Treating Heartburn While On Warfarin

By: Alere Staff

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. You should see your doctor if you are getting heartburn more than twice a week, have difficulty swallowing, persistent nausea or vomiting or your symptoms are not easily resolved with the use of over-the-counter medications.3  Heartburn that occurs frequently interrupting your activities is called GERD (Gastroesphogeal Reflux Disease).3

Many over-the-counter and prescription medications are available to relieve heartburn symptoms, but may interact with your warfarin medication. You may need to test your INR more frequently while taking these medications. 

You should always consult your doctor regarding the use of any prescriptions or nonprescription medications, such as over-the-counter products. Download the Safe Medications form here and take it to your doctor to complete.  

  Medication Type4   INR Effect   Common Medications

Antacids - over-the-counter. 

Neutralizes acid in stomach.

  May decrease5

Alka-Seltzer®, Rolaids® and Tums® (calcium carbonate) Maalox® and Mylanta® (simethicone)

Foaming Agents - over-the-counter.

Coats stomach with foam to prevent reflux.

  May decrease5

Gaviscon (calcium carbonate or aluminum/magnesium)
H2 Blockers - over-the-counter
OR prescription. Decreases acid production for short term relief.



Tagamet® (cimetidine), Zantac® (ranitidine), Pepcid® (famotidine), Axid® (nizatidine)

Proton Pump Inhibitors (PPIs) - prescription. Reduces acid

production and promotes healing.



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. Diseases and Conditions: Heartburn.
  4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIH Publication No. 07–0882. May 2007.
  5. Bristol-Myers Squibb Company. Medication Guide for Coumadin Tablets and Coumadin for Injection [Package Insert]. 2009. Princeton, NJ: Bristol-Myers Squibb Company.