A study was conducted on 155 individuals who were randomly divided into two groups, one receiving ranitidine 150 mg twice daily and placebo swallowable calcium carbonate antacids as required (placebo antacids), and the other group receiving swallowable calcium carbonate antacids 750 mg as required (study antacids) plus placebo ranitidine twice daily. The subjects received the treatment for 12 weeks.

The parameters involved in the study included reductions in the frequency and severity of heartburn episodes, erosive esophagitis healing, antacid consumption, improvement in the quality of life and safety of both the ranitidine group and antacid group. The daily heartburn frequency and severity scores were assessed for day 1 till day 14 of the treatment.

Findings:

• Significantly fewer (P ≤ 0.015) episodes of heartburn were observed among subjects within 1 day of receiving ranitidine treatment as compared to antacid treatment, and the average severity of the episodes was also lesser.
• Mean weekly rescue antacid consumption was observed to be significantly less by the 6^th week among ranitidine treated subjects and this difference continued till week 12 (P < 0.001).
• Ranitidine treated group showed significantly better healing (55%, P=0.022) of erosive esophagitis as compared to the antacid treated group (29%).
• Both the groups showed improvement in quality of life. But ranitidine showed numerically superior values for all quality of life parameters, which were statistically superior for various quality of life indices at week 6 and for pain-related index by week 12 (P < 0. 05).
• Both the drugs were well-tolerated. 

Conclusion: The study concluded that for subjects self-administering antacids for chronic heartburn, ranitidine at a dose of 150 mg b.d appears to be more effective than antacids in decreasing heartburn, healing erosive esophgitis, reducing pain and improving quality of life.

Source: Earnest D, Robinson M, Rodriguez-Stanley S, et al. Managing heartburn at the `base of the GERD `iceberg: effervescent ranitidine 150 mg b.d. provides faster and better heartburn relief than antacid. Aliment Pharmacol Ther 2000;14(7):911-8.