Heartburn (Acid Reflux) Medication: Over-the-counter Options

By Sarah Malka, MD
Medically reviewed
October 12, 2021

Heartburn is a common and uncomfortable symptom, affecting more than 15 million Americans daily.

Thankfully, there are many treatment options available, including prescription and over-the-counter (OTC) medications. 

In this article, I’ll describe the causes of heartburn and the OTC medications available.

I’ll also cover the side effects of heartburn medication and how to use heartburn medication safely.

Finally, I’ll explain when you should see a healthcare provider for more personalized care.

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What is Heartburn/Acid Reflux?

Heartburn can be a symptom of many different conditions, including gastroesophageal reflux disease (GERD), acid reflux, and pregnancy. 

Generally, heartburn is an uncomfortable burning feeling in your chest that can move up and down your throat.

Other signs of heartburn can include:

  • Regurgitation, or the feeling of fluid or food coming up into the chest
  • Chest pain or burning that worsens when lying down or bending over
  • Bitter, hot, sour, or acidic taste in the mouth
  • Pain or discomfort that appear after a large or spicy meal
  • Difficulty swallowing
  • Pain that can move into your throat, but doesn’t usually radiate to your shoulders, neck and arms

For some, heartburn is triggered by lifestyle and diet habits.

You are more at risk for developing heartburn if you:

  • Eat large portions of food
  • Eat spicy, fatty, or greasy foods
  • Eat acidic foods such as tomatoes or citrus
  • Eat close to bedtime
  • Drink large amounts of caffeinated, alcoholic, or carbonated drinks
  • Experience stress
  • Smoke
  • Wear tight-fitting clothes

However, heartburn can also be caused by other conditions, including:

Heartburn, acid reflux, and GERD

Though the terms are sometimes used interchangeably, heartburn, acid reflux, and GERD have distinct meanings. 

Heartburn refers to the symptom that can be caused by acid reflux or GERD.

Acid reflux refers to the condition when stomach acid flows back up into the mouth through the esophagus.

This occurs when the valve at the end of the esophagus doesn’t close properly when food enters the stomach.

GERD is chronic acid reflux, a condition in which stomach acid persistently leaks back up into your esophagus. 

Everyone can get heartburn and acid reflux from time to time, but GERD is a chronic condition that can lead to more serious problems if not treated.

Over-the-counter Medications for Heartburn

Over-the-counter (OTC) medications can help treat heartburn, but it may take a little trial and error to figure out what works best for you.

If you still experience symptoms after two weeks, see your healthcare provider or doctor, who may recommend prescription medication.

OTC treatment options include:  

Histamine-2 (H2) blockers

These medicines, available both by prescription and OTC, help reduce the amount of acid your stomach produces, which can help alleviate heartburn.

H2 blockers don’t work as quickly to reduce heartburn as antacids, but the effect can last longer.

Examples of H2 blockers include famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75). 

Antacids 

OTC antacids are usually the first-line recommendation for acid reflux and heartburn.

They work by neutralizing acids in your stomach and can provide fast, short-term relief.

Antacids are available in multiple forms—chewables, dissolving tablets, and liquids.

Some examples of antacids include calcium carbonate (Tums), loperamide (Imodium), simethicone (Mylanta), and sodium bicarbonate (Alka-Seltzer).

Proton pump inhibitors (PPIs) 

PPIs are especially effective at reducing stomach acid to treat symptoms of indigestion and heartburn.

Your doctor may recommend PPIs if antacids or H2 blockers have failed to resolve your symptoms.

Recently, some PPIs have become available OTC, including esomeprazole (Nexium) and omeprazole (Prilosec). Other PPIs, like rabeprazole (AcipHex), are only available with a prescription. 

Side Effects of Heartburn Medication

Like most medicines, heartburn medications may cause side effects.

Though rare, the most commonly reported side effects of antacids and acid-reducing medications are:

If you experience one or more of the above side effects while taking an antacid or acid-reducing medication, they will likely go away on their own.

If side effects persist, reach out to your doctor.

Side effects of proton pump inhibitors (PPI) may be more serious.

Research shows that long term use of PPIs can lead to kidney problems, including kidney failure.

Experts recommend using PPIs only when necessary and not as a regular medication.

Additionally, you should not take PPIs if you are elderly, immunocompromised, postmenopausal, or have been treated for a Clostridium difficile (C. diff) infection in the past.

Talk to your healthcare provider before taking any OTC heartburn medication.

How to Use Heartburn Medication Safely

Before starting any new medication, talk to your healthcare provider to ensure that it’s safe to use.

If you do start using one of these medications, it’s important to take it exactly as directed on the label.

Do not exceed the amount or timing recommended.

If your symptoms continue even after taking medication, reach out to your provider.

Suffering from heartburn? Chat with a doctor today for just $23

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When to See a Healthcare Professional

Many cases of mild heartburn can be managed at home and with OTC medication.

But if you experience any of the below symptoms, reach out to your doctor or healthcare provider immediately:

  • Unintentional weight loss or loss of appetite
  • Bloody vomit
  • Frequent vomiting
  • Black, tarry stool
  • Severe, constant stomach pain 
  • Difficulty swallowing that gets progressively worse
  • Fatigue or weakness
  • Shortness of breath, sweating, or chest pain that radiates to the neck, jaw, or arm
  • Chest pain with stress or exertion
  • Yellowing of the skin or eyes
  • Heartburn symptoms that last longer than two weeks

How K Health Can Help

Abdominal pain and chest pain caused by heartburn can be treated. Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a healthcare provider in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

What medication relieves heartburn the fastest?
Antacids provide the fastest, short-term relief from heartburn. Histamine (H2) blockers and PPIs don’t work as quickly as antacids, but their effects can last longer.
Is it safe to take heartburn medication when pregnant?
Heartburn is common throughout pregnancy, especially during the third trimester. Over-the-counter (OTC) antacids may help relieve symptoms, but it’s important to speak with your doctor or OBGYN first to ensure that they are safe to use. Diet and lifestyle changes—eating smaller, more frequent meals and avoiding greasy or spicy foods—may also provide relief.
Is it OK to take heartburn medication every day for extended periods?
Speak to your healthcare provider before taking any medication regularly. Research shows that prolonged use of proton pump inhibitors (PPIs) can lead to serious kidney problems, including kidney failure, or may increase your risk of some infections.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.