Lansoprazole or Ranitidine

[jackrussell]

In general , is one better than the other or is it a case of what suites one doesn,t  suite another, and with long term use ,as many of us no doubt do use them long term, is there a good reason to use one rather than the other.I realise they act in a slightly different way to each other,however with choice is one more beneficial ?.

[PMRpro]

Don't think one is more beneficial than the other although it is said the PPI (lansoprazole) is more effective, not sure there is a lot of difference. Some people suffer bad side effects with PPIs and when you stop taking them there is more chance of rebound reflux. Ranitidine is a different mechanism so has different side effects. Longterm use of PPIs is said to lead to reduction in bone density - as if we weren't at risk anyway! They reduce calcium absorption.

I've never taken either - yoghurt seems to have done enough. The current version of pred I take probably passes through the stomach before being absorbed and I certainly don't have any problems.

[Chris-Bromsgrove]

Hi Jackrussell

I started on Ranitidine when I underwent my initial treatment for MPA. I was on it for a few weeks without problem, then I started to suffer from acid reflux while I was sleeping. The stomach acid runs into your wind pipe and it is not very nice to say the least. I was then put on Lansoprazole  which helped. I just got the occasional reflux occurring but after finishing the cyclophosphamide infusions and dropping down to a low dose of Pred it stopped altogether. I was on Lansop for about two years. I didn't experience any side effects attributable to either drug and I did not experience any problems coming off Lansop. For my situation Lansop was the better drug. Chris

[Barnclown]

Good question: thanks for asking it!

My chronic upper GI conditions have been thoroughly investigated.  Now I seem able to lifestyle manage my predispositions pretty darn well (these are childhood onset, due to complex overlapping multi system connective tissue conditions & immune dysfunction: persistent reflux, dysphagia and gastroporesis + chronic gastritis & oesophagitis).  My GP had me using pantoprazole for several years to settle persistent nausea...but eventually it ceased to be effective.  during an especially severe & widespread upper GI flare in my early 50s, before my version of early onset vascular-type SLE was recognised, gastroenterology put me on daily oesomeprazole + domperidone indefinitely...this continued for 6 years.  Although I was able to reduce time on domperidone, taking it now & then as required

Whatever, i was told I'd be on oesomeprazole daily for the rest of my life.  During the first of those 6 years, these meds helped a lot.  But meanwhile my chronic lower GI issues began to get worse in various ways.  After 5 years I was managing what we now know is chronic small bowel dysmotility + back-up overflow diarrhoea.  Plus my rate of loss of bone density had accelerated so fast that rheumatology wanted me on bisphosphonates even though I was still only osteopenia.  It was awful.  

So I researched PPIs and discovered the link with loss of bone density etc. By then, I had become much more skilled & confident about lifestyle managing my upper GI probs.  So I asked my GP if I could come off oesomeprazole.  She said never.  But my lower GI stuff had become such an ordeal that I decided to try stopping oesomeprazole cold turkey.  And lifestyle management stood me in good stead....+ the lower GI symptoms damped down...and at my next 3 yearly dexa scan, my rate of bone density loss had slowed down

But 5 years ago we discovered I have infant onset SLE...eventually my lupus & Vasculitis clinic + immunology have figured out there is sjogrens + ehlers danlos hypermobility & an underlying immunodeficiency in my mix.  So I'm on the usual heavy duty combined therapy daily meds which, at 62, help me feel better than I have since my 20s.  BUT I continue to react badly to oesomeprazole...and need daily PPI when I'm on certain meds (eg prednisolone at greater than 7mg).  This winter, our PMRpro suggested I look into lansoprazole & ranitidine...and my GP offered me to trial lansoprazole & ranitidine.  I took my repeat meds list to my fav most reliable pharmacist, who said these alternative PPIs are worth trialling, but that she finds patients tend to have even more trouble tolerating them...more sideffects etc.  And I'm a very reactive patient...am I sensible to just stick to oesomeprazole, the enemy I know?

So, I've just had to resort to a week of daily oesomeprazole during a recent flare...of course this messed up my lower GI stuff.  But I'm off it now & coaxing my lower GI stuff back into better function. So I'm very interested in your question & the replies

Apologies for going on at such length, but for sure I know i'm not the only Complex Patient struggling with a relatively functional GI system which reacts adversely to PPIs, so maybe the details I've given can be useful to others

Coco

[jinasc]

Acid Reflux

Juice of one lemon (place in microwave for about 50 secs - triple the juice).

Divide into three and take with water before meals.

It works.

[leedsnel]

lanzoprazole made me sickly ironically!!

[BronteM]

PPIs have not been a success with me. Pantoprazole pinned me to the loo for whole mornings, and I ended up controlling it with Imodium. That seemed silly so changed to omeprazole, which gave me UTI symptoms and has left me with an even more sensitive bladder. I think I tried one or two others with similar results but those two were the worst. I now take Ranitidine, backed up occasionally with gaviscon, and that is absolutely fine. So, yes, you are right....we are all different and it ends up being trial and error to find the right one. 

[Winter64]

Ranatidine is a H2 receptor so is often prescribed with a H1 antihistamine for chronic urticaria as part of a treatment plan. I tried ranatidine but it made my reflux worse. I now take lansoprazole 15mg every 2nd day because of the bone density issue, I reduced down from 30mg daily to what I take now and it keeps everything mainly under control and just add in tums if a little extra needed. My spine density dropped 7% last year and I have a neck fracture so I'm hoping this slows it down. Xxx

[PMRpro]

Just to add: they rarely mention the fact that PPIs are even more likely to cause loss of bone density than pred. That all PPIs can cause awful gut problems. Or that the FDA warns they should not be used long term.

Everyone is different - but a lot of people will do better on something else such as ranitidine and many will manage well on pred with just yoghurt or taking their tablets in the middle of a meal - half your breakfast, take the pred, finish your breakfast and NEVER take ordinary pred without a decent amount of food. And probiotics are also likely to help - not the noddy variety, the sort with millions and millions of bugs...

[Juliemo]

I have tried every single brand out there except lanoperzole or however its spelled. No other brand has helped except nexum, but had to go off that one for a reason I don't remember. I have suffered greatly on rantidine in the last 6 wks and have been on it for 5months or more along with a protonic. I skipped one day and woke up with relief however I had a headache for more than half the day instead. Anyway my doctors gives up they're sending me to a g.I. doc.

[jackrussell]

I had been having stomach problems ,thought it might be the Lansoprazole, so spoke to my GP and decided to try Ranitidine, however it didn,t make a lot of difference, eventually through my Vasculitis consultant I was sent to GI DR.who arranged an endoscopy, result I have a 4cm Hiatus Hernia,which I had no idea I had, at least it explained some of my stomach problems ,and am now back on Lansoprazole as the consultant felt I would do better with that ,together with watching what I eat I have been getting some relief. ( My question re Lansoprazole or Ranitidine was prior to my changing from Lansoprazole to Ranitidine.).

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