ConsultPharmacist
Emailed question: I am experiencing severe heartburn! What causes heartburn? And can you recommend a heartburn medication?
Background information obtained: 23 year old male, allergy, current medication(s) and medical condition: penicillin allergy, Clindamycin 150mg taken four times daily for 7 days (for infection prevention after wisdom teeth extraction, started 1 day ago) and Tylenol #3 (for pain). He takes his last dose of Clindamycin before bedtime. There is no family history of heart problems nor does he experience any chest pain such as tightness, pressure or shortness of breath, and pain does not radiate from chest to back, neck, jaw or left arm.
From the information that I have gathered, we can rule out any heart conditions such as heart attack or angina pain. It appears that the cause of your severe heartburn is most likely due to taking clindamycin. Clindamycin is an antibiotic that can be used to prevent bacterial infection from dental procedures. This medication can be very irritating to the esophagus (passageway that leads from your mouth to your stomach). Your experience of severe heartburn may stem from not taking a full glass of water and lying down after taking your last dose of the day. Therefore, to prevent this from happening again, you should take this medication with a full glass of water and remain upright for at least 30 minutes before going to sleep. You should avoid any spicy or irritating foods or drinks such as coffee, cola, acidic beverages such as citrus juices, and chilli-oil or sauce etc., until your esophagus is fully healed. If you prefer taking an over-the-counter medication, then I would recommend an acid reducer,“H2 receptor antagonists”, such as ranitidine (Zantac) 75mg or 150mg and famotidine (Pepcid) 10mg to 20mg (take one tablet up to twice daily). If there is no improvement in 3 or 4 days, then try a stronger acid reducer, “proton pump inhibitor”, omeprazole (Prilosec) 20mg once daily for 14 days (tablet must be swallowed whole -do not crush or chew). Please see your doctor if no relief after 14 days. By taking these medications, along with avoiding eating or drinking spicy or irritating foods or beverages, you can allow the esophagus to heal, thereby reducing the heartburn symptoms.
Medications that can cause heartburn related symptoms (irritation of the esophagus):
- Non-steroidal Anti-inflamatories pain medications: acetylsalicylic acid (Aspirin), naproxen sodium (Aleve), ibuprofen (Advil, Motrin) and etc.
- Bisphosphonates: alendronate (Fosamax), risedronate (Actonel) and etc.
- Antibiotics: clindamycin (Dalacin), tetracycline, minocycline (Minocin), doxycycline (Periostat, Vibramycin)
- Minerals: ferrous (Iron) or potassium (K-Dur, Slow K etc.
For more information, ask a pharmacist at consultpharmacist.com!
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