Ranitidine alternatives: what to try for heartburn and GERD

Ranitidine was a go-to for many, but recalls pushed people to look for other options. If you need the same kind of relief, there are several safe and commonly used alternatives. Below I’ll walk you through the main drug groups, quick fixes, and simple lifestyle moves that actually help.

Common medication alternatives

H2 blockers — like famotidine (Pepcid) and nizatidine — work similarly to ranitidine by blocking acid production. They’re available over the counter and often start working within an hour. People use them for mild to moderate heartburn and occasional reflux. They can be a good step if antacids aren’t enough.

Proton pump inhibitors (PPIs) — examples are omeprazole, esomeprazole, pantoprazole and lansoprazole. PPIs reduce acid more strongly than H2 blockers and help heal esophagitis and ulcers. They’re best for frequent or severe GERD but may need a prescription for higher doses. Long-term PPI use has known risks like bone density changes, low magnesium, and possible vitamin B12 reduction, so talk with your doctor if you plan to use them regularly.

Antacids and alginate products — Tums, Rolaids, and Gaviscon give fast, short-term relief by neutralizing acid or forming a foam barrier. They don’t heal inflammation but are great for immediate symptoms after a meal or when you need quick relief before bed.

Sucralfate and prokinetics — Sucralfate can protect the stomach lining and help ulcers; prokinetic drugs such as metoclopramide or domperidone speed stomach emptying and can help with reflux due to slow gastric emptying. These options are usually prescription-only and may have side effects, so they’re typically used when other treatments fail.

Lifestyle fixes and when to see a doctor

Small changes often cut symptoms a lot. Try eating smaller meals, avoid trigger foods (spicy, fatty, chocolate, caffeine, alcohol), stop eating 2–3 hours before bed, lose weight if needed, and raise the head of your bed 6–8 inches. Smoking makes reflux worse, so quitting helps fast.

See a doctor if you have trouble swallowing, persistent vomiting, unintentional weight loss, blood in stool or vomit, or severe chest pain. Also talk to your provider if you’re pregnant — safe choices differ during pregnancy and your OB can recommend the best option.

Finally, don’t switch meds or start long-term therapy without checking with a clinician, especially if you take other drugs. Drug interactions and individual health issues change what’s safest for you. If you want help comparing two specific options, tell me which ones and I’ll summarize the differences in plain language.