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Journal of Gastroenterology

, Volume 38, Issue 9, pp 830–835 | Cite as

Nocturnal gastric acid breakthrough during the administration of rabeprazole and ranitidine in Helicobacter pylori-negative subjects: effects of different regimens

  • Kyoichi Adachi
  • Yoshinori Komazawa
  • Hirofumi Fujishiro
  • Takafumi Mihara
  • Masahiro Ono
  • Mika Yuki
  • Akira Kawamura
  • Mohammad Azharul Karim Rumi
  • Yuji Amano
  • Yoshikazu Kinoshita
Article

Abstract

Background. Nocturnal gastric acid breakthrough (NAB) is defined as nocturnal intragastric pH less than 4 for more than 1 h during proton pump inhibitor (PPI) administration. A bedtime dose of an H2 receptor antagonist (H2RA) inhibites NAB, but the efficacy of the H2RA decreases with continuous administration. We carried out the present study to investigate the effect of 14-day H2RA administration on NAB. Methods. Ten male volunteers without Helicobacter pylori infection received four different 14-day regimens of rabeprazole and ranitidine (study a, morning dose of 20 mg rabeprazole; study b, morning dose of 20 mg rabeprazole with a single bedtime dose of 150 mg ranitidine only on the last day; study c, continuous 20 mg morning dose of rabeprazole and 150 mg at bedtime; study d, morning and evening doses of 10 mg rabeprazole). Ambulatory 24-h gastric pH monitoring was conducted on the last day of each regimen. Results. NAB in studies a, b, c, and d was observed in 9, 1, 4, and 4 subjects, respectively, and the longest periods of nocturnal gastric pH at less than 4.0 were 102.5, 14.0, 37.5, and 52.5 min, respectively (study b vs study c, P < 0.05). Conclusions. The continuous inhibitory effect of ranitidine combined with rabeprazole on nocturnal gastric acid secretion declined during 14-day-long administration in H. Pylori-negative subjects. Split dosing of rabeprazole was more effective than the single morning dose for inhibiting nocturnal gastric acid secretion.

Key words

nocturnal gastric acid breakthrough rabeprazole ranitidine tolerance pH monitoring Helicobacter pylori 

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Copyright information

© Springer-Verlag Tokyo 2003

Authors and Affiliations

  • Kyoichi Adachi
    • 1
  • Yoshinori Komazawa
    • 1
  • Hirofumi Fujishiro
    • 1
  • Takafumi Mihara
    • 1
  • Masahiro Ono
    • 1
  • Mika Yuki
    • 1
  • Akira Kawamura
    • 1
  • Mohammad Azharul Karim Rumi
    • 1
  • Yuji Amano
    • 1
  • Yoshikazu Kinoshita
    • 1
  1. 1.Second Department of Internal MedicineShimane Medical UniversityIzumoJapan

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