Most people treat the first symptoms of gastroesophageal reflux disease (GERD) and heartburn with over-the-counter medications, such as antacids and drugs that reduce or prevent the production of stomach acid. 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). Foaming agents that contain antacids (a common brand name is Gaviscon) can also be used to coat the stomach. However, if you have been treating your symptoms with over-the-counter medications for more than two weeks, you should contact your doctor to discuss your symptoms. Also, 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 over-the-counter 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.
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Should symptoms of gastroesophageal reflux disease (GERD) 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 (such as cimetidine, ranitidine, nizatidine and famotidine) 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. You should see your doctor immediately if you have symptoms such as unexplained weight loss, trouble swallowing or internal bleeding in addition to heartburn and/or acid regurgitation. Symptoms that persist after you have made simple lifestyle changes also warrant a visit to your doctor. In addition, if you use over-the-counter medications regularly to reduce symptoms such as heartburn or acid regurgitation, you should consult a physician to determine the best course of treatment for you.