Acid reflux — including gastroesophageal reflux disease (GERD), peptic ulcer disease, erosive esophagitis, and related conditions — is among the most common gastrointestinal complaints treated in primary care. Pharmacological management aims to reduce gastric acid secretion, protect the mucosal lining, and allow healing of acid-damaged tissues.
The two primary drug classes are:
- Proton Pump Inhibitors (PPIs) — the most potent acid-suppression agents, blocking the H+/K+-ATPase pump in gastric parietal cells. Include omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole. Several are OTC at low doses; all are available at higher doses by prescription.
- H2 Receptor Antagonists (H2 blockers) — older class; block histamine H2 receptors on parietal cells to reduce acid secretion. Include famotidine (Pepcid) and cimetidine (Tagamet). Note: ranitidine (Zantac) was withdrawn from US and global markets in 2020.
Misoprostol (Cytotec) is a distinct medication also included here — a synthetic prostaglandin used to protect the gastric mucosa when patients must take NSAIDs long-term, and also used for obstetric indications.
Acid Reflux Medications Available at Lucas Clinic
- Cytotec (Misoprostol) — 100/200 mcg tablets; gastric protection with NSAID use
- Nexium (Esomeprazole) — OTC 20 mg / Rx 40 mg; PPI for GERD and erosive esophagitis
- Prevacid (Lansoprazole) — OTC 15 mg / Rx 30 mg; PPI for GERD and peptic ulcers
- Prilosec (Omeprazole) — OTC 20 mg / Rx 20–40 mg; first widely-used OTC PPI
- Protonix (Pantoprazole) — Rx 20/40 mg; PPI for GERD and erosive esophagitis
- Zantac (Ranitidine) — H2 blocker withdrawn from US market in 2020 due to NDMA; history and alternatives