OTC Heartburn Meds: What Works, What to Avoid, and How to Use Them Safely

When heartburn hits, you reach for something fast—OTC heartburn meds, over-the-counter drugs designed to neutralize or reduce stomach acid. Also known as acid reflux meds, they’re the first line of defense for millions who get that burning feeling after eating. But not all of them work the same way, and using the wrong one—or the right one for too long—can cause more problems than it solves.

You’ve got three main types: antacids, fast-acting pills or liquids that neutralize acid right away. Also known as heartburn relief tablets, they’re great for quick fixes but don’t last long. Then there are H2 blockers, meds like famotidine and ranitidine that cut acid production for several hours. They’re slower than antacids but last longer—perfect if you know you’re about to eat something spicy. And then there are the proton pump inhibitors, stronger drugs like omeprazole and esomeprazole that shut down acid at the source. Also known as PPIs, they’re the go-to for daily sufferers, but they’re not meant for casual use. Mixing them up or taking them too often can mask real issues like GERD, ulcers, or even heart problems.

People often keep popping PPIs for months because they feel better—until they don’t. Suddenly, they get rebound heartburn when they stop. Or their stomach can’t absorb B12 or magnesium. Or they start getting bone fractures. That’s not magic—it’s side effects. And it’s why the FDA warns against using PPIs longer than 14 days without a doctor’s say-so. Antacids? Safer short-term, but too much calcium or aluminum can mess with your kidneys. H2 blockers? Better for occasional use, but they lose power over time.

The real trick isn’t just picking the strongest pill. It’s matching the drug to your pattern. Do you get heartburn after big meals? Try an H2 blocker 30 minutes before eating. Do you wake up with it at night? A PPI at bedtime might help—but only for a couple of weeks. Got it after coffee or wine? Cut the triggers first. Medication isn’t a substitute for changing habits.

Below, you’ll find real advice from people who’ve been there: how to tell if your heartburn is just acid or something worse, why some OTC meds stop working, and which ones to avoid if you’re on other prescriptions. No fluff. No hype. Just what works, what doesn’t, and what you need to know before your next bottle runs out.