STEP UP with Zanzole 24HR
Symptom control for patients with heartburn12,17
Proton pump inhibitors (PPIs) such as Zanzole 24HR, can be used as a STEP UP from antacids,
alginates or H2 receptor antagonists (H2RAs) when required. Patients can then STEP DOWN again
once their symptoms are under control. This individualised approach allows patients to move between
treatment options according to their level of symptom control.

Where does Zanzole 24HR fit in the treatment options for heartburn?
Frequent symptoms (≥2x per week) |
---|
PPI (e.g. Zanzole 24HR) ![]() Zanzole 24HR works by turning off pumps that produce acid in the stomach.3 How quickly does it work? It starts working in 2–3 hours, but can take up to a few days for full effect.3 Can relief last the day? Yes, relief lasts for up to 24 hours.3 |
Dose: 1 tablet per day.12 |
Mild, intermittent symptoms (≤ 1x day per week) |
H2 Receptor Antagonists
![]() H2 receptor antagonists, or H2RAs, work by blocking one of the signals that tell your body to produce acid.3 How quickly does it work? It starts working in as little as 30 minutes.3 Can relief last the day? Relief lasts 12 to 24 hours.3 |
Dose: 1–2 tablets per day.12 |
Antacids
![]() Antacids neutralise acid in the stomach, but heartburn relief is usually short term.3 How quickly does it work? It starts working in as little as 5 minutes.3 Can relief last the day? Relief lasts up to 30 minutes.3 |
Dose: Up to 4 times per day.12 |
Alginates
![]() Alginates form a physical barrier that lies on top of the stomach.15 How quickly does it work? It starts working in as little as 4 minutes.15 Can relief last the day? Relief lasts for up to 3–4 hours.15 |
Dose: Several times per day.12 |
How to take Zanzole 24HR
One Zanzole 24 HR tablet should be taken each day, swallowed whole with a glass of water. Do not crush or chew the tablets. If the tablets are chewed or crushed they will not work properly.2
Zanzole 24HR can be taken with food or on an empty stomach.2
Dosing duration
Zanzole 24HR should be taken for at least 7 days and up to 14 days. Dosing beyond 14 days should only be in consultation with a doctor.2
For full details of possible side effects with Zanzole 24HR, please refer
to the consumer medicine information (CMI). Click here to download.
Setting expectations for your patients
Zanzole 24HR will start to suppress acid within a few hours, however it will not give instant symptom relief.2 Therefore, let patients know they may need to take Zanzole 24HR for a few days before experiencing the full effect.
References:
1. GORD (reflux). healthdirect. Available at: https://www.healthdirect.gov.au/gord-reflux. Accessed September 2019.
2. Zanzole 24HR Tablets. Consumer Medicine Information. July 2019.
3. Fennerty, M et al. Short and long-term management of heartburn and other acid-related disorders: Development of an algorithm for primary care providers. J Fam Pract 2009 Jul;58(7 Suppl Short):S1-S12.
4. Heartburn and GERD: Overview. InformedHealth.org [Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK279254/. Accessed September 2019.
5. Heartburn. Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223. Accessed September 2019.
6. Gastro-oesophageal reflux disease (GORD). NHS inform. Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastro-oesophageal-reflux-disease-gord#causes-of-gord. Accessed September 2019.
7. MacFarlane B. Management of gastroesophageal reflux disease in adults: a pharmacist’s perspective. Integ Pharm Res Pract 2018;7:41−52.
8. 11 stomach-soothing steps for heartburn – Harvard Health. Available at: https://www.health.harvard.edu/staying-healthy/11-stomach-soothing-steps-for-heartburn. Accessed October 2019.
9. Queensland Health. Available at: https://www.health.qld.gov.au/news-events/news/what-is-heartburn-acid-reflux-indigestion-prevention-treatment Accessed September 2019.
10. National Sleep Foundation. Available at: https://www.sleep.org/articles/ease-heartburn-bedtime/ Accessed September 2019.
11. What you should know about: PPIs. Harvard Health Publishing. Available at: https://www.health.harvard.edu/diseases-and-conditions/what-you-should-know-about-ppis. Accessed September 2019.
12. Gastro-oesophageal reflux [published 2016 Mar]. In: eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2018 Jul.
13. Sansom LN, ed. Australian pharmaceutical formulary and handbook. 24th edn. Canberra: Pharmaceutical Society of Australia; 2018.
14. Pharmaceutical Society of Australia. Guidance for provision of a Pharmacist Only medicine Proton pump inhibitors. November 2011.
15. Gaviscon Website. Available at: https://www.gaviscon.com.au/how-gaviscon-works/how-gaviscon-original-works/. Accessed September 2019.
16. Heartburn (indigestion). healthdirect. Available at: https://www.healthdirect.gov.au/heartburn. Accessed September 2019.
17. NPS MedicineWise. Patient Action Plan and fact sheet, Heartburn and reflux: Manage your medicine [Internet]. Sydney: NPS MedicineWise; 2018 [updated 2018 Jun 26]. Available at: www.nps.org.au/news/stepping-the-appropriate-path-with-gord-medicines. Accessed September 2019.
Please login to view this page.