Regularly consuming antacids may seem to provide instant relief from acidity, but it can actually harm digestion, disturb stomach balance, and increase dependency.

FACT: 

Regular or excessive use of antacids can disrupt digestion, cause nutrient imbalances, and interact with other medications. They provide only short-term relief and may mask underlying conditions, so long-term or frequent use is not recommended without medical supervision.

We all reach for antacid pills or antacid powders when acidity hits, chasing that instant relief. But according to Dietitian Shweta J Panchal, this quick fix might be doing more harm than good.

In a viral reel, Panchal, who has 380k followers on Instagram, adds some antacid powder to water, explaining that while it seems like the over-the-counter remedy starts working in seconds, this instant relief is actually causing harm. She adds that when antacids are consumed regularly, the stomach balance gets disturbed, affecting digestion, and leading to greater dependency on these quick fixes.

She also warns that for people taking blood pressure medications, antacids act like a “sodium bomb” for the blood pressure. The gut is already stressed because of the medications, and adding antacids on top of that can be a complete red flag.

Panchal stresses that the biggest issue is ignoring the root cause. “Late-night meals, very spicy meals, timings going up and down until you address the root cause, you won’t get the actual solution,” she says.

What are antacids?

Antacids are medications that neutralise the acid in your stomach, providing quick relief from indigestion and heartburn. They are available as liquids or chewable tablets and can be purchased from pharmacies or shops without a prescription. Antacids can help ease symptoms associated with indigestion, heartburn, acid reflux, gastro-oesophageal reflux disease (GORD), stomach ulcers, or gastritis (inflammation of the stomach lining).

Antacids come in a variety of forms, some marketed under brand names like Gaviscon, which contains alginic acid, or Rennie, which combines calcium carbonate and magnesium carbonate. In India, the popular ENO salts are called an “Ayurvedic Proprietary Medicine containing Svarjiksara (Shudh) and Nimbukamlam (Shushkam).”

However, according to the National Health Service UK, the key ingredients in many antacids include aluminium hydroxide, magnesium carbonate, magnesium trisilicate, magnesium hydroxide, calcium carbonate, and sodium bicarbonate. Some formulations also contain additional components, such as alginate, which forms a protective layer in the oesophagus, or simeticone, which helps reduce gas and bloating.

Can popping antacids for every acidity complaint harm your health?

According to a 2023 article published in the National Library of Medicine, chronic use of antacids, particularly in infants and the elderly, is not recommended due to safety concerns. Certain ingredients commonly found in antacids can have adverse effects. For example, aluminium hydroxide has been associated with toxicity in individuals with renal failure and in infants, potentially leading to osteopenia, microcytic anaemia, neurotoxicity, osteomalacia, constipation, faecal impaction, nausea, vomiting, abdominal cramps, hypomagnesemia, and hypophosphatemia. Calcium carbonate–based antacids may also cause side effects such as abdominal pain, anorexia, constipation, acid rebound, nausea, vomiting, flatulence, dry mouth, headache, hypercalcemia, hypophosphatemia, and, in some cases, milk-alkali syndrome.

Antacids can interact significantly with other medications. Concurrent use with acidic drugs, such as digoxin, chlorpromazine, or isoniazid, may impair their absorption, reducing therapeutic effectiveness. Conversely, some drugs, including pseudoephedrine and levodopa, may have increased absorption when taken with antacids, potentially leading to toxicity. Magnesium-containing antacids like magnesium trisilicate and magnesium hydroxide can bind to antibiotics such as tetracycline and fluoroquinolones, reducing their efficacy. Sodium bicarbonate can alter urine acidity, which may affect renal elimination of certain drugs, inhibiting excretion of basic drugs like amphetamines while increasing that of acidic drugs like aspirin. Absolute contraindications include hypersensitivity to any component of the antacid, and caution is advised in patients with conditions such as “renal failure, heart failure, oedema, cirrhosis, low-sodium diets, uremia, gastrointestinal haemorrhages, hyperparathyroidism, kidney stones, or achlorhydria.”

While antacids are available over the counter, providing symptomatic relief for conditions like GERD, peptic ulcers, and gastritis, their use can mask underlying disorders, potentially delaying diagnosis. Awareness about proper administration, timing, and dosage is essential to ensure effective and safe use, especially in patients taking multiple medications. Nursing staff can verify drug use during intake and exams, while pharmacists play a key role in counselling patients about interactions and proper use. Even seemingly benign medications like over-the-counter antacids can significantly affect patient health, emphasising the importance of interprofessional communication for positive outcomes.

Some antacids, including aspirin-containing brands like Alka-Seltzer, have been flagged by the FDA for risks of serious bleeding, particularly in individuals who are older, have a history of ulcers, or take other medications that increase bleeding risk. Patients are advised to consult their doctor or pharmacist before using such products.

In India, the widely used antacid brand ‘Eno’ clearly lists precautions in its product information leaflet. It states that, “Do not use if you are on a low salt diet, have high blood pressure, congestive heart failure, impaired hepatic or renal function, or are allergic to any of the ingredients. Do not exceed the stated dose as excess or prolonged use may lead to alkalosis.”

The leaflet adds that users should consult a doctor if symptoms persist or worsen, and keep the product out of reach and sight of children. It further notes that the antacid reduces stomach acidity and may interfere with the absorption of other medications, advising that other medicines should be taken at a “different time of the day.”

The leaflet also provides dosing instructions. “For oral administration only. For use in adults and children aged 12 years and over: 5 g (one sachet or one teaspoonful of powder) dissolved in a glass (~150 ml) of water. Drink as symptoms occur. Repeat after 2–3 hours, if necessary. Minimum dosing interval: 2 hours. Maximum daily dose: do not take more than 2 doses in 24 hours. Do not take this medicine for more than 14 days at maximum daily dose. Not recommended for children under 12 years of age.”