Over-the-counter antacids, which you can buy without a prescription, are recommended by doctors to stop acid production or help the muscles that empty your stomach to react normally. Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Riopan, are often the first drugs recommended to relieve heartburn and other mild GERD symptoms.
Most modern brands use varying combinations of three basic salts: magnesium, calcium, and aluminum - with hydroxide or bicarbonate ions to neutralize the stomach acid. However, they do have side-effects.
Magnesium salt can cause diarrhea, and aluminum salts can cause constipation problems. In many cases aluminum and magnesium salts are often combined in a single product to avoid these complaints.
Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can be a supplemental source of calcium but can also cause constipation.
* Foaming Agents
Gaviscon, for example, works by covering your stomach contents with a foam barrier to prevent acid reflux. If you don't have any damage to the esophagus, these drugs may be helpful.
* H2 Blockers
Drugs like cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), stop the stomach from producing excessive quantities of acid. In most cases you can obtain them in prescription strength or over the counter.
Drugs like these offer only short-term relief and should not be used for more than a few weeks at a time. They work in about 50 percent of cases but some people find that taking H2 blockers at bedtime in combination with a proton pump inhibitor works better for them.
* Proton Pump Inhibitors
Omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), are available by prescription only. These drugs are more effective than H2 blockers and can relieve symptoms in most people who have acid reflux.
Prokinetics
These drugs work by strengthening the sphincter muscle and making the stomach empty more quickly. Trade names are bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also works on muscle action in the digestive tract. Note that these drugs have frequent side effects so their usefulness is limited.
In many cases a combination of drugs can control the symptoms of acid reflux. If you get heartburn after eating you can take antacids and H2 blockers. First the antacids work to neutralize stomach acid while the H2 blockers act on acid production. When the antacid stops working, the H2 blocker will have stopped acid production. Ask your doctor for advice on how use medications in combination for your acid reflux symptoms.
