You've Probably Been Taking Heartburn Medication Wrong All Along

You just finished a big plate of some spicy takeout food. It tasted great, but you're feeling a familiar burning in your lower esophagus. Quickly, you take some heartburn medicine and wait. But it doesn't seem to take away much, if any, of the discomfort.

Sound familiar? Though it might seem like your medication isn't working, the real problem might be that you're not taking your medicine correctly. (Here are other mistakes you didn't know you were making with medication.) A 2017 study in Clinical Toxicology found that many people make medication mistakes when self-dosing. However, if you make changes, you may be able to breeze through your next taco and burger run with much less stinging in your throat.

For example, your timing may simply be off. Popular heartburn medicines like proton pump inhibitors (PPIs) need to be taken prophylactically (i.e., before you need their effects.) Ideally, you should ingest a PPI about 30 minutes before eating your breakfast. That way, it can start performing its job, which is to prevent heartburn from starting rather than controlling it once it's already in full swing.

Over-the-counter and prescription PPIs under name brands like Nexium, Prevacid, and Zegerid are designed to interrupt the signals in your body that produce stomach acid. While they don't stop your stomach from making acid, they lower the amount of acid that's used to digest your food. According to a 2010 article in Current Gastroenterology Reports, around two-thirds of your normal stomach acid remains after taking a PPI. That way, your stomach can do its job but with less chance of you experiencing heartburn.

Of course, even if you're taking your heartburn pills as directed, you might still be making other mistakes. For example, have you ever been tempted to take more than the recommended dose? Although PPIs can sometimes be prescribed twice daily (a practice that was supported by a 2024 trial in the Journal of Neurogastroenterology and Motility), you should never double up on any drug without checking with your medical provider.

For instance, let's say that you take omeprazole for heartburn relief one hour before you eat in the morning to allow its delayed-release formula to start working. But what if you get worried and impatient that it's not going to be enough and you take another pill? According to the medication's known side effects, you could end up dizzy, confused, or sick to your stomach. You might even throw up or experience a fast heartbeat.

Even innocent-seeming antacids that look like chalky candies, such as Tums and Rolaids, shouldn't be misused. Although they may seem gentle, their active ingredients (usually calcium carbonate and maybe magnesium) can cause you to become less alert or have trouble breathing normally.

How can you avoid the heartburn of a heartburn medication that doesn't seem to work? A best practice is to read and follow the dosing directions, even if they seem counterintuitive. If your product still doesn't work after giving it a chance, follow the advice of thoraco-esophageal surgeon Dr. Michal Hubka, who explained in an interview with the American Medical Association that "patients who are experiencing reflux should consult their primary care physician." You may need a different prescription or may actually have a different condition that's masquerading as heartburn, such as gallstones or stomach ulcers (here are the signs of an ulcer you should never ignore).