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March 18, 2019 6 min read

Reflux 101 – Part 2:

While acid reflux medicine can lessen heartburn and other associated symptoms, there are side effects that you need to know about before moving forward with acid reflux medication treatment. Before you read any further, please note: you should never change your reflux medications without consulting your doctor. There can be consequences to abruptly stopping or changing treatments. 

In this post, we’ll take a close look at acid reflux medications, side effects, and how our Reflux Relief System can help. Use the links below to skip ahead to the section you’re most interested in, or read through for a comprehensive overview of acid reflux medicine.

Introduction to Acid Reflux Medications

In our first Reflux 101 post, we talked about acid reflux, GERD, and how lifestyle changes are the first line of defense in relieving your acid reflux symptoms. The next course of action often involves over-the-counter (OTC) and prescription medications recommended by your doctor. Before beginning treatment with an acid reflux medication, it can help to have an understanding of the various types as well as their respective uses and side effects.

Over-the-counter acid reflux medications include:

  • Antacids such as Tums
  • H2-blockers like Zantac
  • Low-dose Proton Pump Inhibitors (PPI) like Prilosec OTC

If symptoms persist after using over-the-counter acid reflux medication, then your doctor may prescribe stronger medications, generally either an H2-blocker or one of the many prescription PPIs, which may be the same brand as the OTC version but with a higher dosage.

Let’s take a look at each category of medications—antacids, H2-blockers, and Proton Pump Inhibitors (PPI)–for a better understanding of what they are and how they work.

doctor holding a bottle of PPI medication

What’s an Antacid?

Antacids have over 100 different formulations that contain a key ingredient to neutralize stomach acid. Common examples of over-the-counter antacids include Tums, Mylanta, and Rolaids. Most antacids contain at least one of these ingredients: calcium carbonate, magnesium hydroxide, aluminum hydroxide, or sodium bicarbonate. While all of these ingredients work to neutralize your stomach’s acid, it’s important to choose one that makes sense for you and avoid possible reactions.

 

woman using tablet antacid

 

Antacid side effects

Like any medication, antacids have certain side effects that are important to consider as you look for ways to treat your acid reflux symptoms. In this section, we’ll take a look at some common and extreme side effects associated with antacids.

 

antacid medication side effects infographic
  • Sodium bicarbonate antacids, such as Alka-Seltzer and Bromo Seltzer, contain baking soda. These antacids should be avoided if you have high blood pressure or are on a salt-restricted diet. Alka-Seltzer contains aspirin, which is linked to Reye syndrome, a rare but serious illness in children. 
  • Calcium carbonate antacids, such as Tums and Alka-Mints, are sometimes used as calcium supplements. These products may cause constipation. 
  • Aluminum-based antacids, like Amphojel, are less potent and work more slowly than other products do. They may also cause constipation. Some may cause calcium loss and should not be taken by women who are past menopause. If you have kidney problems, check with your doctor before using aluminum-based antacids. 
  • Magnesium compounds, such as Phillips’ Milk of Magnesia, may cause diarrhea. 
  • Aluminum-magnesium antacids are less likely to cause constipation or diarrhea than the aluminum-only or magnesium-only antacids. Examples include Maalox, Mylanta, and Riopan. Many of these types of antacids contain simethicone to help break down gas bubbles in your stomach. 
  • Antacids with alginic acid, like Gaviscon, contain a foaming agent that floats on top of the stomach contents. This may help keep acid from coming in contact with your esophagus.

Although antacids are a widely available and commonly used type of acid reflux medicine, it’s always important to consider their potential side effects and how a medication may interact with your body before taking one regularly.

What are H2-Blockers?

Histamine H2-receptor antagonists, also known as H2 blockers, are another type of acid reflux medication that can be found over-the-counter or as prescribed. H-2 blockers help relieve acid reflux by decreasing the amount of acid produced by the stomach—the less acid produced, the lower the risk of reflux. Signals that tell the stomach to make acid are blocked by this type of acid reflux medicine, which makes the stomach contents less acidic and, therefore, less bothersome to the esophagus. H2 blockers are available both over-the-counter (OTC) and with your doctor’s prescription.

Common H2-Blockers and their OTC counterparts:

H-2 Blocker side effects

H2-blockers, which have been used since the 1960s, are said to have occasional side effects including headaches, dizziness, diarrhea, constipation, nausea, and vomiting. While H2-blockers have been found to help acid reflux symptoms, relief for GERD sufferers is not always a given. Studies show that for people taking H2-blockers, more than 5 out of 10 people still have some GERD symptoms.

h2 blocker side effects infographic

What’s a PPI?

Proton pump inhibitors (PPIs) work by reducing the production of acid in the stomach. Then, if stomach contents leak back into the esophagus, there is less irritation because the acidity isn’t as strong. Available as both prescription and over-the-counter (OTC) medications, PPIs have received negative press lately because of significant side effects that may occur with prolonged treatment.

Common prescription PPIs:

  • Nexium
  • Dexilant
  • Prilosec
  • Zegerid
  • Prevacid
  • Protonix
  • AcipHex
  • Vimovo (contains a PPI and naproxen)
  • Common over-the-counter PPIs:
  • Prilosec OTC
  • Zegerid OTC
  • Prevacid 24HR

ppi side effects infographic

PPI side effects

Over the past few years, multiple studies have raised concerns over possible side effects of long-term PPI use. These side effects include higher risk of:

  • Hip, wrist, and spine fracture 
  • Bacterial infections such as clostridium difficile
  • Bone weakening (osteoporosis)

Regarding bone weakening, the United States Food and Drug Administration (FDA) states, “Patients taking prescription PPIs should understand the possibility of increased fracture risk… those using over-the-counter PPIs to treat heartburn should be cautioned not to take these drugs for more than 14 consecutive days and not to take more than three, 14-day treatment courses in one year.”

In 2009, based on health claims data, over 20 million people filled PPI prescriptions in the United States and, on average, continued with their prescription for about 6 months. As this was prior to the FDA’s warning, hopefully, patients and doctors have adjusted their treatment routines in light of the new findings. But are the possible side effects worth it? More than 5 out of 10 people taking PPIs still have GERD symptoms, so it’s in your best interest to research your options, carefully weigh the facts and determine–along with your doctor–what makes the most sense for you.

Considering the possibility of serious side effects linked to acid reflux medications and the lack of effectiveness for many, it’s important to give lifestyle changes a chance before committing to medication.

woman holding chest with acid reflux pain

Alternatives to Acid Reflux Medicine

Make sure you’re not turning to acid reflux medications in lieu of changing habits that can actually improve your health all around. There are several home remedies and lifestyle changes you can leverage to find relief without having to rely on prescribed or over-the-counter acid reflux medicine. Here are a few tips to help you get started:

  • Eat smaller meals
  • Don’t eat too late at night
  • Avoid trigger foods such as foods that are high in fat or acid
  • Maintain a healthy weight
  • Try natural remedies for reflux like chewing gum, ginger, apple cider vinegar, and chamomile
  • Always talk to your doctor before making any changes to your medications
  • Try sleeping with a MedCline Reflux Relief System to relieve your acid reflux naturally
  • Try sleeping with a MedCline Therapeutic Body Pillow behind your back to keep you positioned on your left side.

Find Acid Reflux Relief With Our Help

Our patented three-part Acid Reflux Relief System has been clinically proven to improve symptoms of acid reflux, laryngopharyngeal reflux, and gestational reflux. Constructed using the physician-recommended posture for sleeping with acid reflux, our system not only aims to provide relief but also facilitate a comfortable environment for a good night’s sleep.

Want to learn more about how our Reflux Relief System works? Chat with one of our sleep specialists Mon-Fri 8am to 4pm PST. 

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References

Heartburn: Antacids, Read More

WebMD Medical Reference from Healthwise, Nonprescription Medicines and Products: Antacids and Acid Reducers, (December 15th, 2010).

Micromedex, Histamine H2 Antagonist (Oral Route, Injection Route, Intravenous Route), Read More (March 10th, 2012)

Heartburn/GERD Health Center, H2 Blockers (Acid Reducers) for Gastroesophageal Reflux Disease (GERD), Read More (March 16th, 2010)