If over-the-counter medications are not enough to treat your gastroesophageal reflux disease (GERD) and heartburn symptoms, your doctor might prescribe something stronger. Many of the prescription medications used to treat GERD and heartburn are stronger versions of the same medications that are available without a prescription. These include H2 receptor antagonists that decrease acid production (common brand names include Zantac, Tagamet, and Pepcid) and proton pump inhibitors that block acid production (common brand names include Prilosec, Nexium, and Prevacid). However, you should be aware that the U.S. Food and Drug Administration (FDA) has issued a warning about a possible increased risk of hip, wrist, and spine fractures in people who take proton pump inhibitors to treat GERD and heartburn. The greatest risk of fractures was found in people over 50 years of age who took high doses or took the medication for over a year. There are also prescription medications called prokinetic agents that help the stomach empty itself faster and strengthen the lower esophageal sphincter, which is the muscle that acts like a valve between your esophagus and your stomach. However, significant side effects have been reported with prokinetic agents.
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Atlanta Gastroenterology Associates answered
Should symptoms persist, over-the-counter antacids may decrease discomfort. Antacids, however, only work for a short time and for this reason they have a limited role in treating reflux disease. Histamine H2-receptor antagonists (cimetidine, ranitidine, famotidine, and nizatidine) decrease acid production in the stomach. These medications work well for treating mild reflux symptoms and are quite safe, with few side effects. They are available over the counter at a reduced dose, or at a higher dose when given by prescription by your doctor. Proton pump inhibitors (omeprazole, lansoprazole, pantoprazole, esomeprazole, rabeprazole and dexlansoprazole) are all highly effective in treating reflux symptoms. These medications act by blocking the final step of acid production in the stomach and are typically taken once or twice daily prior to meals. For reflux symptoms that occur frequently, proton pump inhibitors are the most effective medical treatment. Prokinetics, or medications that stimulate muscle activity in the stomach and esophagus, are sometimes provided for the treatment of reflux disease. The only available drug in the market is metoclopramide, which has little benefit in the treatment of reflux disease and has many side effects, some of which can be serious.