New Antacids Let You Get the Jump on Heartburn
Used to be, you’d pop an antacid after the spicy food binge gave you the heartburn from hell. Then you’d hope it would do its job, neutralizing all that churning stomach acid.
But new over-the-counter medicines can also be taken before you order that burrito grande or set foot in the dreaded conference with the boss.
Pepcid AC and Tagamet HB are just two of the antacids that reduce stomach acid production. Pharmacists and physicians approve of their use in certain patients for a limited time. But they still predict a starring role for old-fashioned antacids.
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The Scoop: Pepcid AC and Tagamet HB are less potent versions of prescription ulcer medications.
Pepcid AC, termed an acid controller, contains famotidine, also the active ingredient in prescription-strength Pepcid. The recommended dose is one 10-milligram tablet, and up to two can be taken in a 24-hour period, according to Johnson & Johnson-Merck Consumer Pharmaceuticals Co., the distributor. A package of six tablets is about $3.50 or less.
Tagamet HB, an acid blocker, contains cimetidine, also the active ingredient in the prescription Tagamet. The recommended dose is two 100-milligram tablets, which can be taken up to twice a day, according to SmithKline Beecham Consumer Healthcare, the maker. A package of 16 pills is about $3.50 or less.
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The Process: Normally, food and drink pass through the esophagus to the stomach, where digestion progresses. But if the gastroesophageal sphincter (a kind of valve separating the esophagus and the stomach) relaxes too much, gastric juices can splash back up into the esophagus, causing heartburn. It’s more likely at night, because the back-splash occurs more easily when you’re lying down.
A burning sensation begins in the chest and can travel to the throat. There can be a bitter taste in the mouth.
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The Studies: In clinical studies, subjects who took Pepcid an hour before meals that they expected to be heartburn-producing prevented symptoms, said a representative for Johnson Johnson-Merck.
In one study of Tagamet HB, 75% of heartburn episodes were relieved; in another, 67%.
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The Experts’ Input: The medicines “aren’t meant for an ulcer patient without their doctor’s OK,” says Ryan Chinn, a pharmacist at Longs Drug Stores in Tarzana. But he gives the new OTC options a qualified thumbs-up for garden-variety heartburn.
These medicines “are more powerful than taking Maalox or Tums,” adds Dr. Herbert Rubin, medical director of the Beverly Hills Gastroenterology Institute and the Digestive Diseases Foundation and a UCLA professor of medicine and gastroenterology. He sees the new drugs as most useful “for people who occasionally or predictably have heartburn at night that wakes them up.”
“For people with significant heartburn--heartburn they would be seeking medical attention for--the doses are way too low to be effective,” says Dr. Kenneth Hepps, a Northridge gastroenterologist on staff at Northridge Hospital Medical Center. “This treatment might be good for the ‘walking well.’ ”
Antacids go to work neutralizing stomach acid more quickly than acid controllers reduce acid production, Chinn says. So, antacids are considered a better bet by some experts if you’re facing a sudden, unexpected bout of heartburn.
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Caveats: Occasional or intermittent use of the nonprescription acid controllers is the best idea, says Rubin, who warns that the medicines aren’t a cure. Don’t use either on a regular basis for more than two weeks without consulting a physician, cautions Rubin, echoing a warning that is also on the package labels.
If you’re also taking certain prescription medicines (including theophylline for asthma, warfarin for blood thinning or phenytoin for seizures), you’re also advised to consult a doctor before taking Tagamet HB.
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Other Remedies: Medicine is not the only way to relieve or avoid heartburn. If you’re prone to frequent attacks, avoid foods, beverages and habits associated with heartburn. On that list: alcohol, chocolate, coffee, tea and spicy foods. Don’t eat close to bedtime. Avoid tight-fitting clothes, which can aggravate the symptoms. If you’re overweight, shedding pounds can help. Don’t smoke.
