Onset of action of antisecretory agents is of pivotal importance for patients with gastroesophageal reflux disease (GERD) treated “on-demand.” Aim To study the acute effect of acid-inhibiting drugs and water administration on gastric pH. Method A cross-over study was performed in 12 H. pylori (-), healthy subjects (6 men; mean age: 26 years). A single oral dose of the following agents was received with a wash-out period between each study: a glass of water (200 ml), antacid, ranitidine, omeprazole, esomeprazole, and rabeprazole. Gastric pH was recorded for 6 h after drug intake. Results Water increased gastric pH >4 in 10/12 subjects after 1 min. The time (median) needed to pH >4 was for: antacid 2 min, ranitidine 50 min, omeprazole 171 min, esomeprazole 151 min, and rabeprazole 175 min. Gastric pH >4 lasted for 3 min after water and for 12 min after antacids; it remained >4 until the end of recording in: 4/12 subjects with ranitidine, 11/12 with rabeprazole, and all with omeprazole and esomeprazole. Conclusion Water and antacid immediately increased gastric pH, while PPIs showed a delayed but prolonged effect compared to ranitidine.
Water antacids PPIs Ranitidine Gastric pH Onset of action
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Tytgat GNJ, Blum AL, Verlinden M (1995) Prognostic factors for relapse and maintenance treatment with cisapride in gastro-esophageal reflux disease. Aliment Pharmacol Ther 9:271–280PubMedGoogle Scholar
Khoury RM, Katz PO, Castell DO (1999) Post-pradial ranitidine is superior to post-prandial omeprazole in control of gastric acidity in healthy subjects. Aliment Pharmacol Ther 1211–1214. doi:10.1046/j.1365-2036.1999.00587.x
Robinson M (2001) New generation proton pump inhibitors: overcoming the limitations of early-generation agents. Eur J Gastroenterol Hepatol 13(Suppl 1):S43–S47PubMedGoogle Scholar
Hedenstrom H, Alm C, Kraft M, Grahnen A (1997) Intragastric pH after oral administration of single doses of ranitidine effervescent tablets, omeprazole capsules and famotidine fast-dissolving tablets to fasting healthy volunteers. Aliment Pharmacol Ther 11:1137–1141. doi:10.1046/j.1365-2036.1997.00264.xPubMedCrossRefGoogle Scholar
Chassany O, Bergmann JF, Simoneau G et al (1996) The comparative effects of single intravenous doses of cimetidine, ranitidine, famotidine, and omeprazole on intragastric pH. Curr Ther Res 57:159–169. doi:10.1016/S0011-393X(96)80121-4CrossRefGoogle Scholar
Zacny J, Zamakhshary M, Skertis I, Veldhuyzen van Zanten S (2005) Systematic review: the efficacy of intermittent and on-demand therapy with histamine H2-receptor antagonists or proton pump inhibitors for gastro-oesophageal reflux disease patients. Aliment Pharmacol Ther 21:1299–1312. doi:10.1111/j.1365-2036.2005.02490.xPubMedCrossRefGoogle Scholar