H2 Blockers: Treatment Options for GERD | Health line

What are H2 receptor blockers?

H2 receptor blockers are a class of medications that can be used to treat conditions that cause excess stomach acid. These medications are available without a prescription and with a prescription. Common blockers of the H2 receptor include:

  • nizatidine (Axid)

  • Famotidine (Pepcid, Pepcid AC)

  • cimetidine (Tagamet, Tagamet HB)

  • ranitidine (Zantac)

H2 receptor blockers are the most commonly used to treat gastritis or inflamed stomach and to treat peptic ulcers. Peptic ulcers are painful sores that form in the lining of the stomach, lower esophagus, or duodenum, which is the first part of the small intestine. They often develop as a result of inflammation and excess stomach acid. Doctors may also recommend H2 receptor blockers to prevent peptic ulcers from coming back.

H2 receptor blockers are also frequently used to relieve the symptoms of gastroesophageal reflux disease (GERD). GERD is a chronic form of acid reflux, which causes acidic stomach contents to flow into the esophagus. Frequent exposure to stomach acid can irritate the esophagus and cause uncomfortable symptoms, such as heartburn, nausea, or difficulty swallowing.

H2 blockers can also be used to treat less common conditions such as Zollinger-Ellison syndrome, a condition that causes an increase in stomach acid production

Doctors may also recommend H2 receptor blockers for use not indicated on the label. This means using the medication to treat a condition for which the medication has not been approved. For example, H2 receptor blockers can be used to treat pancreatic problems or in cases of allergic reactions, although traditionally they are not used for these purposes.

How do the H2 receptor blockers work?

When taking a H2 receptor blocker, the active ingredients travel to specific receptors on the surface of stomach cells that release acids. The medication inhibits certain chemical reactions in these cells so that they can not produce as much acid. According to the National Institutes of Health, H2 receptor blockers decrease stomach acid secretions in a 24-hour period by 70 percent. By reducing the amount of acid in the stomach, any damaged tissue has time to heal.

What are the side effects of H2 receptor blockers?

Most of the side effects associated with H2 receptor blockers are mild and usually decrease as a person takes the medication over time. Only 1.5 percent of people stop taking H2 receptor blockers due to side effects.

Some of the side effects that can occur with H2 receptor blockers include:

  • constipation

  • Diarrhea

  • difficulty to sleep

  • dry mouth

  • Dry Skin

  • Headaches

  • Ringing in the ears

  • a runny nose

  • problems urinating

Call your doctor if you have any other symptoms you suspect may be due to taking a H2 receptor blocker.

In rare cases, H2 receptor blockers can cause more serious side effects, such as:

  • blistering, burning or peeling skin

  • changes in vision

  • Confusion

  • agitation

  • difficult breathing

  • wheezing

  • chest tightness

  • irregular heartbeat

  • hallucinations

  • suicidal thoughts

Call your doctor or go to the hospital right away if you experience any of these symptoms.

Despite its possible side effects, H2 receptor blockers are usually a very effective treatment for conditions that cause excess stomach acid. You and your doctor can analyze the potential risks and determine if H2 receptor blockers are the best option for your particular condition. You should never stop taking your medication without first talking to your doctor.

H2 receptor blockers against proton pump inhibitors (PPI)

Proton pump inhibitors (PPIs) are another type of medication used to reduce stomach acid and treat acid reflux or GERD. Examples of PPIs include esomeprazole (Nexium) and pantoprazole (Protonix).

Both drugs act by blocking and decreasing the production of stomach acid, but PPIs are considered stronger and faster to reduce stomach acid. However, H2 receptor blockers specifically reduce the acid released at night, which is a common factor in peptic ulcers. This is the reason why H2 receptor blockers are specifically prescribed to people who have ulcers or who are at risk of contracting them. PPIs are prescribed more frequently for people who have GERD or acid reflux.

In general, doctors do not recommend taking either a PPI or an H2 receptor blocker at the same time. H2 receptor blockers can interfere with the effectiveness of PPIs. If your GERD symptoms do not improve with the use of a PPI, your doctor may recommend an H2 receptor blocker instead.

Alternative treatments

If you have peptic ulcers or GERD, your doctor may recommend that you avoid taking specific medications and make certain lifestyle changes to relieve your symptoms.

If you have peptic ulcers, your doctor may recommend that you limit the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. Frequent and prolonged use of these types of medications can increase your risk of peptic ulcer disease. Your doctor may suggest that you take acetaminophen instead. However, you should not stop taking any medication without first talking to your doctor.

Making some adjustments in lifestyle can also help reduce the symptoms of peptic ulcer. These include:

  • limiting alcohol consumption

  • avoiding spicy foods

  • reducing stress

  • give up smoking

If you have GERD or acid reflux, lifestyle remedies that can relieve symptoms include:

  • eat several small meals per day instead of three large

  • Avoid alcohol, tobacco and foods and drinks known to trigger symptoms.

  • Raising the head of the bed about 6 inches.

  • consuming less fat

  • Avoid lying down for at least two hours after eating.

  • Avoid the sandwiches before going to bed.

Talk to your doctor if your symptoms do not improve with medications or lifestyle remedies. You may need more aggressive treatment or surgery to remove an ulcer or reduce acid reflux.

You should seek emergency medical attention if any of the following symptoms occur:

  • develops abdominal pain that is much worse than what you are used to

  • you develop high fever

  • Experience vomiting that is not easily relieved.

  • develops dizziness and lightheadedness

These are signs of complications of peptic ulcer disease that must be addressed immediately.


Is there anyone who should not take H2 receptor blockers?


Only patients who have severe or life-threatening reactions to H2 blockers should avoid taking them. This class of medication is category B in pregnancy, which means it is safe to take during pregnancy.

Tyler Walker, MDThe answers represent the opinions of our medical experts. All content is strictly informative and should not be considered medical advice.

Reference: https: //www.healthline.com/health/gerd/h2-blockers


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