The effect of over-the-counter ranitidine 75 mg on night-time heartburn in patients with erosive oesophagitis on daily proton pump inhibitor maintenance therapy
Article first published online: 14 FEB 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 5, pages 649–653, March 2006
How to Cite
VAKIL, N., GUDA, N. and PARTINGTON, S. (2006), The effect of over-the-counter ranitidine 75 mg on night-time heartburn in patients with erosive oesophagitis on daily proton pump inhibitor maintenance therapy. Alimentary Pharmacology & Therapeutics, 23: 649–653. doi: 10.1111/j.1365-2036.2006.02796.x
- Issue published online: 14 FEB 2006
- Article first published online: 14 FEB 2006
- Publication data Submitted 24 November 2005 First decision 6 December 2005 Resubmitted 10 December 2005 Accepted 12 December 2005
Background H2-receptor antagonists are widely used with proton pump inhibitors.
Aim To determine if H2-receptor antagonists used in conjunction with proton pump inhibitors were effective for nocturnal heartburn in patients taking proton pump inhibitors.
Methods We evaluated 386 patients with erosive oesophagitis documented at endoscopy who were receiving single daily maintenance proton pump inhibitor therapy to determine if they had symptoms of nocturnal heartburn. Patients with two or more episodes of night-time a week were invited to participate in the study. Patients were randomly assigned to a single dose of an over-the-counter preparation of ranitidine 75 mg at bedtime or matching placebo for 14 days.
Results The prevalence of nocturnal symptoms was 10.6%. Mean symptom scores on the first day of the trial (baseline) were similar between the treatment group (1.1 ± 0.9) and the placebo group (1.1 ± 1.1). On day 3, symptom scores were significantly lower in the ranitidine group (0.71 ± 0.69) compared with the control group (1.4 ± 1.2; P = 0.045). On day 14, mean symptom scores were similar in the ranitidine group (0.82 ± 0.95) and the control group (1 ± 0.84).
Conclusions Nocturnal heartburn is uncommon on proton pump inhibitor therapy; the addition of ranitidine at bedtime resulted in a decrease in symptom scores on day 3 but there were no differences on day 14.