The best heartburn medicine

Samantha Loomis

Heartburn can usually be avoided by paying attention to what you ingest. Keep a heartburn diary of the foods and drinks that cause heartburn. That way you can learn what your “triggers” are and then avoid them.

Heartburn or acid reflux is a temporary inflammation that can cause discomfort and indigestion. It affects people of all ages, although it is most common in adults. It often prevents you from enjoying your favorite spicy or high-acid dishes, and if you do happen to indulge, you will pay for it for with at minimum: a sleepless night. But it can also make you feel sick for several days. That is, if you don't take heartburn medication.

Relief is as simple as a run to the local drugstore to purchase an over-the-counter heartburn medication (and take it before a meal). But what isn't easy is knowing what kind of heartburn you are experiencing and what kind of medicine will provide relief. We've researched several different types of medications and what benefits are available with those types. Overall, we recommend Nexium 20 mg 24HR Delayed Release Heartburn Relief Capsules for those with frequent heartburn.

Considerations when choosing heartburn medicines

Types of heartburn medications

In terms of over-the-counter heartburn medications, there are three main types that are available.

Acid neutralizer: This type uses chemical bases, like calcium carbonate, to decrease the level of acidity in the stomach. They are commonly referred to as "antacids" because the chemical base interacts with the acid in the stomach, which moves the pH level in your stomach closer to neutral. They provide the most immediate relief because the antacid goes directly into the stomach. Common antacids are Tums, Rolaids, and Alka-Seltzer.

Proton pump inhibitor (PPI): Proton pumps are used by the body to inherently balance the stomach's acidity level. Ingesting certain foods can aggravate those pumps into over-stimulation, which can trigger heartburn if the acid enters the esophagus. Taking a PPI will block the proton pumps from producing acid, which reduces the amount of acid present in the stomach. PPIs take longer to reach effectiveness, but then they provide longer relief. Examples include Nexium, Prilosec, and Prevacid. 

Histamine 2 receptor antagonist (H2RA): A more common name for this type is a histamine blocker. As the name implies, they block a form of histamine from directing the stomach to produce more acid. If the stomach produces less acid, then the acid doesn't reach the esophagus, or if it does it doesn't do as much damage or cause as much pain. Brands include Pepcid, Tagamet, and Zantac.

How heartburn medications work

How the drug interacts with your body in order to stop heartburn is important to know when choosing a medication. Antacids chemically neutralize the stomach without preventing acid production. PPIs shut down acid production. H2RAs block acid production. Which drug to take depends on the severity and frequency of your heartburn. Ask your doctor which type she or he recommends for you.

Relief onset time

If you experience chronic daily heartburn, taking PPIs or H2RAs is almost always your best choice. While they won't provide instant relief, they last longer. If you only experience heartburn when eating certain foods, an antacid will most likely do the job. They act quickly but don't last as long. They are recommended when you need immediate relief.

Side effects and drug interactions

It's always important to speak with your primary care provider if you regularly need heartburn medication. It's possible that frequent use could cause side effects like constipation or diarrhea. If you find yourself experiencing side effects, speak with a doctor in case there is an additional factor causing your heartburn.


PPIs and H2RAs weren't always available over the counter. They became available only after high demand of them caused the U.S. Food and Drug Administration to approve them for over-the-counter sales. Long-term use can be damaging to your health. Read your medication's instructions for use and warnings before taking it, and discuss with a physician to ensure there won't be long-term health effects.


Even the most expensive heartburn medicines are still relatively affordable. The products range from $5 to $15. Price depends on the dosage as well as the count in each package.


Q. Can I take multiple types of heartburn medication at once?

A. It is usually safe to consume an antacid as well as a PPI or H2RA. But it's dangerous to take a PPI and H2RA at the time because they perform entirely different functions. In degrees of severity, first take an antacid. If that doesn't work then try an H2RA. If that still doesn't provide relief, upgrade to a PPI.

Q. Can I take too much of a heartburn medication?

A. Yes. There are recommended dosages on each package, and there will be a warning regarding how long it is safe to use that medication. After a certain time period, you may need to visit a physician to address a deeper heartburn cause.

Heartburn medicines we recommend

Best of the best: Nexium 20 mg 24HR Delayed Release Heartburn Relief Capsules

Our take: This medication is for those who experience chronic heartburn and are looking for long-term relief. 

What we like: One tablet lasts for 24 hours, which ensures heartburn won't interrupt a good night's sleep.

What we dislike: It's a PPI, which is the strongest type of heartburn medication. Long-term usage is not advised.

Best bang for your buck: Pepcid 20 mg Maximum Strength All-Day Heartburn Relief Treatment

Our take: If you know your trigger foods and you're still determined to eat them, simply take a Pepcid tablet 10 minutes to one hour prior to consuming those foods. It will neutralize acid and allow you to enjoy your favorites.

What we like: Has 20 milligrams of famotidine, which is an acid reducer that provides maximum strength aid.

What we dislike: Consumers have reported that there isn't much difference between Original Strength and Maximum Strength.

Choice 3: Zantac 150 mg Maximum Strength Cool Mint Tablets

Our take: A middle-of-the-road medicine, Zantac lasts for as long as 12 hours. For those who experience mild heartburn, but don't require full-day protection.

What we like: Cool mint flavor makes for easy ingestion, whereas some medicines leave a chalky aftertaste.

What we dislike: Consumers have reported needing to take more than the recommended for effects to be felt.

Samantha Loomis is a writer for BestReviews. BestReviews is a product review company with a singular mission: to help simplify your purchasing decisions and save you time and money. BestReviews never accepts free products from manufacturers and purchases every product it reviews with its own funds.

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