Gastroesophageal Reflux Disease Medications 2011

Several prescription medications are available to treat GERD. The dosages listed represent the usual daily dosages for the treatment of gastroesophageal reflux disease; precise effective dosage varies from person to person and depends on many factors. Do not make any changes to your medication without consulting your doctor.

The instructions represent the typical way to take the medication. Your doctor's instructions may differ. Always follow your doctor's recommendations. If you have difficulty swallowing pills, empty the contents of the capsule onto 1 Tbsp of cold applesauce. Mix and take immediately.

Over-the-counter formulations of some of these medications are available. Prilosec OTC should not be taken for more than 2 weeks straight or more often than every 4 months unless directed by your doctor. The following drugs should not be taken for more than 2 weeks straight unless directed by your doctor:

  • Axid AR
  • Pepcid AC
  • Pepcid Complete
  • Prevacid 24HR
  • Tagamet HB
  • Zantac 75
  • Zantac 150
  • Zegerid OTC

Proton Pump Inhibitors to Treat GERD

  • AcipHex (rabeprazole; generic versions first approved by the FDA in November 2013)—one 20-mg tablet 1x/day with or without food. Swallow whole (do not crush, chew, or split).
  • Nexium (esomeprazole)—one 40-mg capsule 1x/day at least 1 hour before a meal. Swallow whole.
  • Prevacid (lansoprazole)—one 15- or 30-mg capsule in the morning 1 hour before eating. Swallow whole.
  • Prilosec (omeprazole)—one 20-mg capsule 1x/day 1 hour before a meal. Swallow whole.
  • Protonix (pantoprazole)—one 40-mg tablet 1x/day with or without food. Swallow whole.
  • Zegerid (omeprazole/sodium bicarbonate)—Capsule: one 40-mg/1,100-mg capsule on an empty stomach 1x/day at least 1 hour before a meal and with a full glass of water. Swallow whole. Powder: empty one 20-mg/1,680-mg packet into 1-2 Tbsp of water 1x/day. Mix and take immediately with a full glass of water.

Common side effects of proton pump inhibitors include headache, diarrhea, nausea, dizziness, and constipation. If you are taking warfarin (Coumadin), your doctor may monitor your prothrombin time (a measure of how fast your blood clots) more closely. Zegerid contains sodium and thus may not be appropriate for people on a low-salt diet. Long-term use (over one year) of PPIs carries the risk of fracture of the hip, wrist, and spine.

Call your doctor if you experience:

  • skin rash
  • signs of a B12 deficiency (unusual weakness, sore tongue, numbness or tingling of the hands or feet)
  • chest pain
  • dark urine
  • severe stomach pain
  • fast or irregular heartbeat

Histamine H2-antagonists (H2-blockers) to Treat GERD

  • Axid (nizatidine)—one 300-mg capsule 1x/day with or without food.
  • Pepcid (famotidine)—one 20- or 40-mg tablet 2x/day with or without food.
  • Tagamet (cimetidine)—two 400-mg tablets 2x/day or one 400-mg tablet 4x/day with food.
  • Zantac (ranitidine)—one 150-mg tablet 2x/day with or without food.

Common side effects of H2-blockers include headache, dizziness, diarrhea, and constipation. People with kidney disease need to take a lower dosage to prevent side effects such as confusion and dizziness. Call your doctor if you experience signs of liver problems:

  • unusual tiredness
  • persistent nausea or vomiting
  • severe stomach or abdominal pain
  • dark urine
  • yellowing eyes or skin

Promotility Agents to Treat GERD

Reglan, Metozolv ODT (metoclopramide) are promotility agents that may be used to treat gastroesophageal reflux disease. Usual dosage is one 10-mg tablet or one 10-mg and one 5-mg tablet taken 30 minutes before symptoms usually occur (e.g., before meals and sleep) not more than 3-4x/day for up to 12 weeks.

Common side effects include diarrhea, drowsiness, and fatigue. People using a promility agent should avoid alcohol, because it can add to the drowsiness side effect. Call your doctor if you experience involuntary movements of the eyes, face, or limbs; muscle spasms; or trembling of the hands.

Mucosal Protectant to Treat GERD

Carafate (sucralfate) is a mucosal protectant that may be used in GERD treatment. The usual dosage is one 1 g tablet 4x/day on an empty stomach (1 hour before or 2 hours after each meal and at bedtime). Common side effects include constipation, dry mouth, and upset stomach. This drug can interfere with the absorption of other medications; take other drugs 2 hours before or 2 hours after using Carafate. It can be taken with an antacid, but take the antacid 30 minutes before or after Carafate. Call your doctor if you experience an unusual or persistent feeling of fullness in the stomach, nausea or vomiting, stomach pain (especially after meals).

Updated by Remedy Health Media

Publication Review By: H. Franklin Herlong, M.D.

Published: 29 Mar 2011

Last Modified: 07 Jan 2015