From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For acid reflux during pregnancy, the most effective medication, based on the latest evidence, is a proton pump inhibitor (PPI) such as omeprazole, but only after the first trimester and when symptoms are severe, with antacids or H2 blockers like ranitidine being considered first-line treatments. The management of acid reflux during pregnancy should follow a step-up approach, starting with lifestyle modifications, including eating smaller meals, avoiding trigger foods, not eating close to bedtime, and elevating the head of the bed 1. If these modifications are not sufficient, antacids containing calcium carbonate or aluminum hydroxide are generally considered safe first-line medications 1, 2. For persistent symptoms, H2 blockers such as ranitidine at 150mg twice daily or famotidine at 20mg twice daily may be recommended 3, 4. However, according to the most recent and highest quality study, PPIs like omeprazole are significantly more effective than H2 blockers like ranitidine in resolving heartburn, especially in patients who are still symptomatic after treatment with H2 blockers 5. It's essential to consult with a healthcare provider before starting any medication during pregnancy, as individual circumstances vary and recommendations may change based on the trimester and severity of symptoms 1, 2. Key considerations include:
- Starting with lifestyle modifications
- Using antacids or sucralfate as first-line medical therapy
- Considering H2 blockers like ranitidine for persistent symptoms
- Reserving PPIs like omeprazole for severe cases or when symptoms are intractable, typically after the first trimester.