GERD medications, such as sodium bicarbonate, omeprazole or cimetidine, help to inhibit acid production, or neutralize acidity in the stomach, which are common occurrences of gastroesophageal reflux disease (GERD). Symptoms associated with this condition include heartburn or stomach burning, that can radiate up to the throat.
GERD is characterized by the backflow of stomach content into the esophagus and towards the mouth. This can cause persistent pain and inflammation along the esophageal wall, as well as other symptoms like nausea, vomiting, indigestion or excessive belching. Learn more about what causes acid reflux and GERD and the symptoms associated with it.
GERD medications are typically prescribed by a gastroenterologist and should only be taken as directed, as some of these can cause side effects like drops in blood pressure, agitation, urine retention or even palpitation or cardiac arrhythmia.
Medications for reflux
The most commonly prescribed medications for GERD include:
1. Vonoprazan fumarate
Vonoprazan fumarate is a potassium-competitive acid blocker that is indicated for the treatment of erosive reflux esophagitis caused by GERD. It inhibits the production of acid in the stomach, helping to relieve heartburn and burning in the stomach.
The normally recommended doses of vonoprazan fumarate are 10 to 20 mg, taken once a day before or after a meal. Treatment duration is indicated by the doctor, and can vary from 4 to 80 weeks.
Vonoprazan fumarate is available in tablet form and is sold in pharmacies with a prescription.
This medicine should not be used by children under 18, pregnant or breastfeeding women, or people who are allergic to the components of the tablet.
2. Omeprazole
Omeprazole is a proton pump inhibitor that works by inhibiting the production of stomach acid by blocking the proton pump. This pump is present in stomach cells and is essential for the production of stomach acid.
This medication therefore allows the mucous membrane of the stomach and esophagus to heal, as acid can be corrosive and lead to increased lesions. It helps to reduce the symptoms of gastroesophageal reflux, such as heartburn, a burning sensation in the stomach or throat, or excessive belching.
This medicine can be found in the form of 10, 20 or 40 mg capsules and should be used in the doses and for the length of treatment advised by the doctor.
Omeprazole is contraindicated for children under 1 year old, pregnant or breastfeeding women, or people with serious liver problem. It should not be taken by anyone with allergies to the components in the capsules.
3. Dexlansoprazole
Dexlansoprazole is another proton pump inhibitor indicated for the treatment of heartburn or burning sensations caused by non-erosive gastroesophageal reflux.
This medicine can be found in the form of delayed-release hard capsules containing 30 mg or 60 mg of dexlansoprazole, under the brand name Dexilant.
To relieve the symptoms of non-erosive gastroesophageal reflux, the recommended dose of dexlansoprazole is one 30 mg capsule, taken once a day on an empty stomach, for 4 weeks of treatment.
Dexlansoprazole should be used as directed by a gastroenterologist. It is contraindicated for children under 18, pregnant or breastfeeding women, or people taking atazanavir, nelfinavir, methotrexate, warfarin or St. John's wort.
4. Rabeprazole sodium
Rabeprazole sodium is another proton pump inhibitor that can be indicated for the treatment of gastroesophageal reflux symptoms or taken for long-term maintenance treatment.
The normally recommended dose of rabeprazole sodium is 10 to 20 mg, taken once a day on the morning on an empty stomach. The duration of treatment should be advised by your doctor.
Rabeprazole sodium can be found in the form of 10 or 20 mg coated tablets.
This medicine should not be used by anyone under the age of 18, during pregnancy or breastfeeding, or by people who have severe liver problems, low magnesium levels, or who are being treated with methotrexate, atazanavir or cyclosporine.
In addition to omeprazole, dexlansoprazole and rabeprazole sodium, other proton pump inhibitors that may be indicated by the doctor are esomeprazole, pantoprazole or lansoprazole.
5. Cimetidine
Cimetidine is a histamine receptor antagonist indicated for the treatment of reflux esophagitis caused by gastroesophageal reflux. It acts by inhibiting the production of stoamch acid by binding to proteins present in stomach wall cells. This preventsthe action of histamine, which increases acid production when activated.
This medication must be prescribed by a doctor, and the dose normally recommended for adults to treat reflux esophagitis and relieve reflux symptoms is 400 mg of cimetidine, 4 times a day, with meals and before bedtime, for 4 to 8 weeks.
The most common side effects caused by the use of cimetidine are diarrhea, headache, drowsiness, tiredness, muscle pain or constipation. It is contraindicated for children under 1 year of age, pregnant or breastfeeding women, or people being treated with dofetilide.
Other histamine receptor antagonists that your doctor may recommend are nizatidine or famotidine, for example.
6. Domperidone
Domperidone is a prokinetic agent that accelerates gastric emptying. This means it increases gastrointestinal movements, causing food to stay in the stomach for less time. This prevents it from back-flowing to the esophagus and therefore reduces reflux symptoms.
This medicine can be found in the form of tablets or oral suspension. Learn more about the dosing of domperidone and how it is taken.
Domperidone should only be taken as directed by a doctor for short periods, as it can cause side effects such as drops in blood pressure, agitation, nervousness, drowsiness, diarrhea, dry mouth, urine retention, palpitations or cardiac arrhythmia.
It should not be used by people with a risk for bleeding, obstruction or perforation of the stomach or intestines. It should not be taken by babies or children under 12, or during pregnancy. Domperidone should only be used during breastfeeding if recommended by a doctor.
Other medications that help to speed up gastric emptying that your doctor can prescribe include metoclopramide and cisapride.
7. Sodium bicarbonate
Sodium bicarbonate, or baking soda, is an antacid that can be used to relieve heartburn or a burning sensation in the stomach. It quickly neutralizes stomach acid to temporarily relieve discomfort.
However, it does not cure inflammation in the esophagus that is caused by stomach acid. It is usually used in combination with other reflux medications.
This antacid should be diluted with water. The recommended dose is usually 1 teaspoon of baking soda powder in a glass of filtered water, taken 30 minutes before a meal.
You should not exceed more than 3 teaspoons a day, and it should only be used for a maximum of 2 weeks, as excessive use can worsen symptoms of heartburn and burning in the stomach.
Baking soda should not be used by children under 2, pregnant women, or people with alkalosis, vomiting or intestinal obstruction.
Home remedies
Home remedies for gastroesophageal reflux, such as ginger tea or chamomile tea, contain substances with anti-inflammatory or antacid action, which help to relieve inflammation, acidity and protect the lining of the stomach and esophagus.
These home remedies are a great way to help manage heartburn or burning sensations in the stomach or throat, and can be used to complement the treatment recommended by your doctor. Check out other GERD and acid reflux home remedies that you can take to manage symptoms.
Your doctor may also recommend lifestyle changes, such as losing weight, quitting smoking, and dietary changes. You may benefits from maintaining a GERD diet, which is made-up of fresh fruit, vegetables and lean protein.