Onset of Action of Antisecretory Drugs: Beneficial Effects of a Rapid Increase in Intragastric pH in Acid Reflux Disease

Abstract

Background : The majority of patients who have symptomatic acid reflux disease will have a normal oesophageal mucosa or will have only a mild degree of oesophagitis. Treatment to relieve symptoms as they occur may be the best way to manage these patients, to whom the speed of symptom relief is of primary importance. The effervescent complex used to formulate effervescent ranitidine contains sodium bicarbonate and monosodium citrate, and has, therefore, an intrinsic acid-neutralizing capacity in addition to the well-documented antisecretory activity. Methods : The results of studies of the effects of effervescent ranitidine tablets on intragastric pH and on the relief of heartburn are reviewed. Results and Conclusions : When compared with the standard ranitidine tablet, the effervescent formulation results in a significantly greater and more rapid rise in intragastric pH in the hour immediately after dosing. Comparative studies show that intragastric pH is raised significantly faster after a single dose of effervescent ranitidine than after a famotidine rapid release tablet and after either an omeprazole or a lansoprazole capsule. In patients with acid reflux disease, effervescent ranitidine provides quicker relief of symptoms than a standard tablet and is preferred by most patients for this reason. The majority of patients (more than 80%) report symptom relief within 60 min of taking effervescent ranitidine.