A. A. Ciociola

Ranitidine, 75 mg, over‐the‐counter dose: pharmacokinetic and pharmacodynamic effects in children with symptoms of gastro‐oesophageal reflux

The use of over‐the‐counter antacids has increased in children under the age of 12 years, and has been followed by an apparent increase in the use of over‐the‐counter histamine‐2 receptor antagonists. However, the pharmacokinetic and pharmacodynamic effects of over‐the‐counter histamine‐2 receptor antagonists in the paediatric population are largely unknown.

Synergy between low-dose ranitidine and antacid in decreasing gastric and oesophageal acidity and relieving meal-induced heartburn.

The pathophysiology of recurrent postprandial heartburn and the basis for the effectiveness of antacids or low doses of histamine H2‐receptor antagonists have not been well studied.

A single dose of ranitidine 150 mg modulates oesophageal acid sensitivity in patients with functional heartburn.

Background : The rapid onset and symptomatic response to histamine‐2 receptor antagonists prior to the pharmacological effect on acid secretion suggests a different mechanism of action.

Control of Nocturnal Gastric Acidity: A Role for Low Dose Bedtime Ranitidine to Supplement Daily Omeprazole

In some patients, proton pump inhibitors do not abolish nocturnal gastric acidity and additional evening antisecretory medication may be required. In 16 subjects with chronic heartburn, 24-hr gastric and esophageal pH were measured at baseline and again after six days of 20 mg omeprazole alone at 08:00 hr followed by placebo, 75 mg ranitidine, or 20 mg omeprazole at 22:00 hr. Integrated acidity was calculated from the cumulative, time-weighted mean acid concentrations (derived from pH values for each second). Baseline integrated gastric acidity increased progressively over 24 hr, whereas integrated esophageal acidity increased only until 22:00 hr. Morning omeprazole nearly abolished 24-hr esophageal acidity and significantly decreased overall gastric acidity but did not abolish nocturnal gastric acidity. Adding evening ranitidine or omeprazole nearly eliminated the nocturnal increase in gastric acidity. Integrated acidity was more sensitive than time pH < 4 in assessing gastric and esophageal acidity as well as their inhibition by omeprazole and ranitidine. In conclusion, integrated acidity provides novel information regarding the synergy of omeprazole plus ranitidine. Adding low-dose ranitidine helps control nocturnal gastric acidity that can occur with conventional omeprazole administration. Although the heartburn patients in the present study had nocturnal gastric acidity without accompanying nocturnal esophageal acid reflux, other patients who do have nocturnal esophageal reflux might profit from addition of bedtime ranitidine or another gastric antisecretory agent.

Effects of antacid formulation on postprandial oesophageal acidity in patients with a history of episodic heartburn

Heartburn self‐treatment with antacids is extremely common. If the oesophagus is the primary site of antacid action, chewable antacids might raise the oesophageal pH more effectively than swallowable tablets.

Determination of the time of onset of action of ranitidine and famotidine on intra‐gastric acidity

Background : No standard methods exist for determining the onset of action of gastric antisecretory agents in human subjects.

Single-dose non-prescription ranitidine 75mg is superior to single-dose omeprazole 20mg for prevention of postprandial and nighttime heartburn following a provocative meal

Single-dose non-prescription ranitidine 75mg is superior to single-dose omeprazole 20mg for prevention of postprandial and nighttime heartburn following a provocative meal

H. pylori status influences the efficacy of omeprazole 20mg but not ranitidine 75mg for prevention of nighttime heartburn following a provocative meal

Purpose: Acid inhibition appears less effective in H. pylori negative individuals (Hp neg) than in H. pylori positive ones (Hp pos) with proton pump inhibitors but not with H2-antagonists and may result in insufficient control of heartburn (HB) in many subjects. We evaluated a bedtime provocative meal and response to treatment in healthy subjects (18–75 yrs) who tested Hp neg (429) or pos (61) with a history of nighttime HB (2 episodes/wk) rated as moderate to very severe.