Heartburn medicine - tips for effective relief

Heartburn medicine - tips for effective relief

Heartburn Medicine: It's all the same, right?

According to the advertising, they all work wonderfully. Rolaids, Pepcid, Prilosec, Prevacid. But is there no difference between antacids and The Purple Pill? What about over-the-counter medications versus prescription medications?

Not only is there a difference in how these medications work, but there is also a big difference in price. Knowing what to use can not only relieve your symptoms but also be easier on your wallet.

For occasional heartburn symptoms, such as those associated with eating a spicy meal, there are several possibilities. If you know in advance that the food you are about to eat will cause heartburn, pretreatment is the best answer. Both the over-the-counter H2 blockers (Pepcid, Zantac, Axid and Tagamet) and the proton pump inhibitors (PPIs) (Prilosec, Prevacid) are effective. The PPIs are stronger, but the H2 blockers are cheaper. For most people, any of these functions will work. Generally, it takes at least an hour for acid production to decrease. Unlike antacids (Rolaids, Maalox, Tums), they must first be absorbed into your bloodstream to work.

If you forget to take medications before taking them, you can safely take those medications as soon as symptoms appear. The antacids neutralize stomach acid on contact and provide the fastest relief. (Remember your high school chemistry?) The more acid produced, the more antacids are needed. Pepcid Complete contains both famotidine and a combination of two antacids (calcium carbonate and magnesium hydroxide). The antacids neutralize stomach acid until the famotidine can be absorbed and reduce acid production. The same can be achieved less expensively by using generic famotidine or ranitidine (generic Zantac) along with a generic antacid.

Some patients complain that the H2 blockers (Pepcid, Zantac, Axid and Tagamet) are ineffective. These medications reduce stomach acid production by on the order of 50%. The OTC medications have about half the milligram strength as prescription versions, but are the same medications. Generics of Zantac, Axid, Pepcid, and Tagamet still require a prescription and may cost less than over-the-counter medications - a monthly supply may cost as little as $4.

The PPIs (Prilosec, Prevacid) reduce acid emissions by up to 90%. In recent years, two have gone over the counter, while several others are available by prescription (Aciphex, Protonix, Dexilant, Nexium). They all work about the same, although certain patients seem to get more relief from one or the other. The OTC versions cost $20 to $30 per month, compared to well over $100 for prescription drugs.

One problem with taking these medications over the counter is the risk of masking a serious problem. The OTC medications warn you to see your doctor if symptoms persist for more than a few weeks. This is certainly good advice. You don't want to mask a serious ulcer or cancer. If you need occasional relief from heartburn, using over-the-counter medications is fine. If it is a daily problem, see your doctor to rule out any serious concerns.

Copyright 2010 Cynthia J. Koelker, MD

Inspired by Cynthia Koelker