Managing acid reflux can be challenging. You might take a proton pump inhibitor like omeprazole (Prilosec), lansoprazole (Prevacid) or esomeprazole (Nexium). Chances are, within a few weeks your symptoms would be less troublesome. But if you take such a PPI for a month or more, you could have rebound heartburn when you stop. Choosing a different drug might make sense. What do you know about the risks of Pepcid Complete?

Are the Risks of Pepcid Complete the Same as for Other Heartburn Medicines?

Q. I have been taking Pepcid Complete for a year and it has cleared up my acid reflux problems. I’ve just read about a study that concluded that famotidine (Pepcid) is one of the drugs that can cause C. diff infections.

I am not clear on whether Pepcid Complete is different from plain Pepcid. Am I asking for trouble by taking Pepcid Complete?

The Difference Between Pepcid and Pepcid Complete:

A. Pepcid contains only famotidine. Pepcid Complete contains famotidine plus the antacids calcium carbonate and magnesium hydroxide.

H2 Antagonists May Not Lead to C. Diff Diarrhea:

Famotidine, like cimetidine (Tagamet) or ranitidine (Zantac) reduce acid secretion in the stomach by blocking histamine receptors there. That is why they are called H2 blockers.

The study you describe concluded that these weaker acid-suppressing drugs are not linked to recurrent severe diarrheal infections caused by Clostridium difficile, although stronger drugs (the PPIs) like lansoprazole or omeprazole are (Tariq et al, JAMA Internal Medicine, June, 2017).

PPIs and C. Diff Infections:

The is not the first study to find that people taking PPI drugs for acid reflux are more likely to come down with diarrhea caused by C. diff. We have written about the connection here, here and here. Such medications reduce the diversity of microbes found in the digestive tract, which can make a person more susceptible to C. diff.

We offer several resources that can help you learn more about this problem. We interviewed Dr. Lawrence J. Brandt and Catherine Duff about the benefits of fecal transplants for overcoming C. diff infections (Show 935). In a more recent podcast (Show 1078), Dr. Robynne Chutkan discussed how to have good digestion without relying on heartburn medications. You may also be interested in our Guide to Digestive Disorders, which reviews the pros and cons of both PPI and H2 antagonist acid-suppressing medications.

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