Sudden burning in your chest after a meal, a sour taste in your mouth, a dry cough at night — these are classic signs of acid reflux. When symptoms are mild to moderate, many people look to over-the-counter (OTC) medicines for relief. But with antacids, H2 blockers, and PPIs all sitting on the same pharmacy shelf, it’s not always obvious which one you should take, when to take it, or how they differ.

This comprehensive guide explains what acid reflux is, how each OTC option works, who each option best serves, typical timing and duration, safety points, and practical tips to get better results. You’ll also learn when OTC care isn’t enough and it’s time to speak with a healthcare professional.

What Acid Reflux Is — And Why It Burns

How Reflux Happens
At the bottom of your esophagus sits a circular muscle that behaves like a valve. When it relaxes at the wrong time or doesn’t close completely, acidic stomach contents can flow upward and irritate the esophageal lining. That backward flow is reflux; repeating episodes can cause the burning sensation known as heartburn.

Common Symptoms To Recognize

  • A burning feeling behind the breastbone (often after meals or when lying down)

  • A sour, bitter, or acidic taste in the mouth

  • Throat clearing, hoarseness, or a dry cough

  • Sensation of food “sticking” or slow swallowing

Not everyone has every symptom, and severity can vary day to day. The right OTC medicine often depends on how quickly you need relief, how long you want it to last, and how frequently symptoms occur.

Your OTC Toolkit: Antacids, H2 Blockers, and PPIs

How These Categories Differ

  • Antacids work in the stomach to neutralize acid that’s already there. Relief is fast, but relatively short-lived.

  • H2 Blockers (H2 Antagonists) reduce acid production by blocking histamine-driven signaling in stomach cells. Relief is steadier and longer than antacids, but not immediate.

  • Proton Pump Inhibitors (PPIs) switch off the stomach’s final acid-secreting step. They take longer to “ramp up,” but provide the most robust and sustained acid reduction.

Each category has a role. The “best” OTC choice depends on your symptom pattern and goals.

Antacids: Fast, On-Demand Relief

What They Are
Chewable tablets and liquids (e.g., calcium carbonate, magnesium hydroxide/aluminum hydroxide combinations) that directly neutralize stomach acid.

When They’re Best

  • Infrequent, mild heartburn (for example, after an unusually heavy or spicy meal)

  • Situations where you need relief right now — minutes matter

Onset and Duration

  • Relief often starts in minutes

  • Effects last roughly 30 minutes to a couple of hours, depending on stomach contents and the product used

How To Use Them Wisely

  • Follow the label for maximum daily doses

  • Liquids may coat and soothe more quickly; chewables are convenient on the go

  • If you need antacids more than occasionally, you likely need a longer-acting option

Potential Drawbacks

  • Short duration; symptoms can return

  • Some products can cause constipation (calcium, aluminum) or diarrhea (magnesium)

  • Do not rely on antacids to heal esophageal irritation; they’re for rapid symptom relief, not long-term control

H2 Blockers: Longer Relief With Flexible Dosing

What They Are
Nonprescription options typically include famotidine (e.g., Pepcid AC). They reduce the stomach’s acid output by blocking histamine-stimulated cells.

When They’re Best

  • Mild to moderate heartburn that occurs a few times per week

  • “Predictable” triggers (e.g., you know a late, spicy dinner sets you off) — you can dose before the meal

  • Nighttime heartburn when you want relief lasting several hours

Onset and Duration

  • Onset in about 30–60 minutes (sometimes sooner if taken in advance)

  • Effects commonly last 6–12 hours

Usage Tips

  • For prevention, consider taking 10–30 minutes before a known trigger meal

  • For treatment, you can take at the first sign of symptoms; some people pair a single antacid dose for immediate relief with an H2 blocker for staying power (avoid chronic “stacking” of categories without professional advice)

Potential Drawbacks

  • Not as powerful as PPIs for frequent or severe symptoms

  • May cause headache, fatigue, constipation, or diarrhea in some users

Good Fit Profile
You want something stronger and longer than antacids, but you don’t have heartburn most days of the week.

PPIs: Strongest OTC Acid Suppression

What They Are
OTC PPIs (e.g., omeprazole, esomeprazole, lansoprazole) target the proton pumps in stomach cells — the final pathway of acid production.

When They’re Best

  • Frequent heartburn (for many, ≥2 days per week)

  • Morning or daily symptoms that erode quality of life

  • Situations where healing of irritated esophageal tissue is a goal

Onset and Duration

  • Not immediate: benefits build over 1–4 days of once-daily dosing

  • Once “on board,” control is sustained throughout the day

Usage Tips

  • Take once daily, ideally 30–60 minutes before breakfast, to align with pump activation

  • Use as a 14-day course per labeling; many brands suggest waiting months before repeating without professional guidance

  • Do not treat like an antacid — PPIs are preventive controllers, not quick-relief agents

Potential Drawbacks

  • Because they’re strong, they can mask persistent problems — if you need repeated courses, seek medical advice

  • Possible side effects include headache, abdominal discomfort, or loose stools

Good Fit Profile
You have frequent, recurring heartburn and want predictable all-day control after a short ramp-up period.

Quick Selector: Which OTC Option Fits Your Pattern?

Occasional “Oops” Meals (Less Than Weekly)

  • Start with an antacid for rapid relief

A Few Times Weekly or Predictable Triggers

  • Consider an H2 blocker (optionally timed before a trigger meal)

  • You can add a single antacid dose for immediate relief when needed

Most Days of the Week

  • Use an OTC PPI once daily for 14 days as directed

  • If symptoms persist or recur quickly after a course, talk to a healthcare professional

Practical Dos and Don’ts for Better Results

Take the Right Medicine at the Right Time

  • Antacids: at symptom onset (or right after trigger foods)

  • H2 Blockers: 30–60 minutes before triggers, or at the start of symptoms

  • PPIs: once daily before breakfast, consistently for the course

Avoid Unnecessary Stacking

  • Combining categories routinely can cause missed interactions or excessive suppression. If you need to mix (e.g., antacid + H2 blocker for a tough evening), keep it occasional unless your clinician advises otherwise.

Mind Interactions

  • Antacids can affect absorption of some antibiotics, thyroid meds, and iron.

  • H2 blockers and PPIs can alter the way certain drugs are metabolized or absorbed.

  • If you take prescription medicines, ask a professional about timing and potential interactions.

Store Medicines Correctly

  • Keep in a cool, dry place (not the steamy bathroom).

  • Close caps tightly to protect chewables and powders from moisture.

Lifestyle Habits That Boost Your OTC’s Effectiveness

Adjust Meal Patterns

  • Eat smaller, more frequent meals rather than large, late dinners

  • Avoid lying down for at least 3 hours after eating

Identify and Limit Personal Triggers

  • Common culprits include fatty/fried foods, spicy dishes, chocolate, peppermint, tomatoes, citrus, caffeine, alcohol, and carbonated beverages

Optimize Sleep Setup

  • Elevate the head of the bed 6–8 inches (wedge or blocks) rather than stacking pillows, which bends the neck

Supportive Daily Habits

  • Maintain a balanced eating pattern rich in vegetables, lean proteins, and fiber

  • Stay active most days of the week

  • Work on stress management and healthy sleep routines

  • If you smoke, seek support to quit

Special Situations: When To Be Extra Careful

Nighttime Symptoms

  • An H2 blocker at bedtime can help short-term; persistent nocturnal reflux may warrant a professional evaluation.

Frequent NSAID Use

  • Pain relievers like ibuprofen or naproxen can irritate the stomach. Discuss protective strategies and alternatives with a clinician.

Pregnancy

  • Start with non-drug measures: smaller meals, avoiding trigger foods, and not lying down after eating. If medicine is needed, ask your prenatal provider which OTC options are appropriate for you and how to use them.

Older Adults

  • More sensitive to side effects and drug interactions; review all medications (including supplements) with a professional before long-term OTC use.

When OTC Isn’t Enough — Signs To Call A Professional

Seek Prompt Care If You Have:

  • Chest pain or pressure that lasts more than a few minutes, spreads to the jaw/arm/back, or comes with shortness of breath, sweating, dizziness, or nausea

  • Vomit that looks like coffee grounds, or black/tarry stools

  • Food sticking or progressive swallowing difficulty

  • Unexplained weight loss, hoarseness, chronic cough, or frequent regurgitation

  • Heartburn most days despite proper OTC use and lifestyle measures

A clinician can confirm the diagnosis, look for complications (like esophagitis), check whether another condition is mimicking reflux, and decide whether prescription-strength therapy or further testing is appropriate.

FAQs: Getting Granular About Your Choices

Can I Use an Antacid and an H2 Blocker Together?
Occasionally, yes: an antacid can give immediate comfort, while an H2 blocker sustains relief. Avoid habitual stacking without medical advice.

Are PPIs “Stronger” Than H2 Blockers?
For acid suppression and healing irritated tissue, PPIs generally provide a more powerful and consistent effect — but they take longer to work.

How Long Should I Take an OTC PPI?
Follow the label’s 14-day course. If symptoms return quickly or never fully improve, consult a professional rather than repeating course after course on your own.

Do Any of These Heal the Esophagus?
H2 blockers may help some healing; PPIs are more effective for promoting healing when irritation is present. Antacids do not heal — they simply neutralize acid.

What If My Symptoms Feel Different Suddenly?
Any change in the character of chest or upper-abdominal discomfort — especially pressure-like, crushing, or associated with breathlessness or sweating — warrants urgent evaluation.

The Bottom Line

There’s no single “best” OTC treatment for everyone — the right fit depends on how often you have symptoms, how quickly you need relief, and whether healing and all-day control are priorities.

  • Choose antacids for rapid, occasional relief.

  • Choose an H2 blocker when you need several hours of control or want to pre-empt predictable triggers.

  • Choose a PPI when symptoms occur most days and you need the strongest, sustained acid reduction after a short ramp-up.

Pair any medication with smart meal timing, trigger awareness, sleep positioning, and daily habits to get better, longer-lasting results. And if symptoms are frequent, severe, or changing, involve a healthcare professional to keep you safe and comfortable.