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Compare famotidine alternatives | OTC antacids | H2 blockers | PPIs | Natural alternatives | How to switch meds
Most people have heard of the brand-name stomach medications Pepcid or Pepcid AC. The generic form of Pepcid is famotidine. Famotidine is an FDA-approved over-the-counter (OTC) medication that is used to treat heartburn, indigestion, and stomach pain. It is specifically indicated for gastroesophageal reflux disease (GERD) and gastric or duodenal ulcer.
The cells in the stomach that are responsible for producing acid are called parietal cells. These cells produce acid when stimulated by three things: the vagus nerve, gastrin, and histamine. Famotidine blocks the histamine receptor; specifically histamine type 2 receptors. By doing this, it decreases the amount of acid these cells can secrete into the stomach.
There are several heartburn medications available. Some are more effective than others and some cause side effects and drug interactions that may make an alternative necessary.
What can I take instead of famotidine?
If looking to switch from famotidine to another drug within the same class of medications (H2 blockers or H2 receptor antagonists), there is Tagamet (cimetidine) and Axid (nizatidine). Zantac (ranitidine) had been a viable alternative for years, however, a couple years ago this was removed from the market due to a potential carcinogen being discovered in the manufacturing process (this has not been found with famotidine). Cimetidine and nizatidine are fairly equivalent in their efficacy with acid reflux and stomach ulcer healing as compared to famotidine. However, nizatidine is often not as readily available as the others.
If the issue is that famotidine is not working as well as you would have liked, it may be time to jump up to a more potent class of acid reducers, which would be the proton pump inhibitors (or PPIs). These include Prilosec (omeprazole), Nexium (esomeprazole), Protonix (pantoprazole), Aciphex (rabeprazole), Prevacid (lansoprazole), Dexilant (dexlansoprazole), and Zegerid (omeprazole-sodium bicarbonate). These medications are stronger acid reducers, and usually work better to treat stubborn acid reflux symptoms. PPIs also will be better at healing duodenal or gastric ulcers. They work by inhibiting the final common pathway in the production of stomach acid by the parietal cell, the proton pump (hence their name). The H2 blockers just stop one step on the way to the acid production.
If it is just a quick fix you are looking for mild, occasional heartburn symptoms, try one of the fast-acting antacids, such as Tums (calcium carbonate), Rolaids (calcium carbonate-magnesium hydroxide), or Gaviscon (aluminum hydroxide-magnesium carbonate). These medications are fairly inexpensive and work faster than the H2 blockers or the PPIs to curb heartburn symptoms. However, they are not indicated to heal ulcers.
Compare famotidine alternatives |
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|---|---|---|---|
| Drug name | Uses | Dosage | Coupons |
| Pepcid (famotidine) | GERD, PUD, erosive esophagitis | 10 mg, 20 mg, 40 mg once to twice daily | Pepcid coupons |
| Tagamet (cimetidine) | GERD, PUD, erosive esophagitis | 200 mg once to twice daily | Tagamet coupons |
| Axid (nizatidine) | GERD, PUD, erosive esophagitis | 150 mg once to twice daily, or
300 mg daily |
Nizatidine coupons |
| Tums (calcium carbonate) | Heartburn, upset stomach | 2-4 tabs every 2-3 hours as needed | Tums coupons |
| Rolaids (calcium carbonate/magnesium hydroxide) | Heartburn,
upset stomach |
2-4 tabs every 2-3 hours as needed | Rolaids coupons |
| Gaviscon (aluminum hydroxide/magnesium carbonate) | Heartburn,
upset stomach |
15-30 mL every 6 hours as needed | Gaviscon coupons |
| Protonix (pantoprazole) | GERD, PUD, erosive esophagitis | 20 mg, 40 mg once to twice daily | Protonix coupons |
| Prilosec (omeprazole) | GERD, PUD, erosive esophagitis | 20 mg, 40 mg once to twice daily | Prilosec coupons |
| Nexium (esomeprazole) | GERD, PUD, erosive esophagitis | 20 mg, 40 mg once to twice daily | Nexium coupons |
| Prevacid (lansoprazole) | GERD, PUD, erosive esophagitis | 15 mg, 30 mg once to twice daily | Prevacid coupons |
| Dexilant (dexlansoprazole) | GERD, PUD, erosive esophagitis | 30 mg, 60 mg once to twice daily | Dexilant coupons |
| Aciphex (rabeprazole) | GERD, PUD, erosive esophagitis | 20 mg once to twice daily | Aciphex coupons |
| Zegerid (omeprazole/sodium bicarbonate) | GERD, PUD, erosive esophagitis | 20 mg/1100 mg 40 mg/1100 mg once to twice daily | Zegerid coupons |
Top 3 famotidine alternatives
1. Over-the-counter antacids
These include Tums, Rolaids, Alka Seltzer, Maalox, and Gaviscon. These medications are safe, inexpensive, act fast, and can be taken several times a day if needed. The downside is that their effects often don’t last that long, and they are not indicated for erosive esophagitis or peptic ulcer disease.
RELATED: Pepto Bismol vs. Tums
2. H2 blockers
These are the same class as famotidine, and include alternatives cimetidine and nizatidine. These alternatives are equally effective as famotidine for the most part, are available OTC, and are usually inexpensive. The potential downside is they will likely present the same issues as your original reasons for switching medications in the first place.
3. Proton pump inhibitors
The proton pump inhibitors include Prilosec (omeprazole), Nexium (esomeprazole), Protonix (pantoprazole), Aciphex (rabeprazole), Prevacid (lansoprazole), Dexilant (dexlansoprazole), and Zegerid (omeprazole-sodium bicarbonate). These medications are stronger acid reducers, and usually work better to treat stubborn acid reflux symptoms, and also will be better at healing gastric or duodenal ulcers. The downside is that they can be more expensive OTC alternatives compared to the other medications discussed.
RELATED: Famotidine vs. omeprazole
Natural alternatives to famotidine
GERD is a condition where there are probably more natural remedies than any other gastrointestinal condition (save constipation perhaps). I tell my patients with mild reflux symptoms that I am fine with using natural remedies and lifestyle changes, so long as they have no condition that requires a prescription medication. This would include Barrett’s esophagus and reflux induced esophagitis. These conditions would require PPIs, usually long term.
Baking soda, which is sodium bicarbonate, a basic compound, can neutralize the acid in the stomach. A tablespoon in a glass of water when heartburn occurs, can be very effective as a fast-acting antacid.
Aloe vera juice can also help to coat the esophagus and stomach. This is sold in many super markets. It can be purchased as a juice in a bottle, or as a capsule. About 4 ounces twice a day is usually sufficient.
Many of my patients with reflux or indigestion have had a good response to apple cider vinegar. A teaspoon or tablespoon as needed when symptoms occur, or on a daily basis can help relieve indigestion symptoms quickly. This likely works by a negative feedback to tell the stomach to stop producing acid.
Always ask your healthcare provider before using supplements to treat heartburn or any other condition as supplements can affect your other medications or health conditions, causing potential for serious side effects.
RELATED: The best diet for acid reflux
How to switch to a famotidine alternative
It’s always a good idea to taper any long-term medication prior to discontinuing. Although it may not be necessary, it certainly won’t hurt. The same is true with famotidine. Even though it does not necessarily require a taper for safety reasons, tapering famotidine will prevent any rebound acid reflux from occurring (although this is less necessary than with the PPIs, where tapering is strongly recommended). As you are tapering off the famotidine, you can try the alternative medication, whether it is another H2 blocker, a stronger PPI medication, or a fast-acting antacid. Remember, if you have any questions about switching medications, or if you experience worsening symptoms despite switching, contact your healthcare provider for medical advice.
