When lifestyle changes aren't sufficient to reduce symptoms of gastroesophageal reflux disease, or GERD, providers may recommend or prescribe a medication. All GERD medications work in different ways, and it may take trying different medications, or using a combination of GERD medications to control symptoms.
Most patients will first try over-the-counter antacids, such as sodium bicarbonate or calcium carbonate, to relieve heartburn and other mild GERD symptoms. Antacids can have side effects, including diarrhea and constipation.
Histamine-2 (H2) Blockers
H2 blockers, such as famotidine and ranitidine, decrease acid production and provide short-term relief for many GERD symptoms. They can also help heal the esophagus. H2 blockers come in over-the-counter and prescription forms. Some providers may recommend taking an H2 blocker in combination with another medicine. H2 blockers are known to become less effective when used every day for more than two weeks, a phenomenon known as tachyphylaxis.
Proton Pump Inhibitors (PPIs)
PPIs lower the amount of acid the stomach makes. In addition to treating GERD symptoms, they can also heal the esophageal lining. Providers often prescribe PPIs for long-term GERD treatment, especially for patients with complicated disease, such as esophagitis or Barrett's esophagus. However, taking PPIs for a long time or in high doses can have potential side effects, such as bone thinning, and should be discussed individually with a provider.
Prokinetics, such as reglan or erythromycin, help the stomach empty more quickly to prevent reflux. Side effects can be severe, and can include nausea, diarrhea, fatigue, depression, anxiety, and delayed or abnormal physical movement. Prokinetics can also interact poorly with other medications.