Gastroesophageal Reflux Disease Medications

If you suffer from frequent heartburn or acid reflux and over-the-counter antacids are not resolving your symptoms, your doctor may prescribe one of the GERD medications that have been shown to reduce acid production or strengthen the tone of the lower esophageal sphincter muscle.

A variety of prescription and over-the-counter medications are available to treat GERD. Doctors commonly prescribe these medications indefinitely because the medications primarily address symptoms of GERD and not the root cause.

Types of Medications

Antacids: Commonly available over-the-counter, antacids work by reducing the acidity of stomach contents to decrease the damage caused by acid reflux.

H2 Blockers: Histamine-2 receptor blockers reduce stomach acid production and are useful for mild GERD. Some H2 blockers are now available without prescription.

Proton Pump Inhibitors (PPIs): Considerd to be the most effective of the GERD medications, PPIs rapidly reduce stomach acid production and are part of a long-term, often lifelong, GERD treatment strategy.

Coating Agents: These medications bind with proteins in the wall of the esophagus and stomach to create a protective coating.

Promotility drugs: By helping the stomach empty faster, promotility drugs help reduce pressure on the LES and reduce the frequency of reflux.

Histamine Antagonists (H2 Antagonists)

Over-the-counter medications can help neutralize acid if you’re suffering from heartburn or acid reflux. However, these medicines will only work for a short amount of time and may not be enough to help people who suffer from GERD, gastroesophageal reflux disease. If you’re taking antacids and still having heartburn, your doctor may be able to prescribe GERD medications that will help.

One of the GERD medications that doctors recommend is histamine antagonists, or H2 antagonists. Tagamet, a commonly prescribed H2 antagonist, was one of the first GERD medications available by prescription.

How do histamine antagonists treat GERD?

Histamine is a chemical that is released within the wall of your stomach and stimulates acid production. H2 antagonists block the histamine receptors on acid-producing cells, resulting in less stomach acid being produced. These GERD medications are generally taken 30 minutes before meals to combat the stomach’s increased acid production during digestion. They may also be taken at night to help prevent nighttime heartburn.

Histamine antagonists treat GERD by reducing the amount of acid produced by the stomach, thereby reducing the risk of acid reflux. They do not, however, treat any inflammation that may exist in the esophagus. Histamine antagonists are available over-the-counter and by prescription, with the prescription varieties containing higher doses of the active medicine. The four available H2 antagonists are cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine, (Pepcid).

Proton Pump Inhibitors

Commonly referred to as PPIs, proton pump inhibitors are GERD medications designed to reduced the production of acid in the stomach. The idea is that having less stomach acid produced will greatly reduce the chance of having stomach acid flow back into the esophagus. PPIs have been proven to be an effective treatment option for many GERD sufferers.

The PPIs that are currently available include Prilosec, Protonix, AcipHex, Nexium, and Prevacid. With the exception of AcipHex, all PPIs are designed to be taken first thing in the morning, before breakfast, with a glass of water.

The most common side effects of proton pump inhibitor therapy are headache, diarrhea, abdominal pain, nausea, constipation, and bloating. PPIs may also interfere with the effectiveness of other prescription medication, so be sure to talk to your doctor about any medications you are currently taking before adding new GERD medications.

Promotility Drugs

Unlike other GERD medications that are designed to target acid production, promotility drugs address a weakened LES that allows acid to flow back into the esophagus from the stomach. These drugs also enhance the emptying of food from the stomach, reducing the time that reflux can occur. Promotility drugs are usually prescribed when GERD is the result of an underlying medical condition that prevents proper emptying of the stomach, such as diabetes.