Heartburn and indigestion are caused when harsh stomach juices come in contact with and irritate the sensitive lining of the esophagus. These juices, which are produced by the stomach to help the body digest food, contain a powerful acid called hydrochloric acid. Normal in the stomach but highly inflammatory if it rises into the esophagus, the acid is produced by billions of tiny pumps in the stomach lining. Each pump is controlled by three main signals, which activate acid production. Heartburn remedies are taken to alleviate symptoms, but there are a variety of medications, and they work in different ways.

Treat or Prevent?

To know which heartburn medication to take, you must first decide if your goal is to treat or prevent heartburn.

If your goal is to treat heartburn, the selection of a product should be based on the onset and duration of symptom relief provided by the medication and the frequency and severity of your heartburn.

If you are able to predict when your heartburn will occur—for example, your heartburn is brought on by eating certain foods or drinking specific beverages—you may wish to use a medication to prevent heartburn.

Antacids

Antacids like Tums®, Rolaids® and Maalox® partially neutralize existing stomach acid and are typically used to treat mild, occasional heartburn. But these remedies provide relief that lasts only 20 to 30 minutes when taken on an empty stomach. Taking an antacid after a meal prolongs its effect for two to three hours.

H2 Receptor Antagonists

H2 receptor antagonists, also known as H2 blockers, are used to treat mild to moderate, infrequent heartburn. These medications partially block one of the three signals that activate the acid pumps, reducing the release of some of the acid the pump produces. They begin to relieve heartburn within an hour, and their effect generally lasts six to 10 hours.

The lower nonprescription dosages—Zantac 75® and Pepcid® AC, for example—should be used for mild heartburn. The higher nonprescription dosages—Zantac 150® and Maximum Strength Pepcid® AC—should be reserved for more moderate symptoms.

An over-the-counter H2 antagonist that also contains an antacid, Pepcid® Complete, is also available. This medication provides both immediate and six- to 10-hour relief of heartburn.

Proton Pump Inhibitors (PPIs)

Proton pump inhibitors (PPIs) work directly on active acid pumps to significantly inhibit acid production, allowing just enough acid to be produced for normal digestion of food. In contrast to antacids and H2 blockers, PPIs usually take two to three hours to begin to relieve your heartburn, but relief often lasts up to 24 hours with each pill.

Nonprescription omeprazole magnesium, Prilosec OTC®, is intended for people who suffer from frequent heartburn, or heartburn that occurs two or more days a week; it should not be used to treat mild or occasional heartburn. It may take up to three or four days for some people to experience the full therapeutic effect of Prilosec OTC, but many people get complete heartburn symptom relief within 24 hours after the first dose.

Heartburn Medications Comparison Chart

The downloadable Heartburn Medications Comparison Chart (Adobe® Acrobat® Reader® required) will help you better understand which medication might be best for you by allowing you to compare characteristics of commonly available medications, including how they work and whether they treat or prevent heartburn.

* Tums® is a registered trademark of GlaxoSmithKline. Rolaids® is a registered trademark of McNeil-PPC, Inc. Maalox® is a registered trademark of Novartis Consumer Health Inc. Zantac 75® and Zantac 150® are registered trademarks of Boehringer Ingelheim Pharmaceuticals, Inc. Pepcid® AC, Maximum Strength Pepcid® AC and Pepcid® Complete are registered trademarks of Johnson & Johnson-Merck Consumer Pharmaceuticals Co.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis or recommended treatments. For severe heartburn or heartburn that persists after trying over-the-counter treatment or lifestyle modifications, visit your doctor to determine the right treatment for you. See the Terms and Conditions for more information.