Gastroesophageal reflux disease (GERD)
Clinical basis & sources
- Primary source
- OCP Minor Ailments Prescribing
Sources used
- Ontario Regulation 256/24: GeneralGovernment of Ontario · 2026
- Minor Ailments: Drug Classes and Specified DrugsOntario College of Pharmacists · 2026
- Executive Officer Notice: Update to Funding for Minor Ailment Services in Ontario Pharmacies (Effective July 1, 2026)Government of Ontario · 2026-05-19
- ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux DiseaseAmerican College of Gastroenterology · 2022
- Gastroesophageal Reflux DiseaseStatPearls / NCBI Bookshelf · 2025
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Allowable drugs under Schedule 4 (14)
Drugs an Ontario pharmacist may prescribe for Gastroesophageal reflux disease (GERD) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Alginic acid
- Aluminum hydroxide
- Calcium carbonate
- Cimetidine
- Dexlansoprazole
- Esomeprazole
- Famotidine
- Lansoprazole
- Magnesium salts
- Nizatidine
- Omeprazole
- Pantoprazole
- Rabeprazole
- Ranitidine
Symptoms this assessment screens
- Heartburn or burning behind the breastbone
- Acid regurgitation, sour taste, or bitter taste
- Symptoms after meals, bending, or lying down
- Nocturnal reflux symptoms
- Food, alcohol, caffeine, smoking, large meal, or late-meal trigger pattern
- Prior antacid, alginate, H2 blocker, or PPI response
Red flags — any positive means refer
- Chest pain, pressure, shortness of breath, sweating, fainting, or radiation to arm, jaw, back, or shoulder
- Difficulty swallowing, painful swallowing, choking, food sticking, or progressive swallowing symptoms
- Vomiting blood, black stools, suspected GI bleeding, or anemia
- Unexplained weight loss, persistent vomiting, early satiety, or progressive symptoms
- Severe abdominal pain, jaundice, suspected ulcer complication, or systemic illness
- New higher-risk presentation, refractory symptoms, repeated recurrence, pregnancy complexity, or significant comorbidity
- Possible medication-induced esophagitis or injury from NSAIDs, bisphosphonates, iron, potassium, or other high-risk medicines
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