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Frequently Asked Questions About Heartburn and Reflux

1. When should I take an antacid vs. a Pepcid-AC or Prilosec-like product?

Let's start with the basics. Antacids neutralize excess stomach acid to relieve heartburn, sour stomach, acid indigestion, and stomach upset. They are sometimes prescribed to help relieve the pain of stomach and duodenal ulcers. Some antacids also contain simethicone, an ingredient that helps eliminate excess gas.

You should take antacids exactly as directed by your doctor, or according to the manufacturer's directions. For stomach or duodenal ulcers, take the medicine for as long as your doctor tells you. If you are using the tablets, chew them well before swallowing for faster relief.

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Serious side effects can occur with an overdose or overuse of antacids. Side effects include constipation, diarrhea, change in the color of bowel movements, and stomach cramps.

Products like Pepcid-AC are called histamine-2 blockers or H2 blockers. These drugs reduce production of stomach acid. Pepcid AC and other H2 blockers such as Tagamet HB, Zantac 75, and Axid AR are available in prescription-strength or in lower doses in over-the-counter varieties. These products are for relief of heartburn, acid indigestion, sour stomach, and other conditions, such as stomach ulcers.

The newest type of heartburn medication to become available without a prescription is Prilosec. Prilosec belongs to a family of drugs called proton pump inhibitors or PPIs. This type of drug is often used when antacids or H2 blockers fail. PPIs block the secretion of acid from the stomach. Prevacid can be bought over the counter. Protonix, Aciphex, Dexilant, and Nexium are examples of other PPIs that are available only by prescription.

PPIs generally cause few side effects, but they do interact with other common drugs such as warfarin (Coumadin) and diazepam (Valium), so it is important to review all medications with your doctor.

Antacids work the quickest to relieve occasional heartburn. For patients who do not respond to antacids, H2 blockers and PPIs are alternatives. Remember, though, that frequent or severe episodes of reflux should always be discussed with your doctor.

Your doctor may want you to take antacids when you start taking H2 blockers to help control your symptoms until the H2 blocker takes effect. If your doctor prescribes an antacid, take it an hour before or an hour after H2 blockers. Take H2 blockers regularly for as long as directed by your doctor, even if you do not have any pain or your symptoms improve.

Possible serious side effects that need to be reported to your doctor right away include confusion, chest tightness, bleeding, sore throat, fever, irregular heartbeat, weakness, and unusual fatigue. Other less serious side effects include mild headache, dizziness, and diarrhea, which are usually temporary and will likely go away on their own.

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