Heartburn is a common problem faced by many people. Patients often treat episodic heartburn themselves using non-prescription antacids. There are drugs that can reduce gastric volume and increase the pH of refluxed material and help relieve heartburn.

A study was designed by Ciociola et al to determine the safety and efficacy of low-dose regimens of ranitidine for relieving heartburn. They recruited adults with heartburn for at least 3 months in a randomized, double-blind, parallel group, multicenter dose-ranging study. There was a 1-week, open-label run-in phase to determine baseline heartburn frequency. Participants were then randomized to receive treatment with one tablet of either ranitidine 75 mg (n = 537), ranitidine 25 mg (n = 539) or placebo (n = 544). The treatment was advised as needed up to four times a day for 2 weeks.

Findings from the study –

• 75 mg ranitidine was found to be statistically (P < 0.05) and clinically (≥10% improvement) more effective compared to placebo in relieving episodic heartburn and decreasing antacid intake.
• 25 mg ranitidine was statistically better (P < 0.05) than placebo in providing relief from heartburn.
• Both the drug regimens appeared to be superior to placebo with regard to relief from heartburn within 30 to 45 minutes of dosing.
• The effect of ranitidine was persistent and it was as effective over placebo in the treatment of the last heartburn episode as in the treatment of the first episode.
• The drug was found to be equally effective over placebo in the treatment of mild, moderate, and severe episodes of heartburn.
• The 75 mg regimen was statistically superior to placebo in relieving nocturnal heartburn episodes.
• The treatment was well tolerated.

In conclusion, use of low-dose ranitidine is associated with quick and lasting relief of heartburn, with a safety profile comparable to that of placebo.

Source: Ciociola AA, Pappa KA, Sirgo MA. Nonprescription doses of ranitidine are effective in the relief of episodic heartburn. Am J Ther. Nov-Dec 2001;8(6):399-408.