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Medications and Supplements That Can Cause Heartburn

Experts say if your reflux symptoms are sudden, these pills and powders may be to blame

spinner image illustration of a stomach filled with flames representing heartburn and GERD caused by acid reflux-inducing medications or supplements
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Got heartburn? You’re not alone. Nearly a third of U.S. adults experience heartburn each week, according to a 2020 study published in the journal Gastroenterology. And almost everyone will experience it at some point in their lives, says the American College of Gastroenterology.

Heartburn is what you feel when you have reflux: acidic stomach contents flowing back into the tube that connects your mouth and your stomach, irritating the tissue there. It often occurs after a meal or when you lie down, and it can feel like burning in your throat or a pain in your chest, says Sonja Olsen, M.D., a gastroenterologist with Tampa General Hospital’s Gastro Group of the Palm Beaches.

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Heartburn can also manifest as a cough, or the feeling that you need to repeatedly clear your throat, she says.

If it occurs often, you might be diagnosed with frequent heartburn, which doctors call gastroesophageal reflux disease (GERD).

Heartburn is especially common among older adults, experts say, thanks to the toll time takes on the aging body. For example, the esophagus thins and the muscles that are meant to keep the acid in the stomach weaken with increasing age.

Weight gain can also play a role. Obesity is a major risk factor for heartburn because — like pregnancy — the extra weight puts pressure on the stomach, especially when someone reclines, pushing up acid and causing discomfort.

But some of the most frequent triggers of heartburn in older adults are the pills, of all varieties, that people take to stay well.

“Medicines are a big reason, honestly, and supplements,” said Cary Cotton, M.D., a clinical assistant professor in the gastroenterology division at the University of North Carolina.

7 medications that can cause heartburn

Many common medications can cause or worsen heartburn symptoms, including:  

  1. Antibiotics, such as tetracycline (including doxycycline) and clindamycin
  2. Benzodiazepines, such as Valium, Xanax, Halcion, Atavin and Klonopin
  3. Opioids, such as Percocet, codeine and OxyContin
  4. Calcium channel blockers, often prescribed for high blood pressure, and nitrates, given for chest pain
  5. Pain relievers, such as ibuprofen (Advil) and aspirin
  6. Bisphosphonates, given for osteoporosis 
  7. Anticholinergics, prescribed for conditions including overactive bladder syndrome and irritable bowel syndrome, and for some symptoms of Parkinson’s disease

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6 supplements that can cause heartburn

Common supplements that rev up reflux include:

  1. Iron supplements
  2. Glucosamine
  3. Valerian
  4. Peppermint — though for some people, it eases heartburn, Olsen says.
  5. Potassium
  6. Vitamins, particularly when the pills are large and can get stuck in the esophagus and cause irritation, Olsen says.

Another culprit: polypharmacy, or the regular use of multiple medications. This is especially common among older adults; an estimated 42 percent of people 65 and older take five or more medications, according to a report from the Lown Institute.

Even if the medications you take don’t trigger heartburn on their own, the effects of several together can add up and cause discomfort, Cotton explains.  

How do I know if a medication or a supplement is to blame?

“If someone comes to me with new reflux, it’s almost always medications until proven otherwise,” Olsen says. That’s because heartburn triggered by food is often something that develops over time, she says.

A new medication or supplement, on the other hand, may trigger a quick, noticeable reaction. So, keeping track of when your symptoms start is important, Cotton says.

If you suspect a medication or supplement is causing your heartburn, you may want to check with your medical provider to see if it’s safe to take a break or if it’s possible to find a substitute, said Tom Lamont, M.D., a professor at Harvard Medical School and author of Acid Reflux & Heartburn in 30 Minutes. If you do so, and your heartburn disappears, there’s your answer, he says.

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Sometimes, though, it’s hard to pinpoint which pill is the culprit. In that case, experts recommend going over with your doctor a list of all the medications and all the supplements — herbs, vitamins, protein powders and more — you take. Better yet: Write the list down or print it out before your appointment so you’re organized and ready.

Easing the symptoms

If you can’t take a break from your heartburn-causing medications, you can do other things to get some relief. Heartburn can often be managed with lifestyle changes and occasional over-the-counter medications.

For starters: Don’t eat at least three hours before bed. “That’s not always so easy to do,” Olsen says, “but it really does help.”

Experts also recommend trading big meals for more frequent, smaller ones; avoiding carbonated beverages and fatty foods, both of which can increase reflux; taking pills with a full glass of water to make sure they wash all the way down; and staying away from foods that seem to trigger your heartburn.

“We used to think there were some tried and true foods,” like alcohol, chocolate and spicy foods, that caused reflux, Olsen says. “But now we’re learning it’s very patient-specific.” 

You can also head to the drugstore for remedies. “Most of the major treatments for heartburn are now available over the counter,” Lamont says.

Antacids like Tums or Rolaids are fast-acting treatments for mild cases of heartburn. Histamine blockers like Pepcid, which can be more effective than antacids, work within a day. Proton pump inhibitors, like Prilosec, can take several days to kick in and are the most potent heartburn medications now available without a prescription. Just be sure to ask your doctor which option is right for you.

And know, too, that no medication, even if it’s over the counter, is meant to be used long-term, Cotton says. “If you’re using them every day, for weeks or months, you should probably talk to your doctor about it,” he says.

Physicians can perform an upper endoscopy and other tests to ensure that there aren’t aggravating, underlying conditions requiring separate treatment or even surgery to correct.

Also, if heartburn is waking you up from sleep, if it’s giving you a progressively worsening cough, or if you’re noticing any shortness of breath or chest tightness, those are warning signs to seek medical attention, Olsen says.

That said, for most of us, most of the time, heartburn is just another inconvenience of daily living. “Everybody in the whole world will have heartburn once in a while,” Lamont says. “It’s universal.”

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