For occasional heartburn, an over-the-counter antacid containing calcium carbonate or magnesium hydroxide will neutralize stomach acid within minutes. If heartburn keeps coming back, stronger options like H2 blockers and proton pump inhibitors can suppress acid production for hours or even an entire day. The best choice depends on how often your symptoms flare and how long they last.
Antacids for Quick, Short-Term Relief
Antacids are the fastest-acting option. Products like Tums (calcium carbonate), Maalox, and Mylanta work by directly neutralizing the acid already in your stomach. You’ll typically feel relief within 5 to 15 minutes, but the effect wears off in one to two hours. That makes antacids ideal for the occasional burn after a heavy meal, but not great for symptoms that keep returning throughout the day.
Chewable tablets and liquid forms are equally effective. Liquids tend to coat the esophagus on the way down, which some people find more soothing. If you’re reaching for antacids more than twice a week, that’s a signal to consider a longer-acting medication instead.
Baking Soda: A Pantry Fix With Limits
Plain baking soda (sodium bicarbonate) is a legitimate antacid. A half teaspoon dissolved in a glass of water can relieve heartburn quickly. The Mayo Clinic lists a standard adult dose of half a teaspoon in water every two hours, with no more than five teaspoons in a day.
The catch is sodium. Each half teaspoon contains over 600 mg of sodium, which is roughly a quarter of the daily recommended limit. If you have high blood pressure, heart disease, kidney problems, or are on a sodium-restricted diet, baking soda isn’t a safe choice. It’s fine as an occasional home remedy for otherwise healthy adults, but it shouldn’t replace a proper antacid if heartburn is a regular problem.
H2 Blockers for Longer-Lasting Control
H2 blockers reduce the amount of acid your stomach produces rather than neutralizing what’s already there. Famotidine (sold as Pepcid) is the most widely available option over the counter. The standard dose is 20 mg taken once or twice a day. For more persistent symptoms, a 40 mg dose at bedtime can be used for up to 12 weeks.
These medications take 30 to 60 minutes to kick in, so they aren’t as fast as antacids. Their advantage is duration: a single dose can suppress acid for 6 to 12 hours. Many people take an antacid for immediate relief and an H2 blocker to keep symptoms from returning overnight or the next morning. H2 blockers are well-suited for predictable heartburn, like the kind that always hits after dinner or wakes you up at night.
Proton Pump Inhibitors for Frequent Heartburn
If you’re dealing with heartburn two or more days a week, proton pump inhibitors (PPIs) are the strongest over-the-counter option. Brands include Prilosec (omeprazole), Prevacid (lansoprazole), and Nexium (esomeprazole). PPIs block acid production at the source, reducing it far more completely than H2 blockers.
PPIs work differently from antacids. You take them on an empty stomach, 30 minutes to an hour before eating, and they need a few days of consistent use to reach full effect. Some people need one pill before breakfast; others take one before breakfast and one before dinner. OTC versions are designed for a 14-day course, and most labels recommend waiting at least four months before repeating a course.
Long-term, unmonitored PPI use does carry some health considerations. Extended use has been linked to reduced calcium absorption, which can contribute to bone loss and a higher risk of fractures at the hip, spine, and wrist. There’s also an association with low magnesium levels. None of this means PPIs are dangerous for a two-week stretch, but using them continuously for months or years without medical guidance isn’t ideal.
Lifestyle Changes That Actually Help
Medications handle the acid, but certain habits can reduce how often heartburn shows up in the first place. These aren’t minor tweaks. For many people, they’re enough to cut heartburn episodes significantly.
- Stop eating 2 to 3 hours before bed. Lying down with a full stomach is one of the most reliable heartburn triggers.
- Elevate the head of your bed. A 20 cm (about 8-inch) wedge under the head of your mattress, creating roughly a 4- to 5-degree angle, reduces nighttime acid exposure. Stacking pillows doesn’t work as well because it bends your body at the waist rather than tilting it evenly.
- Eat smaller, more frequent meals. A stretched stomach puts more pressure on the valve that keeps acid out of your esophagus.
- Identify your trigger foods. Spicy food, fatty food, chocolate, coffee, alcohol, and citrus are the most common culprits, but triggers vary from person to person.
- Stay upright after eating. Sit up straight during meals and avoid lying down for at least an hour afterward.
Heartburn During Pregnancy
Heartburn is extremely common in pregnancy, especially in the second and third trimesters, as the growing uterus pushes upward on the stomach. The treatment sequence is slightly different because safety matters more than potency.
Lifestyle measures come first: smaller meals, avoiding food close to bedtime, sitting upright after eating, and raising the head of the bed. If those aren’t enough, antacids are considered the safest first-line medication. Both tablet and liquid forms are safe at recommended doses during pregnancy. If antacids don’t fully control symptoms, H2 blockers like famotidine are the next step and are also considered safe. PPIs, particularly omeprazole and esomeprazole, have been widely used in pregnancy when needed, though they’re typically reserved for cases where antacids and H2 blockers haven’t worked.
When Heartburn Might Be Something Else
Most heartburn is just heartburn. But chest pain that feels like burning can also be a sign of a heart problem, and the two can be difficult to tell apart. If you have chest pain along with shortness of breath, pain radiating to your arm or jaw, lightheadedness, or sweating, call 911. Those are cardiac warning signs, not heartburn.
Even without those acute symptoms, persistent heartburn that doesn’t respond to OTC treatment, difficulty swallowing, unintentional weight loss, or vomiting blood are all signs that something beyond simple acid reflux may be going on. If you’ve had an episode of unexplained chest pain that resolved on its own, it’s worth following up with a doctor even after the fact.