Different medications have different mechanisms of action to treat reflux. Antacids are most effective during a bout of reflux because they directly neutralize the acid. But they do not prevent reflux and only last for brief periods of time. Antacids are used for temporary relief and have short-lived effects. Antacids are not generally taken every day but on an as-needed basis.
H2 blockers and are best taken before reflux occurs. For example, a person with nighttime acid reflux might take a bedtime dose of an H2 blocker. If you have occasional acid reflux and plan to have a spicy meal, then taking a dose prior to the meal (as needed) may be better. Those with more frequent or severe symptoms can take a full dose of medication daily. Most H2 blockers are taken two, three, or rarely, four times a day. H2 blockers can be taken daily or before reflux occurs and usually take about an hour to start working. famotidine/calcium carbonate/magnesium hydroxide (Pepcid Complete) is a combination antacid and H2 blocker that offers immediate relief of reflux and up to 12 hours of acid suppression.
Proton pump inhibitors work by a different mechanism and are very ineffective for treating acid reflux that is already occurring. These medications take 24 to 48 hours to start working. PPIs need to be taken at the appropriate time for maximum effect.
Proton pump inhibitors are most effective before a meal. The pill is taken and absorbed into the bloodstream, and then travels back to act on the acidproducing cells of the stomach. The drug can then block the pump that is primed and ready to release acid as soon as it is stimulated by any food that enters the mouth or stomach. Proton pump inhibitors have maximum strength if taken 30 minutes before food. Most PPIs last for 10 to 18 hours and are taken once or twice a day.
H2 blockers and PPIs are recommended for frequent symptoms that may be long-standing. This prolonged acid contact time can lead to complications such as strictures or Barrett’s esophagus. Improvement of symptomatic esophagitis requires a two-phased approach. Initially, you must heal the acid-induced injury. Then once healed, you enter a maintenance phase to prevent recurrent damage. Most people who start regular use of an acid-suppressing medication stay on it for years, possibly for life.
Given the chronic nature of acid reflux, these drugs are taken at least daily and not sporadically. The only way to change this is by modifying your lifestyle or, if symptoms are debilitating, having anti-reflux surgery. These issues should be discussed with your doctor.
How and When Should Acid Reflux Medications be Taken? References
By Mortin - Copyright 2009
Last modification 31/12/2009