I've heard that some medicines can make the symptoms of GERD worse. Can you tell me more?

Answer From Sahil Khanna, M.B.B.S., M.S.

Certain medicines and dietary supplements can irritate the lining of the tube that connects the mouth to the stomach, called the esophagus. This can cause heartburn pain that is like the heartburn of gastroesophageal reflux disease, often called GERD for short. Other medicines can make GERD worse.

GERD is an ongoing, called chronic, condition in which stomach acid flows back into the esophagus. This backward flow of acid irritates the lining of the esophagus and leads to heartburn and pain.

Medicines and dietary supplements that can irritate the esophagus and cause heartburn pain that is like the pain of GERD include:

  • Antibiotics, such as tetracycline and clindamycin.
  • Bisphosphonates taken by mouth, such as alendronate (Binosto, Fosamax), ibandronate and risedronate (Actonel, Atelvia).
  • Iron supplements.
  • Quinidine.
  • Pain relievers, such as ibuprofen (Advil, Motrin IB, others) and aspirin.
  • Potassium supplements.

Medicines and dietary supplements that may increase acid reflux and worsen GERD include:

  • Anticholinergics, such as oxybutynin, prescribed for overactive bladder and irritable bowel syndrome.
  • Tricyclic antidepressants, such as amitriptyline, and doxepin (Silenor).
  • Calcium channel blockers, statins, angiotensin-converting enzyme (ACE) inhibitors, and nitrates used for high blood pressure and heart disease.
  • Narcotics, also called opioids, such as codeine, and those that have hydrocodone and acetaminophen.
  • Progesterone.
  • Sedatives or tranquilizers, including benzodiazepines such as diazepam (Valium) and temazepam (Restoril).
  • Theophylline (Elixophyllin, Theochron).

If you have GERD, ask your healthcare professional if medicines you take might affect your symptoms.


Sahil Khanna, M.B.B.S., M.S.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Jan. 11, 2024 See more Expert Answers