Heartburn and Warfarin

Approximately 10 million Americans suffer from heartburn at least once a month.1, 2 Heartburn is described as a painful burning feeling in your chest or throat which occurs when stomach acid backs up into the esophagus. This often can greatly reduce your quality of life by affecting your daily activities, your sleep and what you eat.

Many over-the-counter and prescription medications are available to relieve heartburn symptoms, but may interact with your warfarin medication.

You should always consult your doctor regarding the use of any prescriptions or nonprescription medications, such as over-the-counter products.

  Medication Type3   INR   Common Medications
Antacids - over-the-counter
Neutralizes acid in stomach
  May decrease4
Alka-Seltzer®, Rolaids® & Tums® (calcium carbonate) Maalox® & Mylanta®, (simethicone)
Foaming Agents - over-the-counter
Coats stomach with foam to prevent reflux
  May decrease4
Gaviscon (calcium carbonate or aluminum/magnesium)
H2 Blockers - over-the-counter
OR prescription
Decreases acid production for short term relief
  May increase4
Tagamet® (cimetidine), Zantac® (ranitidine), Pepcid® (famotidine), Axid® (nizatidine)
Proton Pump Inhibitors (PPIs) - prescription
Reduces acid production and promotes healing
  May increase4
Nexium® (esomeprazole), Prevacid® (lansoprazole), AcipHex® (rabeprazole), Protonix® (pantoprazole sodium), Dexilant™ (dexlansoprazole), Prilosec® (omeprazole, Zegerid® (omeprazole/sodium bicarbonate)
  1. Richter JE. Long term management of gastroesophageal reflux disease and its complications. Am J Gastroenterol. 1997; 92(4): 30S 35S.
  2. DeVault KR & Castell DO. Guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Arch Intern Med. 1995; 155(13):2165 73.
  3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIH Publication No. 07–0882. May 2007. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/.
  4. Bristol-Myers Squibb Company. (2007). Medication Guide for Coumadin Tablets and Coumadin for Injection [Package Insert]. Princeton, NJ: Bristol-Myers Squibb Company.