H2 - Blockers

The class of drugs known as H2 - blockers includes a variety of these "interchangeable" drugs, several of which are available in both over-the-counter and prescription forms. For people with acid reflux symptoms that are frequent or severe, or that do not respond to OTC medications, one of the prescription H2 - blockers is usually prescribed for an initial period of four to eight weeks.

The four H2 - blockers approved by the U.S. Food and Drug Administration and their standard does are:

  • cimetidine (Tagamet), 400 mg twice a day
  • famotidine (Pepcid), 20mg twice a day
  • nizatidine (Axid), 150 mg twice a day
  • ranitidine (Zantac), 150 mg twice a day
In the listed does, these four H2 - blockers are roughly equivalent in potency, effectiveness, and safety. They are all well tolerated and are among the most frequently prescribed medications in the United States. Different treatment studies show wide variations in the rate of symptom relief and healing of esophagitis, but a "ballpark" figure is that half of the patients who receive prescription-strength H2 - blockers experience relief from their acid reflux symptoms and healing of esophagitis, if present.

If you are taking an H2 - blockers for acid reflux and your symptoms are relieved, the next decision is whether to continue the treatment or to stop. Since it is best not to take medications unless they are needed, after the initial four to eight weeks of treatment the health care provider will generally recommend stopping the medications. Since many people have only intermittent symptoms of acid reflux and may never have a problem again, it is very reasonable to try a period off medications.