Heartburn — that familiar burning discomfort behind the breastbone — can be frustrating and disruptive. While occasional episodes may be relieved with home remedies or lifestyle adjustments, medications are often the most reliable way to get relief. The right medication for heartburn depends on the severity, frequency, and underlying cause of your symptoms.

From fast-acting antacids to longer-lasting proton pump inhibitors, a variety of treatments are available over the counter or by prescription. In some cases, additional drugs may be used to treat related symptoms like nausea or indigestion. Understanding how each type of medication works will help you choose the most effective option for your needs.

How Heartburn Develops

Heartburn is another name for acid reflux — when acidic contents from the stomach travel upward into the esophagus, the tube that connects the throat and stomach. This backward flow irritates the esophageal lining, causing a burning sensation, sour taste, or pressure in the chest.

Common triggers include:

  • Large or fatty meals

  • Caffeine or alcohol

  • Smoking

  • Lying down shortly after eating

  • Pregnancy or certain medications

For occasional episodes, lifestyle changes may help. But persistent or severe heartburn often requires medical treatment to control acid and protect the esophagus from damage.

Antacids: Quick Relief for Mild Symptoms

Examples: Maalox, Mylanta, Rolaids, Tums

How They Work
Antacids are made of minerals such as magnesium, calcium, or aluminum salts. These compounds neutralize stomach acid, providing fast relief within minutes.

When To Use Them
Antacids are best for infrequent, mild symptoms — for example, after eating a particularly heavy or spicy meal.

Possible Side Effects

  • Constipation (calcium or aluminum-based formulas)

  • Diarrhea (magnesium-based formulas)

  • Nausea or upset stomach in some users

Limitations
While effective for immediate relief, antacids don’t address the root cause of reflux. They also do not heal esophageal irritation from long-term acid exposure. If you find yourself relying on antacids frequently, you may need a stronger treatment.

Bismuth Subsalicylate: A Dual-Purpose Option

Examples: Pepto-Bismol, Kaopectate

How It Works
This medicine treats both heartburn and diarrhea. It reduces inflammation in the digestive tract, acts as a mild antacid, and helps prevent bacteria from attaching to the stomach lining.

Possible Side Effects

  • Darkened stool or tongue

  • Bitter taste

  • Mild nausea or headache

  • Rare neurological effects (confusion, dizziness, or ringing in the ears)

Best Fit
Useful for people who experience heartburn along with nausea or digestive upset. It’s not a first-line choice for frequent reflux but may help with temporary discomfort.

Foaming Agents: Creating a Protective Barrier

Examples: Gaviscon

How They Work
Foaming agents, also known as alginates, create a protective layer that floats on top of stomach contents. This foam barrier helps keep acid from reaching the esophagus.

When To Use Them
They can be used as an alternative or in combination with antacids. They are particularly helpful after meals or before lying down.

Side Effects
Studies show minimal side effects, and they are generally well tolerated.

H2 Blockers: Medium-Term Control

Examples: Pepcid AC (famotidine), Tagamet HB (cimetidine), Zantac (ranitidine – note: availability varies)

How They Work
H2 blockers reduce acid production in the stomach by blocking histamine receptors on stomach cells. They are stronger and longer-lasting than antacids.

When To Use Them

  • For moderate symptoms that occur a few times per week

  • To prevent heartburn from predictable triggers (e.g., eating before bedtime)

Onset and Duration

  • Relief begins in 30–60 minutes

  • Effects last 6–12 hours

Side Effects

  • Headache

  • Dizziness

  • Constipation or diarrhea

  • Rare hormonal side effects with cimetidine (breast enlargement in men)

Best Fit
Good for those who need longer relief than antacids provide but aren’t ready for a daily, long-term treatment.

Prokinetics: Improving Movement in the Digestive Tract

Examples: Reglan (metoclopramide), Urecholine (bethanechol) — prescription only

How They Work
Prokinetics strengthen the lower esophageal sphincter and help the stomach empty more quickly. By reducing the time food spends in the stomach, they lower the risk of reflux.

Limitations
They are not first-choice drugs for heartburn and are usually prescribed only if delayed stomach emptying (gastroparesis) is a factor.

Possible Side Effects

  • Drowsiness or dizziness

  • Anxiety or depression

  • Nausea

  • Rare but serious movement disorders (tardive dyskinesia) with long-term use

Proton Pump Inhibitors (PPIs): Strongest OTC And Prescription Option

Examples: Nexium (esomeprazole), Prilosec (omeprazole), Prevacid (lansoprazole), Protonix (pantoprazole)

How They Work
PPIs block the final enzyme step responsible for producing stomach acid. This makes them the most effective treatment for frequent or severe reflux.

When To Use Them

  • Frequent symptoms (two or more times per week)

  • Evidence of esophageal irritation or erosive esophagitis

Onset and Duration

  • Take one dose daily, typically before breakfast

  • Relief may take several days to build

  • Effects last 24 hours

Side Effects

  • Headache

  • Diarrhea or constipation

  • Stomach pain

  • Rare: possible increased risk of bone fractures with long-term use

Best Fit
Ideal for individuals with persistent or severe reflux who need consistent, daily control.

Simethicone: Targeting Gas and Pressure

Examples: Gas-X, Alka-Seltzer Anti-Gas

How It Works
Simethicone breaks down gas bubbles in the digestive tract, reducing bloating and pressure that can worsen heartburn.

Best Fit
Works best for reflux accompanied by gas or bloating. It is not a primary heartburn treatment but can complement other medications.

Side Effects
Minimal when used as directed; some users may experience mild nausea or loose stools.

What Medication Works Best?

There isn’t a one-size-fits-all solution — the best medication depends on your needs:

  • Mild, occasional symptoms → Antacids or foaming agents

  • Moderate symptoms a few times weekly → H2 blockers

  • Frequent or severe symptoms → PPIs, under medical guidance

  • Heartburn plus delayed digestion → Prokinetics (prescription only)

  • Heartburn with gas → Simethicone alongside other treatment

Zofran (ondansetron), often prescribed for nausea, may ease related symptoms but does not treat acid reflux directly.

Safety Tips And When To See a Doctor

  • Don’t mix multiple heartburn medications regularly without professional advice.

  • Always read labels carefully and use as directed.

  • Store medicines in a cool, dry place to preserve effectiveness.

  • Seek medical advice if:

    • Symptoms persist for weeks despite OTC use

    • You have difficulty swallowing or unexplained weight loss

    • You vomit blood or notice black stools

    • Chest discomfort feels crushing, radiates to your arm or jaw, or comes with shortness of breath

Because heartburn symptoms can mimic heart problems, severe or unusual chest pain always warrants emergency care.

Key Takeaway

Heartburn can often be controlled with OTC or prescription medications. Antacids provide immediate relief, H2 blockers offer longer coverage, and PPIs give the most powerful acid suppression for frequent symptoms. Prokinetics and simethicone may help in specific situations. The right option depends on the frequency and severity of your reflux, and sometimes a combination of strategies works best.

If your symptoms don’t improve, worsen, or change in nature, consult a healthcare provider. Stronger prescription therapy or additional testing may be needed to prevent complications and restore comfort.