New Medication for Acid Reflux

Acid reflux is a condition in which the lower ring of muscle called the esophageal sphincter does not close properly and stomach acid returns (refluxes) up the esophagus and causes a burning sensation in the chest and damage to the esophagus. Consuming large meals can cause acid reflux, as can being overweight, eating close to bedtime, eating fatty or spicy foods or smoking and drinking alcohol. There are several medications now available beyond simple antacids to treat acid reflux.

Histamine Antagonists

H2 antagonists are substances that work by blocking the action of histamine on parietal cells in the stomach, thus decreasing the production of stomach acid. The first H2 antagonist, cimetidine, was developed by Glaxo, Kline, & French (now GlaxoSmithKline) in 1964, and hit the market in 1976 under the name Tagamet. Other H2 antagonists followed, such as Zantac, Axid and Pepcid. The H2 antigonists have the advantage of being longer-acting than common antacids, with greater effect, and can be taken in advance of meals to prevent acid reflux. Side effects are rare but can include dizziness, confusion, changes in vision, irregular heartbeat and other symptoms.

Proton Pump Inhibitors

Proton pump inhibitors are a class of drug that blocks stomach acid by inhibiting an enzyme in the stomach wall that aids in its production. Since their introduction to the market in the 1980s, they have been considered the superior treatment for acid reflux disease and peptic ulcers. They are also considered more cost effective because proton pump inhibitors need only be taken once or twice a day and usually for a shorter duration than H2 antagonists. Proton pump inhibitors have been widely prescribed since the introduction of the drug Prilosec to the market in 1989. Since then, a number of other proton pump inhibitors have been developed. Prevacid, Nexium and a new intravenous form called Protonix I.V. are all used extensively in the treatment of acid reflux disease (GERD) and peptic ulcer disease. The drug is usually well tolerated, but some patients may experience nausea, headache, diarrhea and abdominal pain. Interactions with other drugs should be monitored closely. Long-term use of proton pump inhibitors has been associated with frequency of hip fractures.

Kapidex, Newly Approved for Acid Reflux

A new proton pump inhibitor called Kapidex, developed by Takeda Pharmaceuticals, was approved by the FDA in January 2009. It works similarly to previous proton pump inhibitors by blocking the production of an enzyme in the stomach wall, but its advantage is in that it is a once-daily tablet that functions with two separate releases of medication for full 24-hour symptom relief. This is particularly helpful for those patients who are troubled by heartburn and reflux symptoms that disturb sleep. Side effects similar to other proton pump inhibitors may occur.