OTC Relief for Heartburn and Acid Reflux
OTC Relief for Heartburn and Acid Reflux
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Newsfeed display by CaRP What types of OTC products treat heartburn?
Over-the-counter (OTC) products are medicines you can buy without a doctor’s prescription. Many OTC products are advertised to relieve heartburn or acid reflux. These include antacids, bismuth subsalicylate, H2 blockers, proton pump inhibitors and combination medicines. Combination medicines may include two or more of the following drugs.

How do antacids and acid reducers work?
Antacids neutralize the acid in your stomach. They can provide fast, short-term relief. Many OTC drugs combine different antacids.

H2 blockers reduce the amount of acid your stomach makes. While they don’t relieve symptoms right away, H2 blockers relieve symptoms for a longer period of time than antacids.

Some products combine antacids and an H2 blocker. One example combines famotidine, calcium carbonate and magnesium hydroxide (brand name: Pepcid Complete). These combination medicines can relieve symptoms right away and the relief can last for many hours.

Bismuth subsalicylate works by balancing the way fluid moves through your bowels. It also binds toxins (poisons) from bacteria so that they are not harmful and helps kill germs. It’s also used as an antiemetic (medicine to treat nausea and vomiting) and as an antidiarrheal (medicine to treat diarrhea).

Proton pump inhibitors stop your body’s production of acid. This type of drug requires 1 to 4 days to work. Only people who have heartburn often—at least 2 days a week—should use this drug.

To find out which product is right for you, talk to your doctor.

What problems can OTC antacids and acid reducers help?
These medicines can help relieve heartburn or dyspepsia (pain or an uncomfortable feeling in the upper middle part of your stomach). Heartburn is also called acid reflux disease or gastroesophageal reflux disease (GERD). OTC antacids and acid reducers may also be used as part of a plan to treat ulcers. For treating ulcers, these medicines may be used together and/or combined with antibiotics (drugs that kill bacteria) prescribed by your doctor.

If you aren’t getting enough calcium from your diet, your doctor might suggest that you take additional calcium to help treat or prevent osteoporosis. Antacids that contain calcium carbonate can be used with vitamin D to supplement the calcium in your diet.

What are some common side effects of heartburn medicines?
Antacids and acid reducers usually cause only minor side effects that go away on their own. These may include headaches, nausea, constipation or diarrhea. Bismuth subsalicylate can cause your tongue or stool to turn dark. This is a short-term side effect.

If side effects make it hard for you to take medicine for heartburn, talk to your family doctor. He or she may suggest a different drug or have ideas about how to make the side effects less of a problem.

Who shouldn’t take OTC antacids and acid reducers?
Don’t take these drugs if you have an allergy to any of the ingredients. Phenylalanine is an example of an ingredient in some antacids that can cause a problem for certain people.

If you have a condition called phenylketonuria, you shouldn’t take a medicine that contains phenylalanine.

Don’t take bismuth subsalicylate if you’ve ever had an allergy to aspirin or any other product that contains salicylates. Also don’t give bismuth subsalicylate to children who may have the flu or chickenpox because they will have a higher risk of Reye’s Syndrome.

Other ingredient-related warnings concern your diet while you’re taking an antacid or acid reducer. For example, unless your doctor tells you it’s OK; don’t use products that contain sodium bicarbonate or aluminum hydroxide and magnesium carbonate if you’re on a low-salt diet. Don’t take magnesium hydroxide if you’re following a magnesium-restricted diet.

If you have kidney disease, you shouldn’t use products containing calcium carbonate or aluminum hydroxide and magnesium carbonate without your doctor’s recommendation.

Can OTC antacids or acid reducers cause problems with any other medicines I take?
If certain drugs are taken at the same time, they can react with each other and change the way your body processes them. This is called a drug interaction. When this happens, the risk of side effects increases.

Don’t use more than one antacid or acid reducer at a time. Don’t mix acid reducers and antacids without first talking to your doctor.

If you take any prescription drugs and you’re thinking about taking an antacid, H2 blocker or proton pump inhibitor, talk to your doctor first. These drugs can cause problems with other medicines you take.

The following drugs may be of special concern for people who are taking H2 blockers or proton pump inhibitors:
1. Theophylline (oral asthma drug)
2. Warfarin (brand name: Coumadin) (blood-thinning drug)
3. Phenytoin (brand name: Dilantin) (seizure drug)
4. Prescription medicine for fungal or yeast problems
5. Diazepam (anxiety drug)
6. Digoxin (heart drug)

Bismuth subsalicylate may affect some drugs so that they don’t work as well. It also may cause side effects if combined with other drugs. If you take any of the following drugs, talk to your doctor before taking bismuth subsalicylate:
1. Blood-thinning drugs
2. Drugs to treat gout
3. Drugs to treat arthritis
4. Drugs for diabetes

Also, check with your doctor or pharmacist before taking bismuth subsalicylate if you take pain relievers, cold products or some prescription drugs. These medicines may contain aspirin, which is a salicylate, or they may contain some other type of salicylate. Because bismuth subsalicylate contains salicylate, you may take more salicylate than you intend if you take more than one of these products.

Should I call my doctor for any other reasons?
Before taking an antacid or acid reducer, talk to your doctor if you have any of the following symptoms:
1. Trouble or pain when you swallow
2. Bloody vomit
3. Bloody or black stools
4. Ongoing stomach pain
5. Lightheaded, dizzy or sweaty feeling
6. Chest pain, shoulder pain, or pain that spreads to your arms, neck or shoulders with shortness of breath
7. Weight loss for no reason
8. Nausea or vomiting
9. Wheezing (you’ll hear a squeaky or musical sound in your chest)
10. Heartburn that has lasted more than 3 months

You should stop using antacids or acid reducers and call your doctor if any of the following are true:
1. Your stomach pain doesn’t get better when you use the medicine, or it gets worse.
2. You need to take the medicine for more than 14 days.
3. You’re taking Omeprazole (brand name: Prilosec) and feel like you need to take more than 1 course in 4 months.
4. Don’t try to treat yourself if you have any of these symptoms. They may be signs that you have an ulcer or a more serious problem that needs to be checked by your doctor.

What should I look for on the drug label?
When choosing an OTC antacid or acid reducer, check the drug label for possible side effects or interactions with other drugs you’re taking. This information will appear in the “Warnings” section of the label.

Be sure to check that you’re not taking two medicines that contain the same ingredient.

Always read and follow the directions on the label. Be sure you understand what the label says before taking the medicine. If you have any questions, ask your family doctor or pharmacist.
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Submitted: 06/18/06

Description: Over-the-counter (OTC) products are medicines you can buy without a doctor’s prescription. Many OTC products are advertised to relieve heartburn or acid reflux. These include antacids, bismuth subsalicylate, H2 blockers, proton pump inhibitors and combination medicines.

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