Medications

These drugs use different mechanisms to reduce reflux.

Proton pump inhibitors (PPIs)

• PPIs include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), rabeprazole (Aciphex), and pantoprazole (Protonix).
  
  
• They block the production of an enzyme needed to produce stomach acid.
  
  
• PPIs stop acid production more completely than H2-blockers.

Coating agents

Sucralfate (Carafate) coats mucous membranes and sores to provide an additional protective barrier against stomach acid.

Promotility agents

• Promotility agents include metoclopramide (Reglan, Clopra, Maxolon) and bethanechol (Duvoid, Urabeth, Urecholine).
  
  
• They help tighten the lower esophageal sphincter and promote faster emptying of the stomach.
  
  
• Health care providers often are reluctant to prescribe these medications because they have fairly significant side effects.
  
  
• Promotility agents also do not work as well as PPIs for most people.
  
  
• One of these agents, cisapride (Propulsid), has been removed from the US market because of safety concerns related to lethal drug interactions.

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GERD - Proton Pump Inhibitors

The eMedicineHealth physician editors ask:

Heartburn symptoms caused by GERD are usually relieved by drugs called proton pump inhibitors (Prilosec, Prevacid, Aciphex, Protonix, Nexium, Zegerid); however, proton pump inhibitors sometimes do not work well. If your symptoms were not relieved by treatment with proton pump inhibitors, can you please describe your GERD symptoms that did not improve? If you have other treatments that have been effective, please comment on those.

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