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GERD Update: Bedtime ranitidine - Effect on overnight gastric acid output and intragastric pH and comparison with cimetidine

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eMediNexus    14 January 2022

A dose/response study was conducted in seven patients with endoscopically confirmed duodenal ulcers who were in symptomatic remission.

Investigators compared bedtime ranitidine dose (75 mg, 150 mg and 300 mg) with bedtime cimetidine 400 mg and placebo. Intragastric pH and gastric acid output were measured overnight after a bedtime dose of the drug.

  • Ranitidine maintenance dose of 150 mg was found to be the optimum as it was significantly more effective than ranitidine 75 mg with regard to intragastric pH, and was not different from 300 mg dose in terms of intragastric pH and acid output.
  • Ranitidine 75 mg inhibited acid output by 89%, while ranitidine 150 mg and 300 mg led to an inhibition of 92%. There was no significant difference in the results for all three doses of ranitidine.
  • The inhibition with cimetidine 400 mg was 80%. It was significantly less than that for ranitidine 150 mg (p <0.05) and ranitidine 300 mg (p <0.01).
  • Ranitidine 150 mg was also significantly more effective than cimetidine 400 mg for maintaining intragastric pH over 5 (100% vs. 17% of the overnight period, p <0.001).

To conclude, ranitidine 150 mg appears to have a significantly greater effect compared to cimetidine 400 mg in inhibition of acid output and maintaining intragastric pH.

Source: Chambers JB, Pryce D, Bland JM, Northfield TC. Effect of bedtime ranitidine on overnight gastric acid output and intragastric pH: dose/response study and comparison with cimetidine. Gut. 1987 Mar;28(3):294-9.

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