Save this study. Warning You have reached the maximum number of saved studies Comparison of Pantoprazole and Ranitidine in Dyspepsia The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
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Results First Posted : July 23, Last Update Posted : July 23, Study Description. Detailed Description:. Dyspepsia is one of the common complaints in emergency department. Proton pomp inhibitors, H2 receptor blockers and anti-acids are common drugs for treating dyspepsia in emergency department. However there is no study in the emergency department comparing the effectiveness of these drugs. So the investigators planned this study which drug is effective in these patients in order to provide a cost-effective treatment in dyspeptic patients.
FDA Resources. Arms and Interventions. Outcome Measures. Primary Outcome Measures : Visual Analogue Scale Score [ Time Frame: 30th and 60th minutes ] The investigators are measuring the change of pain from the baseline to the 30th and 60th minutes by visual anologue scale VAS.
Eligibility Criteria. The trial was methodologically rigorous, with careful attention paid to patient selection and blinding. Patients with endoscopy-negative GORD represent the largest subgroup presenting to primary care with chronic reflux symptoms. Of the remainder, most patients have only mild grades of reflux oesophagitis. Few data are available comparing maintenance proton-pump inhibitor therapy with standard H 2 -receptor antagonist therapy in primary care.
Eighty-six per cent of patients receiving pantoprazole had achieved sufficient symptom control at six months. Pantoprazole was clearly superior to ranitidine in the first month of therapy, although many had not responded by then to either therapy.
Our trial did not examine whether all patients require maintenance treatment. However, another study has assessed intermittent treatment over one year in patients with endoscopy-proven symptomatic reflux disease in a randomised controlled trial. Those who became asymptomatic or mildly symptomatic were then followed for 12 months and any recurrences of heartburn were treated with the dose that was successful in initially controlling symptoms.
In all treatment groups, about half of the patients did not need any treatment for at least six months. Such data support a management approach based on self-directed "on-demand" therapy as an alternative to continuous therapy, as patients will often apply this approach by taking medication only when troubled by symptoms.
Safety is a key issue for first-line proton-pump inhibitor therapy for symptomatic reflux disease in general practice. We identified no serious adverse events related to misdiagnosis or treatment in our study after one year of follow-up.
The clinical relevance of eradicating Helicobacter pylori in those infected before initiating suppression remains controversial, so we did not determine H. Longer-term treatment with a proton-pump inhibitor has been associated with a small, though definite, increase in the incidence of gastric corpus mucosal atrophy in patients infected with H. In a study of patients with refractory reflux oesophagitis prescribed omeprazole at standard or higher doses, annual incidences of gastric corpus mucosal atrophy among patients positive and negative for H.
Other investigators have shown that H. Potential failure to identify serious underlying disease is another issue for empirical treatment in patients who have not undergone endoscopy. There is some concern that lesions may be missed or misdiagnosed in patients who are subsequently investigated while receiving proton-pump inhibitor therapy. Case studies have documented failure to recognise early gastric cancers during endoscopy in patients prescribed proton pump inhibitors.
For example, a Canadian study of patients who underwent endoscopy for reflux symptoms found that, regardless of the grade of oesophagitis detected, the most frequent resultant management decisions were dose maintenance or increase in those already receiving a proton-pump inhibitor, and switching to proton-pump inhibitor therapy in those receiving an H 2 -receptor antagonist.
Furthermore, no oesophageal cancers were identified and the prevalence of Barrett's oesophagus was very low. Overall, the literature suggests that the risk of serious disease is minimal in patients with reflux attending primary care. Furthermore, there is no evidence that oesophagitis grade worsens over a year period, regardless of treatment.
Pantoprazole 20 mg daily has been demonstrated elsewhere to provide adequate long-term maintenance therapy for patients with GORD in whom remission had already been achieved with standard-dose proton-pump inhibitor therapy. In conclusion, low-dose pantoprazole appears to be an effective alternative to a standard dose of ranitidine in the long-term management of symptomatic GORD.
An empirical treatment strategy also appears to be safe in general practice, assuming patients with alarm symptoms are excluded. Previous surgery of the oesophagus or gastrointestinal tract with the exceptions of appendicectomy or gallbladder surgery. Concomitant severe diseases or laboratory abnormalities that, in the opinion of the general practitioner, precluded study enrolment. Use of a proton pump inhibitor, sucralfate, H 2 -receptor antagonist or prokinetic drug within the previous week.
Childbearing potential in the absence of intention to use adequate contraceptive measures for the duration of the study. Received 7 November , accepted 27 June Professor Talley has been a consultant to Pharmacia, Janssen-Cilag, Novartis and Astra-Zeneca, and has received research funding from these companies and from Lederle.
Dr Sprogis and Dr Moore have not received personal financial support from the sponsor. This study was initiated and funded by Pharmacia Australia Pty Limited. Publication of your online response is subject to the Medical Journal of Australia 's editorial discretion. You will be notified by email within five working days should your response be accepted. Basic Search Advanced search search.
Use the Advanced search for more specific terms. Title contains. Body contains. Date range from. Date range to. Article type. Author's surname. First page. Issues by year.
Article types. Research letters. Guidelines and statements. Narrative reviews. Ethics and law. Medical education. Volume Issue 8. Randomised controlled trial of pantoprazole versus ranitidine for the treatment of uninvestigated heartburn in primary care.
Med J Aust ; 8 : Topics Digestive system diseases. Omeprazole may be preferred for certain conditions such as H. Ranitidine also comes in more formulations than omeprazole.
Regardless of their differences, ranitidine and omeprazole carry similar side effects such as headache, abdominal pain, and diarrhea. Omeprazole may rarely cause more serious adverse conditions such as C.
It is important to discuss your overall condition and other medications with your doctor to find the best treatment option for you. Skip to main content Search for a topic or drug. Ranitidine vs Omeprazole: Main Differences and Similarities. By Gerardo Sison, Pharm. Want the best price on Omeprazole? Top Reads in Drug vs. Toujeo vs Lantus: Main Differences and S Dulera vs Advair: Main Differences and S Suboxone vs Methadone: Main Differences Looking for a prescription? Search now!
Type your drug name. Omeprazole is the generic name. Oral tablet, delayed release Oral capsule, delayed release Oral powder for suspension.
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