Comparison of low-dose antacids, cimetidine, and placebo on 24-hour intragastric acidity in healthy volunteers

Abstract

Low-dose aluminium (Al) antacids are effective in promoting ulcer healing and symptomatic relief in peptic ulcer patients, although the effect on intragastric acidity is very weak. In this randomized, double-blind study, 24-hr intragastric acidity was compared in 11 healthy volunteers, treated with a low-dose Al antacid regimen (1 tablet four times a day), cimetidine (800 mg at bedtime) and placebo, using the double-dummy technique. Standardized meals were given at 8 AM, noon, and 5 PM. Medication was given 1 hr after meals and at bedtime. Intragastric acidity was recorded with a nasogastric monocrystant antimony pH catheter, connected to an ambulatory digital data recorder. No significant difference in intragastric acidity was observed between antacid and placebo treatment. Treatment with cimetidine reduced circadian and nocturnal (but not diurnal) intragastric acidity significantly, as compared to both placebo and antacid treatment. The results support the hypothesis that Al antacids promote peptic ulcer healing by other mechanisms than acid neutralization.

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

“…To our knowledge, no previous studies have compared the effects of an antacid and an over‐the‐counter dose of a histamine H 2 ‐receptor antagonist on intragastric pH in subjects with meal‐induced heartburn. Other studies have found that when an antacid affected gastric pH, it had a more rapid onset of action and shorter duration of effectiveness than a histamine H 2 ‐receptor antagonist 28–31 . Our finding that antacid did not alter gastric acid concentration differs from findings in other studies, in which antacid did decrease gastric acidity 29–34 .…”

“…Inhibition of gastric acid secretion is known to decrease the time that oesophageal pH < 4 3 , 18–20 . Otherwise, gastric acidity seems to have received limited attention with respect to its potential underlying role in oesophageal acid exposure in GERD 21–27 …”

“…The onset of action of a low dose of ranitidine on gastric acidity observed in the present study agrees with a number of other reports. An over‐the‐counter dose of a histamine H 2 ‐receptor antagonist first reduced gastric acid concentration 1–2 h after dosing and this reduction persisted for several hours 15 , 28–31 , 35 …”

Impact of Acid‐Reducing Agents on the Pharmacokinetics of Palbociclib, a Weak Base With pH‐Dependent Solubility, With Different Food Intake Conditions

“…This DDI study (study 1) was conducted under overnight fasted conditions because palbociclib free base was dosed under minimal fasted conditions in all ongoing clinical trials (fasting 1 hour before and 2 hours after palbociclib dosing) when study 1 was first initiated. A PPI was used in study 1 because PPIs’ acid‐reducing effect is more potent than those of other types of ARAs, and they have a relatively prolonged duration of acid suppression . In order to assess the worst‐case scenario for PPIs’ impact on palbociclib PK, rabeprazole was selected as the PPI agent because it has a higher median 24‐hour intragastric pH, faster onset of action, and maintains acid suppression longer than other PPIs .…”

Sucralfate Protects Blood Clots from Peptic Digestion by Gastric Juice in vitro

“…They bind pepsin and urease and may reduce the number of Helicobacter pylori on the stomach mucosa. Even in low doses antacids have remarkable effects on the healing of peptic ulcers [18,19,20,21,22]. These effects might be consequences of aluminium hydroxide’s ability to bind enzymes and bacteria.…”