Tums vs. Pepcid vs. Gaviscon for heartburn

How do the options compare?

The three are separated first by mechanism, then placed on the stepwise order obstetric guidance actually uses, with your running daily calcium total tracked alongside.

• Tums works fast because calcium carbonate neutralizes stomach acid the moment it hits your stomach, and at the amount on the label, it hasn't been linked to a higher chance of birth defects. 1
• Pepcid takes a different approach: famotidine lowers how much acid your stomach makes in the first place, and studies so far haven't found a higher chance of birth defects with it in pregnancy. 2
• Gaviscon works a third way, forming a foam layer that floats on your stomach contents to physically block reflux, and in a study of 150 pregnant women, more than half felt relief within 10 minutes with no known significant safety concerns for mother or baby. 3
• Doctors don't just pick one product, they usually step up in order: lifestyle changes first, then a calcium antacid or similar option, then an H2 blocker like famotidine, and a proton pump inhibitor only if symptoms still aren't controlled. 4
• Because Tums itself is a source of calcium, using it often on top of a prenatal vitamin can add up fast, and pregnancy guidelines cap total calcium at about 2,500 mg a day from food, supplements, and antacids combined. 5
• A 2022 review of reflux care in pregnancy sets the order as lifestyle changes, then antacids, then sucralfate, then an H2 blocker, then a proton pump inhibitor, and names calcium-containing antacids at normal therapeutic doses its preferred antacid choice. 6

Which option makes sense?

Calcium antacids are the preferred first product in pregnancy guidance, famotidine is the rung above them, and Gaviscon sits outside that stepwise order with thinner pregnancy evidence than either.

Disclosure: Pregnancy Smart offers a supplement that overlaps with one or more options above. This page describes the pregnancy evidence for each option on its own merits.