What Medication Treats Heartburn?

There are many heartburn medications available over the counter or by prescription, aside from home remedies and lifestyle changes. The best heartburn medication depends on the severity of your symptoms but can include antacids, H2 blockers, or proton pump inhibitors (PPIs). Zofran (ondansetron) isn't an antacid but can help with other symptoms like nausea.

Heartburn, also known as acid reflux, occurs when stomach acid seeps up into the esophagus. This tube connects the throat and stomach. The painful, burning sensation of heartburn can cause extreme discomfort. Read on to learn what some of the best medications for heartburn are and how they work.

Antacids

Sold as: Maalox, Mylanta, Pepcid, Rolaids, Tums

Antacids are usually hydroxide or bicarbonate salts that counteract or neutralize the acid in your stomach. They can contain some combination of magnesium, calcium, and aluminum. You can find antacids over the counter as tablets, capsules, or liquids.

Potential side effects include:

• Constipation
• Diarrhea
• Nausea
• Upset stomach

Keep in mind that this class of drugs only treats the symptoms of heartburn. Antacids do not address the root causes of heartburn.

Bismuth Subsalicylate

Sold as: Kaopectate, Pepto-Bismol

This medication, which is available over the counter as tablets, caplets, or liquid, treats both heartburn and diarrhea. Bismuth subsalicylate works by killing harmful bacteria in the intestines, reducing bowel inflammation, and acting as an antacid. It also helps to prevent bacteria from binding and growing on the mucosal cells of the stomach.

Bismuth subsalicylate may cause side effects, including:

• Anxiety or depression
• Bitter taste
• Confusion
• Darkening of the tongue or stool
• Diarrhea
• Headaches
• Muscle spasms or weakness
• Nausea
• Slurred speech

Stop taking the medication if you have ringing or buzzing in your ears. Call a healthcare provider right away if you have other unusual, severe side effects.

Foaming Agents

Sold as: Gaviscon

Foaming agents, or alginates, create a layer of foam that floats on top of the stomach contents. This foam keeps stomach contents, like acid, in the stomach and not the esophagus.

This medication is available over the counter as a tablet or liquid. Research has shown that no significant difference in side effects between foaming agents and antacids.

H2 Blockers

Sold as: Pepcid AC, Tagamet HB, Zantac

These drugs reduce stomach acid production by blocking histamine. Histamine is a chemical the body makes in response to an allergic reaction. H2 blockers also can help the esophagus heal. You can find these medications in liquid and tablet form. They are sold over the counter or by prescription, depending on their strength.

Potential side effects include:

• Constipation
• Diarrhea
• Dizziness
• Headache
• Sleepiness

Keep in mind that some H2 blockers contain cimetidine. This ingredient can lead to breast enlargement in males.

Prokinetics

Sold as: Urecholine (bethanechol), Reglan (metoclopramide)

Prokinetics, which are available by prescription only in liquid and tablet form, strengthen the lower esophageal sphincter. This keeps acid out of the esophagus. Prokinetics also helps the stomach empty faster. Reglan improves muscle action in the digestive tract.

Potential side effects include:

• Anxiety or depression
• Dizziness
• Drowsiness
• Feeling warm
• Upset stomach
• Vomiting

Reglan can cause tardive dyskinesia (TD), or uncontrollable facial movement. Talk with a healthcare provider right away if you develop uncontrollable body movements, a rash, swelling, difficulty breathing, or vision changes.

Note that while prokinetics may be prescribed in some cases, they are not common drugs for treating GERD. Generally, this class of drugs is only reserved for when there is evidence of delayed gastric emptying (when the stomach takes longer to empty).

Proton Pump Inhibitors (PPIs)

Sold as: Aciphex, Dexilant, Nexium, Prevacid, Prilosec, Protonix, Zegerid

PPIs directly inhibit acid production. These drugs are the best for helping the esophagus heal but can take hours to work. PPIs are available by prescription, but you can buy Prilosec and Prevacid over the counter.

Research has shown that PPIs may also be linked to an increased risk of bone fractures. Other side effects include:

• Constipation
• Diarrhea
• Headache
• Itching
• Nausea

Simethicone

Sold as: Alka-Seltzer, Gas-X

Simethicone is an antacid that provides temporary relief. This drug reduces stomach acid and gas that causes pain. You can find simethicone over the counter as a tablet (regular or chewable), liquid, or capsule.

Simethicone doesn't typically cause side effects if you use it as directed. Potential side effects might include mild diarrhea or nausea.

What Medication Works Best for Heartburn? 

Medications like antacids, H2 blockers, and PPIs can relieve heartburn. How well they work might depend on your symptoms. It may take some trial and error to find the best medication that works for you.

If you experience nausea, you might consider taking an anti-nausea drug like Zofran, but it is not recommended as a heartburn medication. Zofran is a serotonin 5-HT3 receptor antagonist, a class of drugs that blocks serotonin, a hormone that can make you feel nauseous.

Contact a healthcare provider if heartburn medication does not resolve symptoms after taking it for several weeks. They can administer diagnostic tests and may prescribe a high-strength medication.

A Quick Review

Heartburn medications include antacids, H2 blockers, PPIs, and more. The best medication can depend on the severity of your symptoms, including whether you have esophageal damage. You may also consider taking a drug like Zofran alongside a heartburn medication. Zofran doesn't help with heartburn, but it can treat other symptoms like nausea.

Talk to a healthcare provider if you're taking heartburn medication for several weeks and your symptoms don't improve or worsen. They may prescribe a stronger medication to alleviate your symptoms.