Monitor the health of your community here

How to Use Proton Pump Inhibitors & H2 Blockers Together

Histamine receptor antagonists (also known as H2 blockers) are a class of drugs commonly used to treat the symptoms of acid reflux 2. They decrease the production of acid in the stomach by blocking the histamine receptors on acid producing cells. The production of acid still continues, however, so using these drugs alone may not provide relief for some patients. Your doctor may recommend the patient also takes a proton pump inhibitor. These drugs disable the acid pump in the stomach cells that produce acid and usually the majority of acid secretion stops. Using these two classes of drugs together may help those patients with severe acid reflux.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Consult your doctor. Your doctor will evaluate your symptoms. Patients with severe acid reflux disease may require more than the standard dose of proton pump inhibitors and H2 blockers. Your doctor may start you off on a high dose, then as your symptoms subside, he or she may decrease your dosage down to a maintenance amount. Fill your prescription. The amount of medication you need to take will depend on the strength of the prescription.

The Best OTC Drugs for Ulcers

Learn More

Take your proton pump inhibitor once a day. Follow your doctor’s instructions on how and when to take your medication, but in general, proton pump inhibitors are taken once a day - with or without food. Patients with severe symptoms may take a pill twice a day (one at morning, one at night). Proton pump inhibitors may take longer than an H2 blocker to begin working, but the effects last longer.

Take your H2 blocker. Again, follow your doctor’s instructions. Over the counter medications will also have instructions on the box. H2 blockers work faster than a proton pump inhibitor, but the effects do not last as long. Some patients will need to take their H2 blocker several times a day. H2 blockers typically take about an hour to take effect, so taking a pill about an hour before meals may help prevent acid reflux symptoms from occurring. You can also take these medications after a meal if you feel symptoms coming on. Your doctor may also suggest you take one at bedtime.


Examples of H2 blocker drugs include cimetidine, famotidine, nizatidine and ranitadine. There are several brand names available over the counter. Examples of proton pump inhibitors include esomeprazole, pantoprazole, omeprazole, lansoprazole and rabeprazole. Some proton pump inhibitors are also available over the counter. These drugs can get expensive, however, so ask your doctor about possibly getting a prescription so that your health insurance can cover some of the costs.


Some H2 blockers may interact with prescription medications, so consult your doctor before beginning treatment with H2 blockers. While generally considered safe, new evidence suggests that long term use of proton pump inhibitors can increase the risk of osteoporosis and the incidence of hip fractures, according to the Ohio State University Medical Center. Tell your doctor if you have had any allergic reactions to medications.