older man with heartburn, acid reflux or indigestion

Americans must suffer from an awful lot of heartburn, because drugs to treat this painful condition have been best-sellers for a number of decades. The current favorites are proton pump inhibitors (PPIs) such as dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) and rabeprazole (AcipHex). But before that, the medications for ulcers, gastroesophageal reflux disease (GERD) and plain old heartburn were cimetidine (Tagamet), famotidine (Pepcid) and ranitidine (Zantac). These are probably all names you recognize.

Recent reports of serious side effects associated with PPIs have some people looking for alternatives that will still treat their heartburn. But they may wonder whether they are jumping from the frying pan into the fire.

Is Ranitidine a PPI Medicine?

Q. I have been taking omeprazole for several years. With all the recent information about the nasty side effects of PPIs, I have decided to wean myself off it.

Ranitidine is giving me good results, but I am wondering if this product is also a PPI. When I tried to look it up on the Internet, I could not find the answer to this question. Is ranitidine any safer than a doctor-prescribed PPI?

A. Ranitidine (Zantac) is not a proton pump inhibitor (PPI). Like cimetidine (Tagamet) and famotidine (Pepcid), it blocks stomach acid production through a different mechanism.

Because these H2 antagonists are less potent, they are generally less likely to cause complications like chronic kidney disease (JAMA Internal Medicine, Feb., 2016). On the other hand, both types of heartburn drugs can interfere with the absorption of B vitamins (especially vitamin B12) from food (Annals of Pharmacotherapy, May 2002).

You can learn more about both H2 blockers and PPI medications, as well as nondrug approaches to treating indigestion, in our Guide to Digestive Disorders.

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  1. Louise Vanderbank

    I had been taking omeprazole and ranitidine now for about ten years or more. It helps me but now I read about the side effects. It is true though as I do have problems with my kidneys now and my liver. I never used alcohol.

  2. Louise
    Los Angeles

    My mother is 86 and has severe heartburn. The doctor prescribed proton-pump inhibitors, which I don’t want her to take. (See all the dangerous side-effects.) I’ve started her taking 1/2 Tbsp apple cider vinegar in 1/2 glass of water with a squirt of honey. She has Alzheimer’s so she frequently protests that it will make her worse, but it ALWAYS works within 5 minutes, usually even faster. I now have her taking it every night so she gets in the habit, and she now says she even like it! It’s a god-send!

    BTW, I have her rinse her mouth out with plain water immediately after and hold off brushing her teeth for at least 30 minutes, as it can soften your tooth enamel.

  3. Valerie

    I was briefly taking Ranitidine by prescription (about 12 years ago) and believe it triggered a severe headache which landed me in the emergency room. My GERD was not severe, and I discontinued medication, but found relief through lifestyle changes – raising the head of our bed by several inches, not eating within a couple hours of going to bed & avoiding laying down after eating, and noting foods that seemed to cause a reaction to try to avoid.

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