Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 34: Is There A Role For A Combination Of Proton Pump Inhibitors And H2 Receptor Antagonists In A Patient With Gerd? (continued)

There is logic to adding an H2 receptor antagonist (H2RA) at bedtime to a proton pump inhibitor (PPI). H2RAs given at bedtime in conjunction with a delayed-release PPI can augment overnight pH control. A single dose of an H2RA (ranitidine 150 or 300 mg) given at bedtime in addition to a delayed-release PPI twice daily has been demonstrated to improve overnight pH control (Figure 34-1). The efficacy of H2RAs is best with the first dose, maintains efficacy in the first week of therapy, and gives variability in pH control over time. Two papers highlight the important issues regarding long-term…