Abstract
This study was carried out in order to compare the effects of mealtime and bedtime regimens of ranitidine on gastric acidity. Fifteen duodenal ulcer pateints in clinical remission were randomized to receive in single-blind fashion either placebo, ranitidine 300 mg at night (2200 hr) or ranitidine 150 mg three times a day given before each of the three daily meals (1800, 0800 and 1200 hr). Over 24 hr, the two active treatments produced a significantly greater acid inhibition than placebo, while the single daily regimen was superior to the three times a day regimen of ranitidine in terms of both rise in pH values (P<0.001) and duration of action expressed as time spent obove 3.0 pH units (P<0.05). The analysis of these two parameters during fractioned periods of the circadian cycle showed that the three divided doses of ranitidine were more effective during the daytime (P<0.01) and the evening (P<0.001), whereas the bedtime dose of ranitidine was superior during the night (P<0.0001). Thus a short-lasting antisecretory action, which is, however, capable of fully controlling the hihg acidity of postprandial periods, might be the key to understanding the results of several recent clinical trials in which the suppression of daytime gastric acidity has been shown to promote similar or even faster duodenal ulcer healing rates than the suppression of nocturnal acidity.
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Savarino, V., Mela, G.S., Zentilin, P. et al. Mealtime versus nighttime acid inhibition. Digest Dis Sci 37, 1368–1372 (1992). https://doi.org/10.1007/BF01296005
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DOI: https://doi.org/10.1007/BF01296005