Do spironolactone, lisinopril, finasteride, or topiramate cause gastroesophageal reflux disease (GERD) or heartburn?

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Last updated: May 19, 2025View editorial policy

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From the Research

Among the medications listed, lisinopril and topiramate can cause heartburn as a side effect. Lisinopril, an ACE inhibitor used to treat high blood pressure and heart failure, may cause heartburn in some patients as it can relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus 1. Topiramate, an anticonvulsant medication used for seizures and migraine prevention, can also cause heartburn or acid reflux in some individuals. Spironolactone, a potassium-sparing diuretic, and finasteride, used for enlarged prostate and hair loss, are not commonly associated with heartburn as a significant side effect, as shown in a study published in the European heart journal 2. If you experience persistent heartburn while taking any of these medications, you should not discontinue them without consulting your healthcare provider, as they may be able to adjust your dosage, recommend taking the medication with food, suggest antacids, or consider alternative medications if the heartburn is severe or persistent. Some studies have investigated the effects of spironolactone on heart failure and blood pressure, but none of them have reported a significant association with heartburn 3, 4, 5. It's essential to note that the most recent and highest-quality study on this topic is not available, but based on the existing evidence, lisinopril and topiramate are the most likely to cause heartburn. Key points to consider:

  • Lisinopril and topiramate can cause heartburn as a side effect
  • Spironolactone and finasteride are not commonly associated with heartburn
  • Consult your healthcare provider if you experience persistent heartburn while taking any of these medications
  • Adjusting dosage, taking medication with food, or using antacids may help alleviate heartburn symptoms.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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