Types of Medication for GERD (Heartburn)

Gastroesophageal reflux disease (GERD) is a condition in which stomach acid flows back into the esophagus, thereby irritating the esophageal lining. Many people experience refluxes now and then, but when reflux occurs frequently over time, it can cause GERD (heartburn).

Most people manage GERD symptoms with lifestyle changes and medications. In rare cases, some people may need surgery to correct this condition.

Some of the commonly prescribed medications for gastroesophageal reflux disease (GERD) include:

1. Antacids: Antacids relieve the symptoms of GERD by neutralizing the stomach acid that causes reflux.
   • Some examples include:
     • Aluminum hydroxide, magnesium hydroxide, and simethicone
     • Calcium carbonate
     • Magnesium hydroxide
2. Histamine-2 (H2) blockers: H2 blockers relieve GERD by blocking the action of histamine. Histamine activates stomach acid, especially after a meal.
   • Some examples of H2 blockers include:
     • Famotidine
     • Nizatidine
     • Cimetidine
   • Ranitidine was revoked from the market in the year 2020 due to the presence of cancer-causing agents.
3. Proton pump inhibitors: These drugs block acid production for longer periods than H2 blockers. They should be taken one hour before a meal.
   • Some examples include:
     • Pantoprazole
     • Rabeprazole
     • Dexlansoprazole
     • Esomeprazole
     • Lansoprazole
     • Omeprazole
4. Promotility agents: These agents work by activating the digestive tract muscles that prevent acid from staying in the stomach for a long period. Additionally, they strengthen the lower esophageal sphincter to reduce reflux into the esophagus. Metoclopramide is the drug used for reducing reflux.

Common side effects of antacids include:

• Brands with calcium or aluminum may lead to constipation.
• Brands with magnesium may lead to diarrhea.
• Rarely, brands with calcium may cause kidney stones or other problems.
• Consuming large amounts of antacids that have aluminum might put you at risk of calcium loss, leading to osteoporosis (weak bones).

Common side effects of H2 blockers include:

• Headache
• Abdominal pain
• Diarrhea
• Nausea
• Gas
• Sore throat
• Runny nose
• Dizziness

Common side effects of proton pump inhibitors include:

• Headache
• Diarrhea
• Abdominal pain
• Bloating
• Constipation
• Nausea 
• Gas

Common side effects of promotility agents include:

• Drowsiness
• Fatigue
• Diarrhea 
• Restlessness
• Movement problems

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to the FDA at 1-800-FDA-1088.

Antacids, H2 blockers, and proton pump inhibitors are safe during pregnancy. Always consult your physician before taking any type of antacids as some of them may contain sodium, causing more water retention. Some also have aluminum, which isn’t considered safe during pregnancy.

Promotility agents should be considered with extreme caution during pregnancy. They should be taken if the benefits outweigh the risk during pregnancy.

• Cimetidine may react with alcohol, leading to increased dizziness and drowsiness.
• Even metoclopramide may interact with alcohol.
• Other H2 blockers, antacids, and proton pump inhibitors don’t interact with alcohol, and combining them is safe.

However, drinking alcohol can worsen the symptoms of gastroesophageal reflux disease. Therefore, it is better to avoid them completely or limit their use.