Acidsuppressive treatment
1. Patients who continue to have symptoms should be offered an acid-suppressive treatment
2. The four available H2-blockers are equally safe and effective. A twice-daily schedule should be used to provide 24-hour acid control.
|
Agent |
Dosage | |
|
Histamine-2 blockers: Inhibit gastric acid secretion | ||
|
Ranitidine (Zantac) Famotidine (Pepcid) Nizatidine (Axid) Cimetidine (Tagamet) |
150-300 mg bid 20-40 mg bid 150-300 mg bid 400-800 mg bid |
Cimetidine may cause impotence and gynecomastia; many drug interactions |
|
Agent |
Dosage | |
|
Prokinetic drugs: Increase lower esophageal sphincter pressure, increase peristalsis | ||
|
Cisapride (Propulsid) |
Up to 20 mg qid [10 mg] |
Mild diarrhea |
|
Proton-pump inhibitors: Inhibit gastric acid secretion | ||
|
Omeprazole (Prilosec) Lansoprazole (Prevacid) |
20 mg qd or bid 30 mg qd |
8 weeks of treatment |
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