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Effect of nizatidine and ranitidine on 24 hour intragastric pH, pepsin, prostaglandin E 2 and serum gastrin concentrations in healthy volunteers
Author(s) -
THOMSON ABR,
KIRDEIKIS P.,
JAMALI F.,
TAVERNINI M.,
ZUK L.,
MARRIAGE B.,
SIMPSON I.,
MAHACHAI V.
Publication year - 1995
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1995.tb01345.x
Subject(s) - medicine , pepsin , placebo , gastrin , ranitidine , prostaglandin , crossover study , gastric acid , endocrinology , stomach , gastroenterology , enzyme , chemistry , biochemistry , secretion , alternative medicine , pathology
In order to achieve possible greater therapeutic efficacy, ranitidine 300 mg bid (R 2 ) may be given rather than 300 mg qhs (R 1 ), or nizatidine 300 mg bid (N 2 ) may be given rather than 300 mg qhs (N 1 ). A randomized placebo‐controlled crossover study was performed in six healthy volunteers (four males, two females) who ranged in age from 23 to 43 years, comparing R 1 R 2 , N 1 , and N 2 versus placebo (P), measuring 24 h intragastric pH by the aspiration technique, gastric juice pepsin and prostaglandin E 2 (PGE 2 ) concentrations, as well as serum gastrin concentrations. In all treatment groups, 24‐h intragastric pH was higher than with P; the 24 h and daytime (0800–2200 h) pH was higher with N 2 than with N 1 but not with R 2 versus R 1 . The percentage pH ≥ 3 was greater with N 2 than with N 1 during the daytime. Night‐time (2200–0800 h) and 24 h pepsin concentrations were higher in R 2 than in R 1 , were similar in N 1 and N 2 , and were lower in these treatment groups than in P. The gastric juice PGE 2 concentration at night‐time, but not at daytime, was increased in the four treatment groups compared with P. Despite the higher pH values at night‐time in the treatment groups, the night‐time concentrations of serum gastrin were unchanged, and yet during the daytime the higher values of pH were associated with increased gastrin concentrations when R 2 or N 2 were given, but not with R 1 and N 2 . There was a negative correlation between intragastric juice pH and pepsin concentration during the daytime, and a positive correlation between pH and PGE 2 concentration during the night‐time. The slopes and y‐axis intercepts between pH and pepsin or PGE 2 , concentrations differed between the placebo and the treatment groups, suggesting that these H 2 ‐receptor antagonists may have an effect on lowering pepsin and raising PGE 2 concentrations in addition to their effects on pH. As the percentage of time over the 24 h period and night‐time periods when the pH was greater than 3 was not different between ranitidine and nizatidine, the two regimens will likely have similar clinical efficacy.