For fast heartburn relief, an over-the-counter antacid containing calcium carbonate or magnesium hydroxide will neutralize stomach acid within minutes. That’s the quickest fix, but it only lasts about one to two hours. If you need longer-lasting relief or deal with heartburn regularly, you have several stronger options, and the right choice depends on how often it happens and what’s triggering it.
Antacids for Immediate Relief
Antacids are the simplest, fastest-acting option. Products like Tums (calcium carbonate) and Maalox (aluminum and magnesium hydroxide) work by directly neutralizing the acid already in your stomach. They raise your stomach’s pH within minutes of taking them. Liquid forms tend to work slightly faster than chewable tablets.
The tradeoff is duration. Antacids typically provide relief for 30 minutes to about two hours, so they’re best for occasional, predictable heartburn, like after a heavy meal. If you find yourself reaching for them multiple times a day or most days of the week, that’s a sign you need something stronger.
Alginate-Based Products
Alginate products like Gaviscon work differently from standard antacids. Instead of just neutralizing acid, they form a gel-like barrier that floats on top of your stomach contents and physically blocks acid from splashing up into your esophagus. This barrier, sometimes called a “raft,” forms within seconds and sits right over the pool of acid that tends to collect near the top of your stomach after eating.
In clinical studies, alginate products reduced reflux episodes from roughly 15 to about 3.5 and increased the time before the first reflux event from around 14 minutes to over an hour. They outperform plain antacids, though they’re not as potent as prescription-strength medications. If your heartburn hits mainly after meals or when you lie down, an alginate product is worth trying before stepping up to something stronger.
H2 Blockers for Longer Protection
If antacids wear off too quickly, H2 blockers like famotidine (Pepcid) are the next step. Rather than neutralizing acid that’s already there, these reduce how much acid your stomach produces in the first place. They take longer to kick in, usually 30 to 60 minutes, but their effects last significantly longer than antacids.
The typical over-the-counter dose is 20 mg taken once or twice a day. Some people take one before a meal they know will trigger heartburn. H2 blockers are a good middle ground: stronger and longer-lasting than antacids, with fewer concerns than the most powerful acid suppressors.
Proton Pump Inhibitors for Frequent Heartburn
Proton pump inhibitors (PPIs) like omeprazole (Prilosec) are the strongest acid-reducing medications available over the counter. They shut down the pumps in your stomach lining that produce acid. The standard dose for reflux is 20 mg once a day, taken before a meal.
PPIs aren’t designed for quick relief. They can take several days of consistent use before you notice a real difference, and a full course typically runs 4 to 8 weeks. They’re meant for people who have heartburn two or more days per week, not for the occasional post-pizza burn.
Long-term PPI use (months to years) has been linked to a higher risk of certain gut infections, reduced bone density, and problems absorbing certain vitamins and minerals. That doesn’t mean they’re dangerous for a standard 4- to 8-week course, but it’s a good reason not to stay on them indefinitely without checking in with a doctor to reassess whether you still need them.
Baking Soda as a Home Remedy
Baking soda (sodium bicarbonate) is a legitimate antacid that works the same way commercial products do. Half a teaspoon dissolved in a glass of water every two hours can neutralize stomach acid and relieve heartburn. The key limitation is sodium: each half teaspoon contains a significant dose of it, and you shouldn’t exceed about five teaspoons in a day. If you’re watching your sodium intake, have high blood pressure, heart disease, kidney problems, or are pregnant, this isn’t the right option for you.
Lifestyle Changes That Actually Help
What you take matters, but so does what you do. A few specific changes have solid evidence behind them.
Timing your last meal matters more than most people realize. Eating within two hours of lying down is one of the most reliable heartburn triggers. Give your stomach time to empty before you go horizontal. When you do sleep, elevating your upper body with a wedge pillow (not just stacking regular pillows, which tends to kink your neck without actually changing the angle of your esophagus) helps gravity keep acid where it belongs.
Sleeping position also plays a role. A study of 57 people with chronic heartburn found that while the number of reflux episodes was similar regardless of position, acid cleared from the esophagus much faster when people slept on their left side compared to their right side or back. The difference comes down to anatomy: your stomach curves in a way that pools acid away from the esophageal opening when you’re on your left.
Carrying extra weight, especially around your midsection, increases abdominal pressure and pushes stomach contents upward. For people who are overweight, even modest weight loss can reduce heartburn frequency noticeably.
Heartburn During Pregnancy
Heartburn is extremely common during pregnancy, driven by hormonal changes that relax the valve between your stomach and esophagus and by the physical pressure of a growing uterus. Calcium-based antacids like Tums are generally considered a reasonable first option, but medication safety during pregnancy is complicated. The risk to a developing fetus tends to be highest during the first trimester, and safety varies by specific ingredients and dosage. Talk with your prenatal provider before taking anything beyond basic antacids, as they can recommend options that have been evaluated for your specific stage of pregnancy.
Heartburn vs. Something More Serious
Typical heartburn feels like a burning sensation in the chest, usually after eating or when lying down. It often comes with a sour taste in the back of your throat and is relieved by antacids. Those are reassuring signs that it’s straightforward acid reflux.
Chest pain that feels more like pressure, tightness, or squeezing, especially if it spreads to your neck, jaw, or arms, is a different situation entirely. A heart attack can mimic heartburn, and the two can be genuinely difficult to tell apart. If chest pain comes with shortness of breath, cold sweats, lightheadedness, or unusual fatigue, call 911. Gallbladder problems can also cause pain that overlaps with heartburn, typically as a steady ache in the upper abdomen after fatty meals that may radiate to the shoulders or neck.
If you’ve had heartburn more than twice a week for several weeks, or if over-the-counter treatments aren’t controlling it, that pattern suggests something beyond occasional reflux that’s worth getting evaluated.