Low‐dose ranitidine for the relief of heartburn

Abstract

The classic symptoms of episodic heartburn and regurgitation associated with over-indulgence are well known to a large segment of the population, and are the hallmark of gastro-oesophageal re¯ux disease (GERD).1 Approximately 30% of adults contacted in a large US survey reported having suffered heartburn, acid indigestion or sour stomach, common terms used with over-the-counter products, within the past month; more than 20% of these individuals reported experiencing heartburn at least once per day.2 Nearly all of the sufferers (93%) in the survey treated their symptoms with a non-prescription product.2 Most individuals with mild symptoms of gastro-oesophageal re¯ux are not seen by physicians, consistent with the iceberg analogy proposed by Castell, which suggests that the vast majority of individuals with GERD, having only mild and/or sporadic symptoms, primarily heartburn, are represented by the largest submerged portion of the iceberg.3 These particular individuals function well without medical intervention and are unlikely to discuss their symptoms with a physician. It is this population who consumes the largest portion of antacids. In SUMMARYBackground: Approximately 30% of adults in the USA suffer from heartburn or related symptoms monthly; more than 20% of these sufferers experience heartburn at least once per day. Although many rely on selfmedication with antacids for the relief of their symptoms, treatments that decrease gastric volume as well as increase the pH of re¯uxed material should be more effective in relieving heartburn. Aim: To compare the safety and ef®cacy of low-dose regimens of ranitidine for the relief of heartburn. Methods: Adults with at least a 3-month history of heartburn were eligible for this randomized, doubleblind, parallel group, multicentre dose-ranging study. Following a 1-week open-label run-in phase to document baseline heartburn frequency, subjects were randomized to receive treatment with one tablet of either ranitidine 75 mg (n 491), ranitidine 25 mg

Short course acid suppressive treatment for patients with functional dyspepsia: results depend on Helicobacter pylori status

“…Conversely, no significant favourable effect was observed in non-infected dyspeptic patients. Using the same outcome criterion, a lower dose of omeprazole, 10 mg a day, and ranitidine given at a dose presently recommended for over the counter treatment of dyspeptic patients,4 were ineffective both in infected and non-infected patients. A favourable effect of omeprazole and ranitidine in non-infected patients cannot be totally excluded because a secondary outcome criterion (that is, complete disappearance of symptoms) appeared to be favourably affected by these two drugs.…”

“…Ranitidine was given at the dose presently recommended for over the counter treatment 4. We intended to conduct the trial in a manner which most closely resembled routine clinical practice.…”

Novel Upcoming Therapies

“…In addition, several studies have demonstrated that approximately 30 % of NERD patients report symptom relief after receiving an H2RA twice daily for 4 weeks [11,12]. H 2 RAs are particularly helpful in relieving postprandial heartburn for up to 12 h [13]. They are also effective in preventing postprandial heartburn if given 30 min before a meal [14].…”

The Effects of Increasing Doses of Ranitidine on Gastric pH in Children

“…Randomized controlled studies in adults with GERD and esophagitis have demonstrated superiority of ranitidine over placebo in symptom relief and healing of the esophageal mucosa. 1,10,11 In children, data are more limited. Although standard recommendations for pediatric ranitidine dosing have often been in the range of 2.5-3 mg/kg/dose twice or thrice daily, The North American Society of Pediatric Gastroenterology and Nutrition recently published guidelines for the management of pediatric GERD recommending a considerably higher dose of 4-10 mg/kg/day orally, 12 based largely on expert opinion because published data are so limited.…”