Holiday Heartburn? Over the Counter vs. Prescription Relief Options

From festive feasts to holiday parties and late-night leftovers, ‘tis the season for celebration. But all the indulgences can also bring unwanted heartburn. Rich foods, alcohol, sweets and larger-than-usual meals can leave many people reaching for relief this time of year.

Occasional heartburn is very common. The American College of Gastroenterology estimates that around 60 million people in the United States experience heartburn at least once a month, and as many as 15 million experience symptoms daily.

If you’re feeling the burn this time of year, it helps to know your options. Here’s a quick guide to understanding what causes “holiday heartburn” and how to choose between over-the-counter (OTC) and prescription medications for lasting relief.

What is holiday heartburn?

Heartburn is a burning sensation in the chest or throat caused by stomach acid moving up into the esophagus. The term is often used interchangeably with acid reflux, but they are different. Acid reflux is the movement of stomach acid into the esophagus, whereas heartburn is the symptom you feel because of acid reflux.

Heartburn can be triggered by several different factors, including the foods you eat and the beverages you drink, or can even be a side effect of the medications you take. The occasional heartburn isn’t much cause for concern, but if you experience it more frequently (more than twice a week), it may be a sign of gastroesophageal reflux disease (GERD).

During the holidays, heartburn and acid reflux can be more common because our diet is typically different than normal. We often eat larger, higher-fat meals, drink more caffeine and alcohol and eat more sweets like chocolate and peppermint, all of which can trigger or worsen heartburn symptoms.

By understanding your triggers for heartburn, you can help prevent symptoms before they start.

Lifestyle tips to prevent heartburn

The best way to manage holiday heartburn is to prevent it before it starts. Here are some strategies to help keep heartburn at bay this festive season:

• Eat smaller portions: Try grazing throughout the holiday instead of overloading on one big meal.
• Avoid trigger foods: Common culprits include spicy, fatty, or fried foods; chocolate, peppermint and citrus.
• Limit alcohol and caffeine: Both can relax the esophageal sphincter, allowing acid to flow upward.
• Stay upright after eating: Wait at least 2 to 3 hours before lying down or going to bed.
• Quit smoking: Nicotine can increase acid production and weaken the esophageal barrier.

OTC relief options

If you experience occasional heartburn, especially during the holidays, then over-the-counter medications are likely a good option to provide fast and effective relief. These options are widely available and can help you manage mild or infrequent symptoms of acid reflux.

Antacids (TUMS^®, Rolaids^®, Maalox^®, Mylanta^®, Pepto-Bismol^®):

• How they work: Antacids neutralize existing stomach acids to provide fast relief from occasional heartburn.
• Best for: Quick, short-term relief after a larger or richer meal.
• When to take it: You typically take an antacid after a meal, and it starts working within about 10 minutes.
• Side effects: Relief is temporary, and overuse can cause side effects such as constipation, diarrhea, changes in color of bowel movement, and stomach cramps.
• Things to know: Antacids wear off quickly.

Blockers (Tagamet^® HB, Pepcid Complete^®, Pepcid AC^®, Zantac 360^®):

• How they work: Histamine-2 agonists (H2 blockers) reduce acid production in the stomach by blocking histamine, which triggers acid release.
• Best for: Moderate, longer-lasting relief that can last up to 12 hours.
• When to take it: It’s typically recommended to take H2 blockers 30 minutes before meals or at bedtime. They start working within 1 to 3 hours.
• Side effects: Headache, diarrhea, constipation and dizziness.
• Things to know: H2 blockers can only be taken continuously for up to 2 weeks unless you’re directed to continue by a doctor.

PPIs (Prevacid^® 24HR, Nexium^® 24HR, Prilosec^® OTC):

• How they work: Proton pump inhibitors (PPIs) block acid production at the source by inhibiting the stomach’s acid pumps.
• Best for: Frequent heartburn that occurs two or more times per week.
• When to take it: You typically take a PPI about 30 minutes before your first meal.
• Side effects: Headache, stomach pain, nausea, diarrhea, constipation, gas and dizziness. If you are post-menopausal or on PPIs for a long time, they can reduce calcium absorption and increase your risk of osteoporosis.
• Things to know: Unlike H2 blockers, it can take up to 4 days to feel the full effects of PPIs. Relief can last up to 24 hours.

Pros of OTC options:

• Convenient and accessible without a prescription.
• Provide relief for occasional or mild heartburn.
• Available in various forms such as chewable tablets, liquids and capsules.

Cons of OTC options:

• Only intended for short-term use.
• May cause side effects or interact with other medications.
• Can mask underlying conditions if used too frequently.

If you find yourself relying on OTC products often or for extended periods, it may be time to talk to a healthcare professional about prescription-strength heartburn treatments.

Prescription relief options

When lifestyle changes and OTC medications aren’t enough, prescription acid reflux medications may be necessary. Persistent heartburn could be a sign of GERD, which requires ongoing management under the guidance of a healthcare provider. Additionally, heartburn symptoms can resemble signs of a heart attack, which requires immediate attention.

Prescription strength H2 blockers (Pepcid®, Tagamet®) and PPIs (Nexium®, Protonix®, AcipHex®) work similarly to their OTC counterparts but are available in higher doses and can be taken for longer periods of time under the supervision of a medical professional.

You should talk to your healthcare provider if you experience heartburn two or more times per week; depend on OTC medications frequently; have difficulty swallowing, chronic cough, or chest pain after eating; or notice that symptoms wake you up at night or don’t improve with OTC treatments. Your provider may recommend additional tests, such as an endoscopy, to confirm a GERD diagnosis and rule out other conditions.

Choosing the right option

Finding the right holiday heartburn relief depends on how frequently you experience symptoms and how well you respond to treatment. For occasional heartburn triggered by a heavy meal or a holiday party, OTC antacids or H2 blockers are often enough.

If symptoms return regularly, occur more than twice a week or interfere with sleep or daily life, it may be a good idea to talk to your healthcare provider about prescription-strength H2 blockers or PPIs. These medications can manage long-term acid control and help prevent complications associated with GERD.

Regardless of the type of medication you choose, it’s always important to use heartburn medication safely. Make sure you read the medication label carefully and follow dosing recommendations closely. Speak with a pharmacist or doctor before you start any new medication, especially if you are pregnant or breastfeeding, have liver or kidney disease, have high blood pressure, or are looking for treatment for a child under 12.

You should also let your healthcare provider know about any other prescriptions, OTC medications, vitamins or supplements you take, since heartburn medicines can interact with other medications. For example, certain H2 blockers like Tagamet® may interfere with common prescriptions such as warfarin (used to prevent blood clots) or certain antidepressants.

Express Scripts Pharmacy support

Pharmacists play an important role in helping you navigate your heartburn medication choices. They can explain how each medication works, check for potential medication interactions, and guide you on when it’s time to see your doctor for alternative treatments.

At Express Scripts® Pharmacy, you have access to convenient, affordable and reliable pharmacy care that fits your life. Whether you’re managing chronic acid reflux or occasional heartburn, Express Scripts makes it easier to get the medication you need and expert support you can trust.

Through our home delivery pharmacy and digital tools, members can easily refill and manage prescriptions, track deliveries, and receive medication reminders online or through our Express Scripts^® mobile app, helping you stay on track with long-term treatment. You also have 24/7 access to licensed pharmacists, ready to answer questions about heartburn medication (both OTC and prescription), medication interactions, and safe use during the busy holiday season.

Our specially trained Express Scripts pharmacists can help you choose the most effective OTC or prescription options for your needs, understand how and when to take your medication, identify triggers or habits that worsen heartburn, and coordinate refills or manage multiple prescriptions from the comfort of your own home.

With personalized guidance, medication safety checks and flexible home delivery, Express Scripts Pharmacy supports your health wherever you are, so that you can focus on enjoying the holidays.

Conclusion

Heartburn is common, especially around the holidays, but with the right approach, it can be manageable. From all of us at Express Scripts Pharmacy, we hope your holiday season is filled with love, joy and, most importantly, heartburn-free celebrations.