These 9 Medications Can Cause Heartburn

Heartburn is a form of indigestion that happens when stomach acid backs up into the esophagus, the tube that connects the stomach to the throat. And if you have heartburn, pills can be your best friend and worst enemy.

Some medications (such as antacids) soothe the painful burning you may experience after downing an order of buffalo wings or drinking one too many glasses of wine.

Other pills—the ones you take for health conditions that are not related to heartburn—may make the acid reflux worse or even trigger heartburn in the first place. Is your medication to blame for your pain? This guide will help you find out.

Aspirin

The world's wonder drug may be able to ease everything from headaches to heart attacks. But for those who experience heartburn, it also comes with a cost: more acid production in the stomach.

Aspirin also keeps the body from forming protective prostaglandins in the digestive tract. Prostaglandins are compounds made by the body and act like hormones. The ones in the stomach prevent cells in the stomach wall from producing and releasing acid.

Ibuprofen

Popular over-the-counter ibuprofen products such as Motrin and Advil can increase acid production in the stomach and reduce protective prostaglandins.

Instead, you can try acetaminophen (Tylenol) for pain relief, which does not increase acid levels, according to Vivek Kaul, MD, a gastroenterologist at the University of Rochester Medical Center, in Rochester, New York.

Even a narcotic such as oxycodone acetaminophen (Percocet) may be better for your stomach than taking six Motrin tablets a day, said Dr. Kaul. But some narcotics can cause heartburn—in addition to being habit-forming—so discuss your options with a healthcare provider.

Antibiotics

Antibiotics like tetracyclines (a class of broad-spectrum antibiotics) that are used to treat common bacterial infections can also cause heartburn.

If you experience heartburn often and need an antibiotic, ask a healthcare provider for one that's gentle on the esophagus and stomach if possible.

Or, an enteric-coated pill may be less abrasive. That's because the coating keeps the pill intact as it passes through the stomach and causes it to dissolve in your small intestine instead of in your stomach.

Blood Pressure Drugs

Blood pressure medications known as calcium channel blockers and beta blockers can provoke heartburn. They might do so by relaxing the lower esophageal sphincter (LES), which can allow stomach acid to seep up into the esophagus.

If this happens to you, ask a healthcare provider about alternatives. "There are a lot of blood pressure medications out there, and sometimes you can successfully switch," said Timothy Pfanner, MD, assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine, in College Station.

Bone-Strengthening Drugs

Drugs for osteoporosis known as bisphosphonates—including alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel)—are notorious for causing heartburn.

Some formulations that are taken less frequently may be easier on the stomach. Zoledronic acid (Reclast), for instance, is an infusion drug that needs to be taken only once a year.

If you're still on a daily or weekly bisphosphonate pill, taking it with a full glass of water and not lying down for 30 minutes afterward may help avoid heartburn.

Sleeping Pills and Sedatives

Medications known as benzodiazepines—such as diazepam (Valium) and lorazepam (Ativan)—are designed to relieve anxiety and help you relax. But they also relax your LES, which may lead to heartburn.

It also doesn't help that most people lie down after taking these medications: Lying down can aggravate acid reflux. When you recline, gravity no longer helps keep stomach acid down, making it easier for the acid to get into the esophagus.

Tricyclic Antidepressants

Some of the older tricyclic antidepressants (such as imipramine or amitriptyline) may contribute to heartburn by slowing the speed at which the stomach empties, said Dr. Kaul.

"If the stomach isn't emptying as it's supposed to, then acid and food products will sit there for a long time and will be more likely to reflux back," explained Dr. Kaul. Tricyclic antidepressants can also relax the LES, which increases the risk of heartburn.

Generally speaking, some psychiatric drugs work in a more targeted way and have fewer gastrointestinal side effects.

Iron Supplements

Iron is a mineral that your body needs for many functions. It spurs the body to produce more red blood cells, which carry oxygen throughout the body. Your body needs the right amount of iron; if you have too little iron, you may develop iron deficiency anemia.

Iron deficiency anemia is a common condition that's treated with iron supplementation. Taking iron supplements as pills can irritate the lining of your esophagus and lead to acid reflux.

Research has suggested that iron erodes the mucosa of the gastrointestinal (GI) tract. Researchers commented that iron pill–induced gastritis (inflammation of the stomach lining) has only been documented when iron supplementation is given in pill form, not in liquid form.

Ask a healthcare provider for alternative forms of iron supplements, or reduce the odds of reflux by taking the pills sitting up or standing, not lying down.

Potassium Supplements

These supplements are often taken to help normalize high blood pressure, but they can irritate the lining of the esophagus, said Dr. Kaul.

Not every person who takes potassium is going to experience heartburn. But to reduce the chances, be sure to take the medicine while sitting up, and wash it down with plenty of water.

If you still feel the burn, ask a healthcare provider for another type of blood pressure medication or for a slow-release enteric-coated version of potassium.

How To Reduce Heartburn Risk

Along with talking to a healthcare provider about alternative medications that don't cause heartburn, there are many lifestyle changes that can reduce or prevent heartburn. Incorporating these changes into your daily routine may help:

• Not lying down within a few hours of eating a meal or taking medication
  
• Eating smaller meals
• Losing weight if needed
• Avoiding tight-fitting clothes

There are also a number of foods and drinks for you to avoid that can trigger heartburn. They include:

• Alcohol
• Carbonated drinks
  
• Citrus fruits and juices
• Caffeine (including chocolate)
• Full-fat dairy products
• Mint (e.g., peppermint, spearmint)
• Spicy, fatty, or fried foods
• Tomatoes and tomato sauces

Also, take medications with water and, if it's okay to do so, with food. Check with a healthcare provider for each medication to make sure that food doesn't intervene with how the medications are absorbed in your body. Additionally, you don't want to change or stop any medications without talking with a healthcare provider first.

A Quick Review

One cause of heartburn can be medications, such as antibiotics, sleeping pills, and bone-strengthening drugs. If you're taking any medicines that may be giving you heartburn, talk with a healthcare provider about other treatment options.

You can also help reduce or prevent heartburn with lifestyle changes, like not wearing tight-fitting clothes or avoiding foods and drinks that trigger heartburn. But seek medical attention if you still have heartburn issues that won't let up.