WebMD Ask the Pharmacist

Heartburn and GERD: Ask the Pharmacist

November 24, 2009. Pharmacist Kristen Binaso, RPh, answers your questions about medicine for heartburn, acid reflux, and GERD.

Question:

I am 51 years old and am in very bad health. I have had some problems with gas, bloating, and acid reflux. I had often have had trouble swallowing. But since yesterday I have been having more problems; it hurts to breathe, eat, and drink. I thought it might be because I was constipated and I had gas trapped in my system, which was the reason for excessive burping. But I almost thought I was having chest pains today and maybe I should go to the ER. But I felt a little better after I tried some home remedies. But the pain is not going way. Can you tell me what is going on and what I need to do?

Answer:

I would recommend going to the ER and have it checked out. Chest pain and not being able to breathe could be signs of a heart attack. It’s better to be safe than sorry. Make sure you advise them how long this has been going on for and what medications you took to try to resolve the problem.

Question:

What are the side effects of Ranitidine in infants?

Answer:

Common side effects in children are constipation and diarrhea. If you notice the infant has darker urine, bruising of the skin, or a yellowish tinge to the eyes or skin, notify your health care provider immediately.

Question:

Has the company that makes Prevacid lost their patent? Isn’t the drug about the same as Nexium?

Answer:

Good question. The company did not lose its patent but was approved to transition to the over-the-counter class of medications. Prevacid OTC will be available late November, early December. It is not the exact same drug as Nexium, but is in the same class (like a family member).

Question:

I have serious heartburn several times during the day and night. I have found that a teaspoonful of baking soda in a little water gives me fast relief. Is this harmful? I have been taking it for several months now.

Answer:

I am concerned that you have "serious" heartburn as frequently as you described and would like to know if you have been evaluated by a health care provider. I would also like to know if you have taken any over-the-counter medications and what their effect was. I don’t think the baking soda in water is harmful but I don't see any benefit either. I would highly recommend seeing a health care provider for further evaluation.

Question:

I need a home remedy for heartburn.

Answer:

This is an interesting request. I would need to ask you a few more questions because there really isn’t any "home remedy" for heartburn. I need to know how often you have been having heartburn and what your exact symptoms are. I also recommend changing your diet. There are many "trigger" foods that can cause heartburn. For more information, including a "diary," visit the National Heartburn Alliance at www.heartburnalliance.org.

Question:

Is it OK to give Tamiflu if you have not been to the doctor to confirm diagnosis?

Answer:

It is not appropriate to take any prescription medication unless you are instructed by a doctor or health care provider to do so. We have to be very careful with Tamiflu since we have had some cases of resistance. And what causes resistance is exactly what you asked -- people not getting a confirmed diagnosis and taking the medication "just because." This medication should only be taken according to the CDC guidelines for the treatment of H1N1 and seasonal influenza.

Question:

Can you take acid reflux medicine and probiotics together?

Answer:

This is a good question because there are a few probiotics on the market that are helpful with the symptoms of IBS. Some patients may be treating their heartburn, gas, diarrhea, or constipation with over the counter medications not realizing that it may be IBS. I would need to ask a few more questions in order to provide information. I need to know exactly what probiotic you are taking and what acid reflux medication. I also need to know what your symptoms are, how long you have had them, and what your diet looks like. There are many factors that can contribute to heartburn and there are some simple lifestyle modifications we can try first to see if that helps.

Question:

Are there side effects of taking Prevacid and what are they?

Answer:

This is a great question that you can ask your pharmacist. The most common side effects of Prevacid are constipation, diarrhea, headache, nausea, and stomach pain. You will want to let your healthcare provider know if you are experiencing these side effects.

Question:

I stopped taking meds for bipolar a week and a half ago, but now I want to start them again. Can I just restart where I left off?

Answer:

I would like to know why you decided to stop taking your medications and does your doctor or health care provider know? This is very risky and it is important that you understand that with some medications, you should not just stop them abruptly because you felt like it. Nor is it wise to just "start them up" again when you feel like it. I would strongly recommend that you call your doctor and let them know what you did. They may want to see you for further evaluation and gradually ease you back onto your medications.

Question:

What are the side effects of taking a proton-pump inhibitor for a long time?

Answer:

Great question, and one that I was just asked the other day at the pharmacy. Long-term use of proton pump inhibitors (PPIs) appears safe, and all of the studies addressing long-term use have a follow-up of 10 years or less. There is still a need for studies that look at long-term use -- over 10 years. If you have any questions, talk to your pharmacist. We are happy to help.

Question:

I have had heartburn for three days, cannot eat or drink anything without severe pain, tried Rolaids, Tums, Pepcid, and Pepto-Bismol -- and nothing works. What do you suggest?

Answer:

Due to the fact that you have tried some over-the-counter medications and it has been three days and you do not have any relief, not able to drink or eat anything (and still severe pain), I would strongly recommend calling your doctor or health care provider as soon as possible or go to the ER to have it checked out. This could be a sign of something serious.

Question:

Does Preparation H help with dark circles under the eyes?

Answer:

This caught my attention because Preparation H should only be used to help treat and relieve the symptoms of hemorrhoids. You should not use over-the-counter products for other areas of the body unless the packaging states so. It is very important that you follow the directions on the package and use these products correctly to avoid serious harm.

Question:

How long do I need to be on Kapidex for it to start working? Do I need to take it before I eat?

Answer:

This is a good question to ask especially when you arrive at the pharmacy to pick up your medicine. Kapidex is a newer medication and can be taken with or without food. It is important that you take the medication everyday and monitor your symptoms. If you do not feel better after a few weeks, touch base with your health care provider for re-evaluation.

Question:

Can I take OTC Zantac after taking OTC Prilosec?

Answer:

I would like to know why you want to take OTC Zantac. Both of these medications are used to treat heartburn but they are usually not taken together. It should be one or the other. Zantac works by trying to decrease the amount of acid in the stomach where Prilosec turns off the pump that makes stomach acid. Typically you should take Prilosec for 14 days in the treatment of heartburn. I would also like to ask if you are taking any other medications, since Zantac can interact with many of them.

Question:

Is Pepcid AC a heartburn remedy?

Answer:

This is a great question you can ask your pharmacist since we know about over-the-counter products as well. Pepcid AC is for the relief of heartburn associated with acid indigestion and sour stomach and for the prevention of heartburn associated with acid indigestion and sour stomach brought on by certain foods and beverages.

Question:

Can Prevacid-DR 30 mg increase your appetite or cause you to gain weight?

Answer:

This is a good question you can always ask your pharmacist. An increase in appetite and weight gain are side effects of Prevacid. If you have gained a reasonable amount of weight, I would suggest speaking with your health care provider. If you need to stay on the medication, you will probably need to make some lifestyle changes including diet and exercise.

Question:

I keep getting sinus drainage that leads to a full-blown cold, and then I have a congested head for the next 2-4 months. I usually end up going to the doctor, getting an antibiotic, and do that for the duration. I've asked "please, can I get a shot of penicillin?” and they tell me that "we don't do that anymore." Why not? I need a jump start on getting ahead of this crud. Is there anything I can get that works or is penicillin "in disguise?" And why can’t I get a shot of penicillin anymore?

Answer:

This caught my eye because I want to make people aware of why we do not give "penicillin shots" or antibiotics for colds. First, antibiotics do not do anything for the common cold. Antibiotics are only helpful if you have an infection that is caused by bacteria. There has been a lot of antibiotic "misuse" in the U.S. (people not taking antibiotics correctly, over-prescribed, saving them for a "rainy day") and that has caused a lot of problems, including the fact that good old stand-by medications like penicillin are not working anymore because the bugs have become "resistant." We are getting "superbugs" that our current antibiotics cannot touch -- and this is a dangerous and important health crisis. To avoid your problem in the future, I would suggest proper symptom management and talking to your pharmacist about what products may be beneficial for you. This may include using nasal decongestants or saline irrigation systems to help cleanse your sinus cavity and avoid the possibilities of infection.

 

Question:

Does Carafate interact with Tamiflu?

Answer:

Carafate does not interact with Tamiflu. Just remember that Carafate should be taken on an empty stomach. Thanks for submitting a question today.

Question:

What exactly do proton-pump inhibitors do?

Answer:

This is a common question that many of my patients ask. It works by decreasing the amount of acid produced in the stomach by trying to "turn off" the process that produces acid in the stomach. This is a great example of something you can ask your pharmacist; after all, we are the medication experts.

Question:

Does a pharmacist always check to see if the new meds will counteract with what is already being taken?

Answer:

This is a great question because this is one of the very important things that we do to protect you and keep you safe. Yes, a pharmacist checks your profile each time we fill a prescription but keep in mind that if you go to more than one pharmacy, we may not know everything you are taking. Most of the national chains are linked; so for instance, if you go to one Target and then visit another Target, they can see all your medications. But if you got one prescription filled at Wal-Mart and another at CVS and another at Joe's Pharmacy, we don't have access (at least not yet -- we really need electronic medical records). It is very important that you carry a personal medication list. This is a list that contains all your prescription medications and also all your over-the-counter medicines, vitamins, and supplements because they can interact with your medications too! Bring this list with you each time you visit the pharmacist as well as each doctor and health care provider.

Question:

What are the risks of taking Zantac 75 for weeks at a time?

Answer:

Products like Zantac 75 are indicated for the treatment of mild to moderate, infrequent, episodic heartburn, and the prevention of heartburn associated with acid indigestion and sour stomach. If you have been taking it for more than two weeks, you really need to make an appointment with your doctor or health care provider for further evaluation.

Question:

I'm taking Prev Pac for 14 days. Can I drink alcohol will taking this medication? I don't drink much -- just occasionally.

Answer:

Due to the fact that you are on medication that is trying to help your stomach, I would not advise drinking any alcohol at all. Alcohol is a known "trigger" for heartburn and other GI conditions. It’s not worth your health.

Question:

I take four ibuprofen a day and I have bad heartburn. Could it be the ibuprofen?

Answer:

Can I ask why you are taking four ibuprofen a day and if you were advised to do so by a doctor or health care provider? How long have you been taking them? You will need to contact your doctor or health care provider for evaluation. Ibuprofen can cause many gastrointestinal side effects and there is a possibility of a link between its use and ulcers. Based on your doctor's evaluation, they may prescribe a prescription medication that does not have these types of side effects.

Question:

If there is a person in your family who has H1N1 virus, how long should we as a family stay quarantined?

Answer:

You should monitor other family members for the signs of the flu but that does not mean that the rest of the family should stay home if they are not sick. Make sure that you wash your hands frequently and cover your nose and mouth when coughing or sneezing to help reduce transmission of the virus.

Question:

Does drinking coffee make heartburn worse or can it help? Do popsicles cause heartburn and make it worse?

Answer:

Actually both foods can contribute to heartburn and may actually make it worse. When treating heartburn, we always recommend non-pharmacological methods like avoiding spicy and fatty foods, stop smoking, and avoid eating at least three hours before bedtime.

Question:

Is high blood pressure a side effect of Prilosec?

Answer:

Yes, elevated blood pressure is documented as a side effect of Prilosec. Have you been taking your blood pressure at home? Keep a diary of your readings and I would advise calling your doctor or health care provider for evaluation. Thanks for submitting a question today.

Question:

I am allergic to penicillin. Can I take amoxicillin?

Answer:

Great question. If you are allergic to penicillin, you are also allergic to amoxicillin (they are related). You want to make sure that all of your health care providers know you are allergic to penicillin including your pharmacist. This is a very important piece of information!

Question:

If I completed at 14-day round of Prilosec OTC two weeks ago would it be OK to start another 14-day round? Thank you!

Answer:

This is a great question. If you have completed a 14-day round of Prilosec OTC and your heartburn is not resolved, you need to see a health care provider for additional evaluation. If you heartburn is resolved, you should continue to use dietary/lifestyle modifications. You should only repeat the 14-day treatment course of Prilosec OTC every four months if needed.

Question:

I take a lot of medication but am hesitant to share all my medical information. If I tell the pharmacist everything I am on and it gets listed in their system, who does that get shared with?

Answer:

There are specific laws in place that do not allow this type of information to be shared with the "common world." You should be aware of the fact that if you don't share this information with the pharmacist, who is a health care provider, you are putting yourself at risk of drug interactions and adverse effects. We don't know all of the medications, OTCs, vitamins, and herbals you are taking and one thing that many do not know is how they may cause a dangerous drug interaction. I went through six years of school focusing on that and protecting you! Talk to your pharmacist, it may actually save your life.

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