Early and late effects of low‐dose famotidine, ranitidine or placebo on pentagastrin‐stimulated gastric acid secretion in man

An increasing number of drugs are becoming available over‐the‐counter, empowering patients to treat them‐ selves. Although drugs presently available over‐the‐counter are generally safe, there are issues of safety and possible delays in diagnosis of serious conditions. Therefore it is vital that patients are made aware of the indications and limitations of over‐the‐counter drugs through improved communication and education. Pharmacists and drug companies will have an increasingly important role in giving information and advice to patients. This review looks at the present and future of over‐the‐counter medication, highlighting the safety aspects.

Section: Drugs For Dyspepsia/heartburnmentioning

confidence: 81%

Review article: over‐the‐counter drugs and the gastrointestinal tract

Sheen

Colin‐Jones

2001

“…3±5 We have previously used a model of pentagastrin-stimulated gastric acid secretion to compare the effect of ranitidine 75 mg and famotidine 10 mg on gastric acid secretion over a 9-h period. 6 These drugs, at the doses studied, were superior to placebo but there was no signi®cant difference between them. Any models designed for the study of the effect of these drugs on gastric acidity should attempt to simulate normal everyday activity.…”

Section: Resultsmentioning

confidence: 99%

Inhibition of intragastric acidity in healthy subjects dosed with ranitidine 75 mg: a comparative study with cimetidine and placebo

Grimley

Constantinides

Snell

et al. 1997

Self Cite

Background Despite the widespread use of over‐the‐counter H2‐receptor antagonists little is known about their duration of action on human gastric acid secretion. There are studies reporting inhibitory effects for up to 9 h post‐dose but few data beyond this period. Methods Profiles of 20‐h intragastric acidity were measured simultaneously in 24 healthy subjects who were dosed (at 12.30 h) with either ranitidine 75 mg, cimetidine 200 mg or placebo in a three‐way crossover study, according to a standard protocol. Five‐millilitre aliquots of gastric juice were aspirated half‐hourly during the day (0–10 h post‐dose) and hourly overnight (10–20 h post‐dose). pH was measured to three decimal places with a glass electrode. Weighted intragastric acidity (AUC/time) was calculated for both day‐ and night‐times using 2.5‐h intervals during the day and 5‐h intervals at night. Statistical analysis was by ANOVA. Results The results are expressed as mean weighted intragastric acidity (mmol/L). (i) Daytime (0–10 h post‐dose): when dosed with placebo the weighted intragastric acidity was 31.03, decreasing to 10.37 (P < 0.001 vs. placebo) and 16.23 (P < 0.001 vs. placebo) when treated with ranitidine and cimetidine, respectively. Ranitidine inhibited weighted intragastric acidity to a greater degree than cimetidine (P < 0.001) during this period. (ii) Night‐time (10–20 h post‐dose): when dosed with placebo the weighted intragastric acidity was 21.36 decreasing to 16.65 (P < 0.001 vs. placebo) when dosed with ranitidine and remaining unchanged at 20.03 (P = 0.886 vs. placebo) when dosed with cimetidine. Ranitidine inhibited weighted intragastric acidity to a greater degree than cimetidine (P = 0.010) during this period. A sub‐analysis of the two 5‐h intervals showed that compared to placebo, ranitidine inhibited weighted intragastric acidity significantly in the 10–15 h period. However, its effect in the 15–20 h period did not differ from placebo. Conclusions In healthy subjects, the inhibitory effect of ranitidine 75 mg on intragastric acidity can be detected 10–15 h after an oral dose. By contrast, the inhibitory effect of cimetidine 200 mg seems to be restricted to the first 10 h.

“…By contrast, Grimley et al . found no significant difference in the efficacy of these drugs in subjects with pentagastrin‐stimulated acid secretion 13 . Food intake thus compromises the antisecretory efficacy of both drugs in over‐the‐counter dosages.…”

Section: Discussionmentioning

confidence: 91%

“…These findings are comparable to other studies which have shown that the antisecretory efficacy of these two drugs is detectable for up to 9 h 7 , . 13 …”

Section: Discussionmentioning

confidence: 99%

“…Studies comparing the efficacy of the H 2 ‐antagonists at over‐the‐counter dosage were usually performed either in fasting or postprandial subjects 6 –11 . It is well known that meal intake reduces the acid inhibitory effect of high dose H 2 ‐antagonists 12 –14 . However, since these results cannot be unconditionally transferred to low dose treatment, the main aim of our study was to compare the antisecretory efficacy of two H 2 ‐antagonists at over‐the‐counter dosage when taken under near‐physiological conditions with food intake during the study period.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of food intake on the antisecretory effect of low‐dose ranitidine and famotidine

Netzer

Eschenmoser

Halter

et al. 1999