Double-blind, placebo-controlled study of ranitidine for gastroesophageal reflux symptoms during pregnancy

Larson, Janet D.; Patatanian, Edna; Miner, Philip B.; Rayburn, William F.; Robinson, Malcolm

doi:10.1016/s0029-7844(97)00126-9

Cited by 63 publications

(23 citation statements)

References 9 publications

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“…Furthermore, based on the overall acceptable quality of the studies included in this metaanalysis as assessed by using the validated Downs-Black scale, the results obtained are reassuring with respect to the safety of the use of H2 blockers in pregnancy, especially considering the large sample size. Additionally, our results are consistent with previous findings that suggest that H2 blockers are not associated with an increased risk for malformations [17][18][19][20][21].…”

Section: Discussionsupporting

confidence: 93%

The Safety of Histamine 2 (H2) Blockers in Pregnancy: A Meta-analysis

2008

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Heartburn and acid reflux increase the severity of nausea and vomiting of pregnancy, and may lead to more serious medical conditions. The fetal safety of histamine 2 (H2) blockers, the most common antireflux medication, during pregnancy needs to be determined. The aim herein is to determine the fetal safety of H2 blockers during pregnancy through systematic review. All original research assessing the safety of H2 blockers in pregnancy was sought. Data included congenital malformations, spontaneous abortions, preterm delivery, and small for gestational age. A random-effects model combined results. With data from 2,398 exposed and 119,892 nonexposed to H2 blockers, overall odds ratio was 1.14 [0.89, 1.45]. Further analysis revealed no increased risks for spontaneous abortions, preterm delivery, and small for gestational age with odds ratios and 95% confidence intervals (CIs) of 0.62 [0.36-1.05], 1.17 [0.94, 1.147], and 0.28 [0.06, 1.22], respectively. H2 blockers can be used safely in pregnancy.

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Section: Discussionsupporting

confidence: 93%

The Safety of Histamine 2 (H2) Blockers in Pregnancy: A Meta-analysis

2008

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“…Metoclopramide, H 2 RAs, and most PPIs (except omeprazole) have a category B FDA safety profile for use during pregnancy, which is based on animal studies showing no risk, as well as on small case series and anecdotal human reports. Ranitidine is the only one of these drugs that has been shown to be effective during pregnancy [223]. PPIs may be safe for aspiration prophylaxis before anesthesia for elective cesarean sections.…”

Section: Treatment In Elderly or Pregnant Patientsmentioning

confidence: 99%

Gastroesophageal Reflux Disease

Vaezi

Richter

2008

Textbook of Gastroenterology

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A 54-year-old female with history of asthma presents with ongoing asthma not responsive to therapy. She complains of persistent coughing and wheezing that occurs on a weekly basis. Over the last year, she has suffered from one attack that required hospitalization. When asked further about her symptoms, she states that she can feel her attacks coming and that they often start with coughing spells and a slight uneasiness in her chest. From previous visits, her therapy has been maximized to a long-acting β-agonist and inhaled corticosteroid combination. KEY CLINICAL QUESTIONS1. Does gastroesophogeal reflux induce pulmonary symptoms such as cough? 2. What is the proper algorithm to evaluate and treat patients with chronic cough? 3. Does the treatment of reflux improve asthma symptoms?

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“…Aufgrund der heutigen Datenlage gilt Ranitidin in der Schwangerschaft als Mittel der Wahl, wenn Histamin-2-Rezeptorantagonisten (H2A) indiziert sind. Ranitidin ist der bisher einzige H2A, der in der Schwangerschaft verabreicht werden darf und gilt als Mittel der ersten Wahl [12]. Die Anwendung von Cimetidin in der Schwangerschaft wird aufgrund der in tierexperimentellen Studien und bei Nicht-Schwangeren beobachteten leichten Feminisierung bzw.…”

Section: Histamin-2-rezeptorantagonistenunclassified

Reflux in pregnancy

Malfertheiner

Costa

2008

Gastroenterologe

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Differenzialdiagnosen und gesicherte Therapien Schwerpunkt: Reflux und refluxassoziierte ErkrankungenDie gastroösophageale Refluxkrankheit wird in der Schwangerschaft, vor allem im ersten Trimenon, häufig nicht erkannt, weil zwischen einer Emesis gravidarum, Unwohlsein, Bevorzugung bestimmter Speisen und einer echten Refluxkrankheit fließende Übergänge bestehen. Sowohl Schwangere als auch die behandelnden Ärzte betrachten gastrointestinale Beschwerden in der Schwangerschaft als "normal", vorübergehend und folglich als zu akzeptierendes "Übel". Über die Gründe für das "normale Unwohlsein" zu Beginn einer Schwangerschaft ist relativ wenig bekannt, und seit Menschengedenken wird lediglich darüber spekuliert, weshalb eine werdende Mutter leiden muss. Traditionelle, kulturelle, spirituelle und pseudomedizinische ("Hormonumstellung") Erklärungen werden seit Jahrhunderten herangezogen, je nach Leidensdruck wird der Zustand mehrheitlich als gegeben hingenommen. > Die Dunkelziffer manifester Refluxkrankheiten in der Schwangerschaft ist wohl höher als angenommenSicherlich handelt es sich nicht immer um eine GERD, wenn Schwangere im ersten Trimenon über gastrointestinale Beschwerden klagen, doch ist anzunehmen, dass die Dunkelziffer manifester Refluxkrankheiten höher ist als bislang angenommen. Daher sollte jeder behandelnde Arzt an eine GERD denken, wenn entsprechende Symptome in der Schwangerschaft auftreten, da ein großer Teil der Patientinnen unter GERD leiden und von einer spezifischen Behandlung profitieren würden.

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Double-blind, placebo-controlled study of ranitidine for gastroesophageal reflux symptoms during pregnancy

Abstract: This study indicates the efficacy of ranitidine 150 mg taken twice daily, rather than once daily, for relief of gastroesophageal reflux symptoms during pregnancy.

Cited by 63 publications

References 9 publications

The Safety of Histamine 2 (H2) Blockers in Pregnancy: A Meta-analysis

The Safety of Histamine 2 (H2) Blockers in Pregnancy: A Meta-analysis

Gastroesophageal Reflux Disease

Reflux in pregnancy

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