What Antacid Works Best for GERD? Understanding Your Treatment Options

October 9, 2025 •

4 min read

According to one study, up to 30% of the US population may experience symptoms of GERD, and for many, finding relief is a top priority. When seeking an effective solution, patients often ask, “what antacid works best for GERD?” The answer, however, depends on the frequency and severity of your symptoms, as not all medications are created equal.

Quick Summary

The best over-the-counter option for GERD relief depends on your symptoms: antacids provide fast but temporary relief for mild issues, while H2 blockers and proton pump inhibitors (PPIs) offer longer-lasting acid reduction for more frequent or severe cases. Alginate-based products are also effective for specific post-meal reflux. A healthcare provider can help determine the most suitable choice.

Key Points

Antacids for Fast Relief: For occasional, mild heartburn, traditional antacids like Tums or Mylanta offer the fastest, albeit shortest-lived, relief by neutralizing stomach acid immediately.
Gaviscon for Post-Meal Reflux: Products like Gaviscon are particularly effective for reflux after meals, combining antacid action with a protective "raft" that blocks acid from coming up into the esophagus.
H2 Blockers for Longer Relief: For more infrequent, but longer-lasting heartburn relief (up to 12 hours), H2 blockers like Pepcid AC reduce acid production and work more effectively for preventative use.
PPIs for Frequent GERD: If heartburn occurs more than twice a week, proton pump inhibitors (PPIs) like Prilosec OTC are the most potent acid reducers and are recommended for chronic GERD, though they take longer to achieve full effect.
Prioritize Lifestyle Changes: No medication is a substitute for addressing the underlying causes of GERD; lifestyle modifications like avoiding trigger foods, eating smaller meals, and sleeping with your head elevated are essential for long-term management.
Consult a Doctor for Chronic Issues: Over-the-counter medications are not a permanent solution. If your symptoms are severe or require treatment for more than 14 days, a doctor's consultation is necessary to rule out more serious conditions.

Antacids vs. Other Acid-Reducing Medications for GERD

When people search for "what antacid works best for GERD?", they are often looking for the fastest way to stop heartburn. While true antacids offer immediate relief, they are not the only, or often the best, option for managing chronic gastroesophageal reflux disease. A crucial distinction must be made between antacids, H2 blockers, and proton pump inhibitors (PPIs), as they work in fundamentally different ways and provide relief for different durations. Understanding these differences is the first step toward effective symptom management.

How Different Medications Work

Antacids: These medications, like Tums (calcium carbonate), Rolaids (calcium carbonate, magnesium hydroxide), and Mylanta (aluminum hydroxide, magnesium hydroxide), act directly to neutralize the acid in your stomach. They work within minutes but provide only temporary, short-term relief, typically lasting about an hour. They are ideal for treating occasional, mild heartburn flare-ups but are not designed for the long-term management of GERD.

Alginate-Antacid Combinations: A specialized type of antacid, products like Gaviscon contain both antacids and an alginate. The alginate creates a foam barrier, or "raft," that floats on top of your stomach's contents, physically blocking acid from coming back up into the esophagus. Studies have shown that this can be more effective than a standard antacid for controlling postprandial (after-meal) acid exposure in GERD patients.

H2 Blockers: These medications, such as Pepcid AC (famotidine) and Tagamet HB (cimetidine), work by reducing the amount of acid your stomach produces. Unlike antacids, they take longer to start working (15-30 minutes for famotidine) but provide significantly longer-lasting relief, up to 12 hours. They are a good choice for mild-to-moderate, less frequent heartburn.

Proton Pump Inhibitors (PPIs): These are the most potent acid reducers and the preferred treatment for frequent or severe GERD. PPIs, including Prilosec (omeprazole), Nexium (esomeprazole), and Prevacid (lansoprazole), work by blocking the specific enzyme system (the "proton pump") that produces stomach acid. They are not for immediate relief and can take 1-4 days to reach full effect but offer the longest-lasting acid control, helping to heal esophageal damage.

Comparison of GERD Medications


Feature	Antacids (e.g., Tums, Mylanta)	Alginate-Antacid (e.g., Gaviscon)	H2 Blockers (e.g., Pepcid AC)	PPIs (e.g., Prilosec OTC)
Mechanism of Action	Neutralizes existing stomach acid	Neutralizes acid and forms a protective barrier	Reduces amount of acid produced	Blocks acid production at the source
Onset of Relief	Within minutes	Within minutes	15-30 minutes	1-4 days for full effect
Duration of Action	~1 hour	Several hours, especially after meals	Up to 12 hours	Up to 24 hours
Best For	Occasional, mild heartburn	Post-meal reflux, immediate relief	Infrequent to mild-moderate heartburn	Frequent (2+ times/week) or severe GERD
OTC Use Limit	As needed, but overuse can cause side effects	As needed	14 days, consult doctor if symptoms persist	14-day course, up to 3 times/year
Side Effects	Constipation (calcium, aluminum), Diarrhea (magnesium)	Generally well-tolerated; same as antacids	Headache, diarrhea, constipation	Headache, diarrhea, nausea, low B-12 (long-term)

Choosing the Right Medication

When deciding what antacid works best for GERD, you need to consider your specific needs. Start by assessing your symptom pattern:

For occasional, immediate relief: If you get infrequent heartburn (less than twice a week), a traditional antacid like Tums or Mylanta is a good option. It offers rapid relief for a short period.
For post-meal reflux: If your heartburn is triggered specifically by meals, an alginate-antacid product like Gaviscon is often highly effective due to its protective "raft" mechanism.
For less frequent but longer-lasting relief: If you need more sustained relief than an antacid can provide, an H2 blocker like Pepcid AC is a better choice. It can be taken preemptively before a known trigger meal.
For frequent or severe GERD: If you experience heartburn two or more days a week, a PPI is the recommended course of action for more powerful, long-term acid suppression. However, these medications should be used for a 14-day course as directed on the label, and you should consult a doctor if symptoms return.

The Importance of Lifestyle Changes

Medication is only one part of GERD management. Lifestyle and dietary changes form the foundation of treatment and can significantly reduce your reliance on antacids. The most effective strategies include:

Avoiding trigger foods: Common culprits include fatty foods, spicy foods, alcohol, caffeine, chocolate, and citrus fruits. Keeping a food diary can help identify your specific triggers.
Eating smaller, more frequent meals: Large meals increase pressure on the stomach and the lower esophageal sphincter (LES).
Elevating the head of your bed: For nighttime reflux, use a wedge pillow or blocks to raise the head of your bed by 6 to 9 inches.
Avoiding lying down after eating: Wait at least three hours after a meal before lying down or going to bed.
Maintaining a healthy weight: Excess weight puts pressure on the abdomen.
Quitting smoking: Smoking relaxes the LES, making reflux more likely.

Conclusion

So, what antacid works best for GERD? For immediate, occasional relief, a fast-acting antacid like Tums or Mylanta is suitable. For more effective post-meal blockage, Gaviscon is a strong contender due to its alginate barrier. For mild-to-moderate, less frequent symptoms, an H2 blocker like Pepcid AC provides longer-lasting relief. However, for chronic, frequent GERD, the most effective over-the-counter treatment is a PPI like Prilosec OTC. For persistent or severe symptoms, it is crucial to consult a healthcare provider to determine the root cause and find a long-term solution. Combining lifestyle adjustments with the right medication strategy will offer the most comprehensive and lasting relief from GERD.

For more in-depth information, you can consult the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) website.

Frequently Asked Questions

Antacids (e.g., Tums) neutralize existing stomach acid for immediate but short-term relief, while Proton Pump Inhibitors (PPIs) like Prilosec work by blocking the pumps that produce acid, providing more powerful, longer-lasting relief for chronic GERD.

Gaviscon is often more effective for GERD than a simple antacid like Tums because it contains an alginate that forms a foam barrier on top of stomach contents, physically blocking reflux, particularly after meals.

Yes, you can safely take an antacid for immediate relief alongside an H2 blocker like Pepcid AC, which will then provide longer-lasting acid reduction. For best results and to avoid interactions, take the antacid 1 hour before or at least 4 hours after other medicines.

Over-the-counter PPIs are intended for 14-day courses, and H2 blockers for up to 14 days at a time. If your symptoms persist or return, you should consult a healthcare provider for further evaluation and a long-term treatment plan.

You should see a doctor if your symptoms are severe, occur frequently (more than twice a week), do not respond to OTC medication, or are accompanied by alarm symptoms like difficulty swallowing, bleeding, or unexplained weight loss.

Yes. Calcium-based antacids can cause constipation, while magnesium-based ones can cause diarrhea. Overuse can lead to more serious issues, such as acid rebound.

Lifestyle changes are the cornerstone of GERD management and often the first line of treatment. They include avoiding trigger foods, eating smaller meals, elevating your head while sleeping, and maintaining a healthy weight.