Antibiotics and heartburn

A tablet can linger in the oesophagus, especially when swallowed with little water or just before lying down. This may inflame its lining and produce pain or burning behind the breastbone. Antibiotics can also disturb the stomach and trigger indigestion, nausea or reflux-like discomfort. Burning does not show whether the antibiotic is working, and chest discomfort has causes other than heartburn.

Check the medicine label and dispensing instructions because some antibiotics have specific directions about food, drinks, antacids or supplements. Swallow the dose with a full glass of water and remain upright afterward when the instructions allow. Do not stop, split or replace the antibiotic without advice from the prescriber or pharmacist. Note when the burning starts, where it is felt and whether swallowing is painful.

Seek urgent care for trouble breathing, swelling of the lips, tongue or throat, faintness, or a rapidly spreading rash because these can signal a serious allergic reaction. Get prompt assessment for severe chest pain, vomiting blood, black stools, painful or difficult swallowing, repeated vomiting, or inability to keep fluids down. Contact the prescriber if heartburn continues, worsens or interferes with taking treatment.

Ask whether the antibiotic can irritate the oesophagus, whether your dose should be taken with food, and how long to stay upright afterward. Mention antacids, acid-reducing medicines, iron, calcium and other supplements because they can affect how certain antibiotics are absorbed. If treatment is for Helicobacter pylori infection, clarify the complete combination and timing of each medicine.