3 Levels of OTC Heartburn Medications

I lean more toward a natural long-term remedy for heartburn and acid reflux. But when I’m suffering from one or both, I’m all for eliminating the pain I’m in at that very moment. Maybe you’re the same?

There are three levels of over the counter (OTC) medications when treating heartburn, acid reflux, and GERD. In their order of aggression are antacids, histamine receptor blockers (H2 blockers), and proton pump inhibitors (PPIs). It may be best to cover your bases by taking a multi-timed attack on your heartburn. I have a plan of attack designed by my doctor that includes antacids, an H2 blocker, and a PPI.

Remember, all medications can have side effects and could possibly interfere with other medications you take and nutrients the body absorbs. Also, we are all different and some remedies may work for one person and not another. Consult your doctor about the following OTC treatment options and other options they may suggest.


OTC Heartburn Medications – Level 1: Antacids

Antacids help neutralize stomach acid. Some go a little further by helping coat and protect the esophagus and stomach forming a barrier against acid irritation. Antacid benefits can take place quickly but are short-lived, usually less than 2 hours. There are many antacid options. I’ve taken most on the list below. You’ll have to experiment to find the one(s) that are right for you and your situation. 

Antacids include:


OTC Heartburn Medications – Level 2: H2 Blockers

Histamine receptor blockers (H2 blockers) decrease the amount of acid the stomach produces. This can decrease heartburn and acid reflux. H2 blockers can provide relief for longer periods than antacids, up to 12 hours of relief. Remember that acid reflux isn’t always caused by an over production of acid. It could be a sign of too little acid. Consulting a doctor to know your situation can help you determine your best avenue of treatment. Low acidity in the stomach can cause the lower esophageal sphincter (LES) to stay open allowing the stomach contents and acid to reflux into the esophagus. If this is the cause of your problem, don’t lower the acid levels in your stomach.

H2 blockers take longer to take effect than antacids and is why I will take antacids while I wait for the H2 blocker to start working.

H2 Blockers include:


OTC Heartburn Medications – Level 3: PPIs

Proton pump inhibitors (PPIs) are used to reduce stomach acid when antacids and H2 blockers aren’t providing the necessary relief. PPI’s are not used for immediate relief of heartburn and acid reflux. It may take days before they start providing relief.

PPIs include:

  • AcipHex (rabeprazole)
  • Nexium (esomeprazole)
  • Prevacid (lansoprazole)
  • Prilosec (omeprazole)
  • Protonix (pantoprazole)
  • Rapinex (omeprazole)
  • Zegerid (omeprazole and sodium bicarbonate)


  1. Donnie 2 years ago

    What about Pepto-Bismol?

    • Author
      Steve 2 years ago

      Hello, Donnie. I have Pepto-Bismol listed under Level 1: Antacids. Do you find that Pepto-Bismol helps your heartburn?

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