Do You Take Your Heartburn Meds Correctly?

When it comes to taking acid reflux medications—timing is everything.

Medically reviewed in February 2021

Updated on March 1, 2021

It’s a couple of hours after dinner, and that familiar burn in your heart and throat is back: acid reflux. You head to the medicine cabinet and reach for your medication. 

But stop right there. Are you taking that medication correctly? How—and, more to the point, when—you take it has a big effect on how well it works. That’s especially true if you suffer from gastroesophageal reflux disease (GERD), a chronic problem that causes heartburn and other uncomfortable symptoms at least twice a week. And research shows that many people don’t know when the best time is to take their GERD medication, causing them not to get the relief they need. 

Are you an “optimal” user? 
Researchers at Case Western Reserve University in Cleveland, Ohio, surveyed 610 people with GERD who were taking proton pump inhibitors (PPIs) for their symptoms. These drugs reduce the production of gastric acid in the stomach, and are considered the strongest meds for treating GERD. They include Nexium (esomeprazole), Prilosec (omeprazole) and Prevacid (lansoprazole). Some people took over-the-counter meds, while others received prescriptions from a primary care doctor or a gastroenterologist. 

The researchers wanted to know how many people were taking their PPIs “optimally.” That meant people took doses once or twice a day, before breakfast and, if necessary, before dinner. PPIs work best when taken consistently, 30 minutes to an hour before the first meal of the day. It’s less effective to use them only when you have symptoms—say, after a big, spicy meal. And it’s not helpful (and could bring on harmful side effects) to take them more often than twice a day. 

The study found that just 39 percent of people who took over-the-counter PPIs were optimal users. That number increased to 47 percent of those who got a prescription from a primary care doctor, and 71 percent who saw a gastroenterologist. 

And guess what? Optimal users had fewer and less-severe symptoms. 

Burning questions 
If your healthcare provider (HCP) recommends a PPI, make sure to follow the directions carefully. And if you're not sure which kind of heartburn medication is right for you, or when to take your reflux meds, ask your HCP. Inquire about potential complications, too. Though relatively uncommon, studies have linked long-term PPI use to health problems including dementia, pneumonia, kidney disease and more. 

Antacids (such as Tums or Alka-Seltzer) and H2 blockers (such as Pepcid or Zantac) aren't as powerful, but they can be helpful for relieving those occasional flare-ups.

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