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In the heartburn wars: speed vs. endurance.(CR health)

Consumer Reports

| March 01, 2004 | COPYRIGHT 2004 Consumers Union of the United States, Inc. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

Negative advertising is not just for political candidates. Makers of over-the-counter (OTC) heartburn remedies are battling for their share of the more than $1.2 billion-a-year market with ads claiming superiority over named competitors and lawsuits charging false advertising.

For example, in a TV spot that claims "nothing's faster" than Turns, a woman says competitor famotidine (Pepcid AC) "takes, like, 40 minutes to start working." Another competitor, omeprazole (Prilosec OTC), "can take one to four days to fully kick in," says a man in the ad. "Delayed release--it should say delayed relief."

Ads for Prilosec OTC--approved as a nonprescription drug last June- claimed, "One pill can relieve heartburn for 24 hours." The ads were "false," lawyers for rival Pepcid AC charged in a U.S. District Court. The judge slapped a preliminary injunction on the ad claims in September, and that order was upheld in December. Prilosec's maker has now revised the ads.

It's enough to give you heartburn as you try to choose among products that treat the problem in different ways. Your basic choice is usually between products Pepcid AC and others, such as nizatidine (Axid AR) and ranitidine (Zantac 75), are [H.sub.2] blockers, which impede histamine, a powerful stimulator of stomach-acid secretion. They can prevent heartburn for up to 10 hours, but can take up to an hour to start working. So [H.sub.2] blockers are the best choice if you take them before a meal that might spark an attack.

Prilosec OTC is a proton pump inhibitor, which keeps the stomach lining from pumping acid into the stomach. Inhibitors are the most effective heartburn drugs, but they can take days to reduce acid levels, so they must be used regularly. They're best for treating chronic or frequent attacks.

Tums and other antacids are best for treating an attack that's under way and are usually sufficient for people with only occasional heartburn.

In September 2002, CONSUMER REPORTS tested 16 antacids. They all started neutralizing stomach acid within a minute or so. But we round differences in how long a maximum dose would last. The longest-acting products included:

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