They can be effective, particularly if you suffer from acid reflux or gastroesophageal reflux disease (GERD). But they're often over-prescribed, unnecessary, and expensive.

The biggest seller by far is the heavily-advertised prescription drug Nexium. With a $240 a month price tag, sales of Nexium in 2008 reached nearly $5 billion. It's the second most commonly prescribed brand-name drug in the U.S.



If your doctor suggests a PPI, Consumer Reports Best Buy Drugs says several over-the-counter alternatives can work just as well and save you thousands of dollars a year. They include generic Omeprizole, Prilosec OTC and new Prevacid 24HR. It's due on drug store shelves in mid-November.



For occasional heartburn, Consumer Reports says before considering a PPI medication, try an antacid like Rolaids or Tums, or an H2 blocker, such as Pepcid or Zantac. Consumer Reports Best Buy Drugs says those over-the-counter medications are quite inexpensive and may be all the average heartburn sufferer needs.



But before you start taking any heartburn medication more than just occasionally, talk to your doctor about changing your diet and lifestyle and see if that helps. Changes that can help include:





Eating smaller meals





Avoiding spicy, fatty foods





Reducing alcohol consumption





Waiting to lie down at least 3 hours after eating





Losing weight

For more of Consumer Reports' advice on heartburn and dozens of other conditions: www.consumerreports.org/health/best-buy-drugs/index.htm.



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