Galmiche and colleagues designed a study to compare the effects of ranitidine 75 mg with either cimetidine 200 mg or placebo on-demand therapy for symptoms of gastroesophageal reflux disease (GERD) over a 15-day period.

In all, 1336 patients, 18 years of age or above, with heartburn episodes, were randomized to receive ranitidine 75 mg, cimetidine 200 mg or placebo. On the basis of the occurrence or persistence of heartburn, treatment was administered as needed up to three times a day, with a gap of at least 2 h between the doses. Rescue medication was given in the form of antacids if symptoms persisted for at least 2 h after the third medication. The study’s primary end-point was the proportion of patients with at least 75% relief of heartburn episodes (relief within 2 h of drug intake, persisting for at least 5 h).

The intention-to-treat population included 504 individuals in the ranitidine group, 515 in the cimetidine group and 270 in the placebo group.

• Primary end-point success rates were 41%, 38% and 28%, respectively, in the three groups.
• Ranitidine 75 mg was noted to be significantly more effective than placebo in terms of overall heartburn relief.
• The differences between the ranitidine and cimetidine groups did not appear to be significant. However, there was greater reduction in heartburn frequency with ranitidine treatment at the end of the study period (P < 0.05).
• Drug dose was lower and there was lesser need for rescue medication in the ranitidine group compared to the placebo group.

On-demand ranitidine 75 mg or cimetidine 200 mg appeared to be safe and effective treatment options for GERD symptoms.

Ranitidine treatment was tied to a greater reduction in heartburn frequency.

Source: Galmiche JP, Shi G, Simon B, et al. On-demand treatment of gastro-oesophageal reflux symptoms: a comparison of ranitidine 75 mg with cimetidine 200 mg or placebo. Aliment Pharmacol Ther. 1998 Sep;12(9):909-17.