication Guide: OTC & Prescription Options

When the acid in your stomach decides to climb up the food pipe, the burning feeling can ruin a dinner or a night out. Heartburn medication is a type of drug that neutralises or reduces that acid, giving you quick relief and protecting your esophagus in the long run.

What exactly is heartburn?

Heartburn is the painful, sour sensation that occurs when stomach acid backs up into the lower esophagus. It’s often a symptom of gastroesophageal reflux disease (GERD), but occasional episodes happen to most people after a big meal, spicy food, or late‑night snacking.

How do medications tame the burn?

Most antacids work by directly neutralising stomach acid for fast relief. Others, like proton pump inhibitors (PPIs) block the stomach’s acid‑producing pumps, lowering overall acid levels. A third group, H2 receptor antagonists reduce the amount of acid the stomach releases, sits between antacids and PPIs in speed and duration.

Over‑the‑counter (OTC) options you can pick up today

OTC products are perfect for occasional flare‑ups or for people who want to avoid a doctor’s visit. Here’s a quick rundown of the most common classes:

• Calcium carbonate (e.g., Tums, Rolaids) - a fast‑acting antacid that also supplies calcium. Works within minutes and lasts 30‑60 minutes.
• Magnesium hydroxide (e.g., Milk of Magnesia) - neutralises acid and can double as a mild laxative, useful if constipation accompanies reflux.
• Alginate‑based formulas (e.g., Gaviscon) - create a foam barrier that floats on stomach contents, preventing acid from reaching the esophagus.
• Low‑dose H2 blockers such as famotidine (Pepcid AC) - start working within an hour, offering relief that lasts up to 12 hours.

These meds are generally safe for adults, but it’s worth checking the label if you’re pregnant, nursing, or have kidney problems.

Prescription‑strength solutions for frequent or severe symptoms

If heartburn knocks you out a few times a week, or if you’ve been diagnosed with GERD, a doctor may prescribe stronger drugs. The main categories are:

• Proton pump inhibitors (PPIs) such as omeprazole, esomeprazole, and lansoprazole - they shut down acid production at its source, providing 24‑hour relief after a few days of consistent use.
• Higher‑dose H2 blockers like famotidine 20 mg taken twice daily - useful for night‑time symptoms when a longer‑acting antacid isn’t enough.
• Prokinetics such as metoclopramide, which help the stomach empty faster, reducing pressure that pushes acid upward - reserved for specific cases because of possible side effects.

Doctors might combine a PPI with an alginate for extra protection during severe flare‑ups.

OTC vs. prescription: a side‑by‑side look

How to pick the right medication for you

Think of the decision as a checklist:

• Frequency: Occasional (once or twice a month) → start with an antacid or alginate.
  Frequent (several times a week) → consider an H2 blocker.
• Severity: If the burn lasts longer than 30 minutes or wakes you at night, you likely need a prescription‑strength PPI.
• Other health conditions: Kidney disease, heart failure, or pregnancy can limit which ingredients are safe.
• Drug interactions: PPIs can affect the absorption of certain antibiotics and blood thinners; always cross‑check with your pharmacist.
• Long‑term plan: Use the lowest effective dose for the shortest time. If you need a PPI for more than 8 weeks, ask your doctor about stepping down to an H2 blocker.

Recording when symptoms occur, what you ate, and which medication you tried can help your doctor tailor a plan that balances relief with safety.

Safety tips and pitfalls to avoid

Even “easy” meds can cause trouble if misused. Here are the most common warnings:

• Over‑use of antacids: Taking more than the label recommends can lead to high calcium levels or kidney stones.
• Long‑term PPI use: Studies link it to higher risk of C. diff infection, vitamin B12 deficiency, and osteoporosis. Schedule a review after 3‑6 months.
• Mixing meds: Avoid taking antacids within two hours of certain antibiotics (e.g., tetracycline) as they bind and reduce absorption.
• Self‑diagnosis: Persistent pain, difficulty swallowing, or weight loss could signal an ulcer or esophageal cancer-see a doctor promptly.

Quick reference cheat‑sheet

1. Burn lasts < 5 minutes? Try a calcium carbonate antacid.
2. Burn lasts 30‑60 minutes? Add an alginate or low‑dose H2 blocker.
3. Burn keeps coming back >2 times/week? Book a GP appointment for a possible PPI prescription.
4. Need nightly relief? Discuss a low‑dose PPI or bedtime H2 blocker with your doctor.
5. Any red‑flag symptoms (bleeding, severe pain, vomiting)? Seek urgent care.

Frequently Asked Questions