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Heartburn. By Our Student Pharmacist for July, Ping Zhu.


Many people have experienced heartburn some time in their lives and used over-the-counter (OTC) medications to treat their heartburn. There are many choices of medications to treat heartburn and choosing the right medicine can become confusing.

Today, we are going to talk about the management of heartburn.


  • Burning sensation of the esophagus or in the chest, usually occurs after eating or while lying down.

When do I need to see a doctor?

  • Frequent heartburn (occurs two or more times per week and lasts for more than three months).
  • You still experience symptoms after trying over-the-counter medications for more than two weeks.
  • Difficulty or painful swallowing.
  • Severe symptoms including vomiting and weight loss.
  • Stomach bleeding, black or bloody stools.

Life Style Changes:

Some life style changes can help to prevent heartburn. Try these changes:

  • Avoid food that can cause heartburn such as:
    • Coffee, alcohol, chocolate, fatty foods, citrus, carbonated drinks, spicy foods
  • Weight loss.
  • Smoking cessation.
  • Raise the head of the bed.
  • Eat your last meal at least three hours before bedtime and avoid lying down directly after a meal.


If you have minor and infrequent heartburn, antacids are a good choice for you. You can take antacids one hour after meals, as needed. Medications that fall under this category are:

  • Amphogel, Basalgel (aluminum salts)
    • Can cause constipation.
    • Avoid in elderly patients, if you drink a lot of alcohol, or if you had a recent GI hemorrhage.
  • Philip’s Milk of Magnesia (magnesium salt)
    • Can cause diarrhea.
    • Avoid if you have kidney disease.
  • Alka-Seltzer, Bromo-Seltzer (sodium bicarbonate)
    • Can cause weight gain and water retention.
    • Avoid if you have high blood pressure, heart failure, and pregnancy. Caution in elderly.
  • Tums (calcium carbonate)
    • Most commonly used.
    • May cause kidney stones.


If you have mild to moderate heartburn, the following medications can help you. They need to be taken 30-60 minutes before you eat, depending on the medication. They last longer than antacids.

  • Tagament HB 200, Acid Reducer 200 (cimetidine)
  • Zantac (ranitidine)
  • Pepcid (famotidine)

If you have frequent heartburn or heartburn that cannot be controlled on the above medications, you can use the following medications:

  1. Prilosec (omeprazole)
  2. Prevacid (lansoprozole)
  3. Zegerid (omeprazole with sodium bicarbonate)
  4. Nexium (esomeprazole)

Things to remember with these medications:

  • Take them one hour before you eat.
  • They can also be used to prevent heartburn.
  • Make sure you follow up with your doctor if your heartburn is severe or frequent.
  • Caution in elderly populations.
  • Do not use these products for more than 14 days without talking to your doctor.

Other medications:

  • Pepto-Bismol (bismuth subsalicylate)
    • Do not use for children <12 years old
    • Do not use if you have an aspirin allergy, the flu, or active chicken pox.

These medications can interact with your prescription medications. Make sure you talk to a pharmacist before using these medications. If you have any questions about the medications, side effects, or drug interactions, please let us know! We are here to help!

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