Heartburn medicine: care, right?
According to the advertisement, they all work fine. Rolaids, Pepcid, Prilosec, Prevacid. But isn't there any difference between antacids and the purple pill? What about over-the-counter drugs versus prescription drugs?
Not only does the difference in how these drugs work, there is a big price difference. Knowing what to use will not only ease your symptoms, but also relieve your wallet.
For occasional symptoms of heartburn, for example, associated with the use of spicy food, there are several options. If you know in advance that the food you plan to eat will cause heartburn, pre-care is the best answer. Both OTC H2 blockers (Pepcid, Zantac, Axid, Tagamet) and proton pump inhibitors (PPI) (Prilosec, Prevacid) are effective. PPIs are stronger, but H2 blockers are cheaper. For most people, any of them will work. Generally speaking, they take at least an hour to begin reducing acid production. Unlike antacids (Rolaids, Maalox, Tums), they must first be absorbed by your bloodstream to work.
If you forget to meditate beforehand, you can, of course, take any of these drugs after the onset of symptoms. Antacids neutralize gastric acid on contact and provide the fastest relief. (Remember your chemistry in high school?) However, as more acid is produced, more antacids will be needed. Pepcid Complete contains both famotidine and a combination of two antacids (calcium carbonate and magnesium hydroxide). Antacids work to neutralize stomach acid until famotidine can be absorbed and reduce the production of acid. The same can be done less expensively by using common famotidine or ranitidine (generic Zantac) along with a common antacid.
Some patients complain that H2 blockers (Pepcid, Zantac, Axid and Tagamet) are ineffective. These drugs reduce the production of acid in the stomach by about 50%. Over-the-counter medications make up about half a milligram as prescription versions, but they are the same drugs. Generic Zantac, Axid, Pepcid and Tagamet are still available by prescription and can actually cost less than over-the-counter medications - a month's offer can cost as little as $ 4.
PPIs (Prilosec, Prevacid) reduce acid output by as much as 90%. Over the past few years, two have passed through the counter, while a few others remain on prescription (Aciphex, Protonix, Dexilant, Nexium). They all work about the same, although some patients seem to get more relief from one or the other. Over-the-counter versions cost between $ 20 and $ 30 per month, compared with more than $ 100 for prescription drugs.
One of the problems associated with the presence of these drugs over the counter is the danger of masking a serious problem. Over-the-counter medications warn you to see your doctor if symptoms persist for several weeks, which certainly is good advice. You do not want to mask a serious ulcer or a cancerous condition. If you need occasional relief from heartburn, the use of over-the-counter medications is excellent. If this is a daily problem, be sure to consult a doctor to rule out a serious problem.
Copyright 2010 Cynthia J. Kelker, MD
