The best over-the-counter (OTC) heartburn remedies include antacids that can treat acid reflux symptoms right away.

Other options include histamine-2 (H2) antagonists and proton pump inhibitors (PPIs), which take some time to work. These drugs help neutralize or reduce stomach acid. The latter drugs can also help heal the esophagus.

GERD, or acid reflux, causes stomach contents to flow backward up the esophagus. The esophagus is a tube through which food flows from your mouth to your stomach. Stomach contents can flow backward if the muscle at the end of the esophagus does not close.

You may develop symptoms like heartburn and an unpleasant taste in your mouth. Stomach contents are acidic, so they can irritate the esophagus.

Other acid reflux symptoms include:

Chest pain

Dry cough

Hoarseness

Trouble swallowing

Medications are available over the counter to treat mild acid reflux symptoms. Options include antacids, H2 antagonists, and PPIs.

One of the best-known classes of drugs for treating acid reflux is antacids. These drugs include Tums, Rolaids, and Mylanta (aluminum hydroxide, magnesium hydroxide).

Antacids contain salt from minerals like magnesium or compounds, such as calcium carbonate, that neutralize acids in the stomach. They are fast-acting and immediately relieve acid reflux symptoms, especially heartburn. They might be used for rare episodes of heartburn. 

If you have frequent acid reflux and take antacids often, you might need more potent treatment. Antacids suppress acid and will make you feel better faster, but they do not heal the lining of the esophagus.

The acid churned out by your stomach can erode the lining of the esophagus over time, which could cause Barrett's esophagus. This precancerous disorder can lead to esophageal cancer.

Standard antacids like Mylanta are relatively safe. Some people who use them may experience diarrhea and constipation, but there are not many side effects.

H2 antagonists, another heartburn drug, can either be prescription or OTC. Tagamet HB (cimetidine) and Pepcid AC (famotidine) are in the drugstore.

These drugs are more potent and long-lasting than antacids. H2 antagonists reduce the acid your stomach produces by blocking histamine, which your body releases when encountering an allergen. H2 antagonists also help heal the esophageal lining to some extent.

You can use them for up to two weeks for short-term acid reflux relief. The drug works for four to 10 hours. Some people take H2 antagonists twice daily, which can be helpful for mild acid reflux.

H2 antagonists are relatively safe. Side effects may include:

Proton pump inhibitors (PPIs) have been available over the counter in the United States since 1989. Options include Prevacid 24HR (lansoprazole), Nexium 24HR (esomeprazole), Prilosec OTC (omeprazole), and Zegerid OTC (omeprazole, sodium bicarbonate).

PPIs block an acid-producing enzyme in the stomach lining. A study published in 2022 found that the success rate was 34.4% to 80.8% among those who took PPIs.

These drugs also help heal the lining of the esophagus more effectively than H2 antagonists. Some evidence suggests that people with erosive esophagitis can possibly be healed when they take a PPI. Erosive esophagitis causes the lining of the esophagus to become visibly irritated or injured.

PPIs take time to work, unlike antacids. Some people may not feel better until a few days after taking them. Side effects may include diarrhea or stomach pain.

The best OTC drug for acid reflux depends on your symptoms. Antacids are generally the drug of choice to treat mild acid reflux. They neutralize stomach acid to provide immediate relief.

H2 antagonists and PPIs, on the other hand, may take longer to work. These drugs may be more helpful if you have frequent heartburn. They both decrease the amount of acid your stomach makes and may heal the lining of the esophagus.PPIs might be more effective for more severe acid reflux symptoms.

It's important not to combine antacids, H2 antagonists, and PPIs without consulting a healthcare provider.If you take other medications, you should also talk to a healthcare provider to determine potential interactions.

Make sure you keep all medications out of reach of children. Store them in a cool, dry place. Hot and humid temperatures, such as in a bathroom, can make these drugs less effective.

Talk to a healthcare provider if you think you need a stronger medication to treat acid reflux. Prescription drugs have higher doses than those available over the counter.

If you have severe symptoms, you may require a prescription. Prescription-strength PPIs, for example, can help reverse damage to the esophagus.

Treating acid reflux involves more than just taking a pill or munching on antacids.

These drugs work in tandem with lifestyle changes, such as cutting out alcohol and caffeine, consuming small, more frequent meals, and quitting smoking. Other ways to reduce heartburn include not eating three hours before you sleep and propping your head up while you sleep.

Talk to a healthcare provider if you have frequent or severe acid reflux symptoms. You might need prescription drugs to treat symptoms and prevent complications that require further treatment.

Contact a healthcare provider if you have:

You'll also want to call a healthcare provider whenever your symptoms change in character. It might be time to seek medical attention, for example, if you used to have heartburn but now feel like food is stuck in your chest.

Acid reflux symptoms can be similar to those of a heart attack. Heart attack signs include shortness of breath, chest discomfort, nausea, and lightheadedness. Get medical attention right away if you think you might be experiencing a heart attack rather than acid reflux.

You can treat heartburn caused by acid reflux, when stomach contents flow backward up the esophagus, with over-the-counter (OTC) drugs, such as antacids, H2 antagonists, and PPIs. Antacids work quickly by neutralizing stomach acid. H2 antagonists and PPIs need more time to work but may help heal the esophagus.

Talk to a healthcare provider if you have severe acid reflux symptoms. They can prescribe a stronger medication to help alleviate symptoms.