GERD medication: how to pick antacids, H2 blockers, or PPIs

Do you wake up with heartburn or burp up a sour taste? That’s classic GERD. Medicines can stop symptoms fast, but choosing the right one matters. I’ll walk you through the main options, when to use them, and how to stay safe.

Common GERD medicines and what they do

Antacids (Tums, Rolaids): Work within minutes by neutralizing stomach acid. Use them for occasional heartburn. They don’t heal damage—just calm the burning. Good when you need quick relief after a heavy meal.

Alginates (Gaviscon style): Make a foam barrier on top of stomach contents so acid is less likely to splash up. They’re handy at night or right after eating.

H2 blockers (famotidine, ranitidine was removed in many places): Reduce acid production for several hours. Famotidine 20 mg is a common OTC dose. H2 blockers help mild to moderate GERD and can work before meals that usually trigger symptoms.

Proton pump inhibitors (PPIs) (omeprazole, esomeprazole, lansoprazole): Cut acid production strongly and for a long time. Typical OTC omeprazole is 20 mg once daily. PPIs heal esophagitis and help people with frequent symptoms. They aren’t instant—take them daily for 2–8 weeks to see full benefit.

How to use GERD meds safely

Start with lifestyle fixes: skip late-night meals, raise the head of your bed, lose weight if needed, and avoid triggers like coffee, chocolate, alcohol, fatty foods, and peppermint. These changes often reduce how much medicine you need.

Use antacids for occasional flare-ups. Try an H2 blocker if symptoms happen a few times a week. Consider a PPI if you have daily heartburn or confirmed esophageal inflammation. Always follow dosing instructions and take PPIs before the main morning meal for best effect.

Watch for side effects. Short-term antacids may cause constipation or diarrhea. H2 blockers can cause headache or sleepiness for some people. PPIs can cause headaches, and with long-term use there’s a higher chance of low magnesium, reduced B12 absorption, bone fractures, or kidney issues. That doesn’t mean avoid them—just use the lowest effective dose and review the need regularly with your clinician.

If you stop a PPI suddenly you might get rebound acid. A simple taper over a few weeks or switching to an H2 blocker can help. Tell your doctor about all meds you take—some interactions matter, like certain blood thinners and specific PPIs.

When to see a doctor: trouble swallowing, unintentional weight loss, vomiting blood, black stools, or severe chest pain. Those are alarm signs that need urgent evaluation, often with endoscopy.

Final tip: don’t mix lots of over-the-counter remedies without checking with a pharmacist or doctor. The right medicine and dose depend on how often you have symptoms, other health issues, and what you’re taking already. If heartburn keeps returning, get a proper checkup—treating GERD the right way protects your esophagus and helps you sleep and eat without worry.