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Why Cant Ranitidine And Gaviscon Antacid Be Taken For More Than Two Weeks?

Posted on Sat, 13 Sep 2014

Question: Dear Dr. Klerida,

I have asked questions to you concerning GERD before. I am tapering from using 8 weeks of PPIs and have tried ranitidine and will try gaviscon antacid. However, I note that both are not recommended for use beyond two weeks. Why is that the case and what would be the consequences for use beyond two weeks in these cases. How else might I taper from using PPIs or what should I do if the GERD issue returns?

Thanks,
Regards

Answered by Dr. Dr. Klerida Shehu (29 hours later)

Brief Answer:
Fundoplication as last treatment for GERD...

Detailed Answer:
Hi back XXXXXXX

Happy to have your news. I'm also happy that your reflux problems are being resolved.

Now, the use of PPIs, ranitidine and antacids is for short periods because: when you use these drugs, the pH of stomach will become higher than normal. Thus, the intestinal flora is going to change, thus, problems with digestion. The aim is to help you improve the symptoms of reflux, but at the same time, we do not want to break the normal balances of the body.

At the end of the treatment, can repeat endoscopy and final conclusions would be made based on:
- physical examination
- endoscopy findings.

If the symptoms will persist or reflux is still there, should go for surgica treatment (i.e. fundoplication, etc.).

All the best! Let me know if I can be of further help!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (6 hours later)

Thanks Dr. Klerida,

I was unsure as the labels for ranitidine and antacids indicate no more than 2 weeks of use but the stronger PPIs can be used for 8 weeks or 16 weeks in some cases for the treatment of GERD. I was told that the reason is that the acid rebound effect for ranitidine and other drugs in its class is stronger.

In that case, could I use a different H2 antagonist after two weeks or will it have no effect in reducing the rebound effect, being a drug in the same class?

Thanks,
Regards.

Answered by Dr. Dr. Klerida Shehu (8 hours later)

Brief Answer:
Rebound effect is the same for all H2 antagonists.

Detailed Answer:
Hi back XXXXXXX

Thank you for following up.

The rebound effect is the same for all H2 antagonists. I advise to start another course with Ranitidine or any other H2 antagonist drug for 2 weeks and see the results first. Then, should evaluate if there is any improvement to decide for further treatment strategy.

I also strongly advise to follow strict diet and lifestyle changes as mentioned earlier. That is important too.

All the best!
Dr.Klerida

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar