Acid Reflux Medication: From Antacids to PPIs

At your local pharmacy or grocery store, you will find whole rows of acid reflux medication and non-prescription remedies for excess stomach acid. Other types of acid reflux medication are available by prescription only. The most popular categories of acid reflux medication are as follows:

(1) Non-absorbable antacids: Sold as Maalox and Mylanta, non-absorbable antacids neutralize stomach acid but are not absorbed by the stomach or intestine. A very mild form of acid reflux medication, non-absorbable antacids usually have few side effects but may cause diarrhea or could reduce the body’s ability to absorb calcium.

(2) Absorbable antacids: Better known as Tums, Rolaids, Alka-Seltzer, and baking soda, absorbable antacids are a little more effective as an acid reflux medication than non-absorbable antacids. Since they are calcium-based, absorbable antacids do not prevent calcium absorption but can cause constipation. In rare cases, taking calcium carbonate as an acid reflux medication for a long period of time has caused elevated levels of calcium in the blood (hypercalcemia), which can lead to kidney failure.

(3) H2 blockers (stomach acid inhibitors): Under the brand names Tagamet, Pepcid, Zantac, Axid, and others, stomach acid inhibitors slow down the production of stomach acid by blocking one important producer of acid called “histamine2.” Stomach acid inhibitors do not neutralize stomach acid like antacids do. Stomach acid inhibitors were once available only by prescription and may interfere with other medications. Some people do not prefer stomach acid inhibitors as an acid reflux medication because they may take up to 90 minutes to work. Side effects include headache, diarrhea, dizziness, or rash. Long-term use of H2 blockers has been shown to possibly cause mental decline and dementia later in life.

(4) Proton pump inhibitors: Proton pump inhibitors, or PPIs, work by shutting down acid-secreting molecules in the stomach (gastric acid pumps). Some proton pump inhibitors are available over the counter and most are obtained by prescription only. Proton pump inhibitors have the longest delay in working as an acid reflux medication because they block the final step of acid secretion in the stomach. Popular proton pump inhibitors include Prilosec, Nexium, Prevacid, Aciphex, and Protonix. Reported side effects of proton pump inhibitors are headache, diarrhea, constipation, nausea, and itching. In recent studies, proton pump inhibitors have been linked to an increased risk of hip fracture.

In addition to—or in lieu of—taking an acid reflux medication, many people have opted to make lifestyle and diet changes to ease their acid reflux symptoms. While an over-the-counter or prescription acid reflux medication may relieve acid reflux pain, many acid reflux drugs are not designed to be taken consistently over a long period of time.