I have acid reflux (especially at night). I have a prescription from a gastroenterologist for a PPI, but I'm worried about taking this type of medication continuously. Am I better off with Zantac (ranitidine)? Or not taking anything at all?

Hello,

This is a very pertinent question that many people ask. First of all, you should know that taking a Proton Pump Inhibitor (PPI) does not have to be done continuously for life in all cases. It is actually recommended in many situations to take the medication continuously for 8 to 12 weeks and then try to stop the medication to see if the symptoms will return. If they do, try taking it again for a short time, or just as needed.

One of the reasons for trying to reduce the duration of use of this drug is that long-term use (for years) of this drug has harmful effects on health. For example, the absorption of iron, vitamin B12 and calcium is reduced. There are also studies that show an increased risk of osteoporosis with fracture when taking PPIs.

It is difficult to know whether Zantac and the other anti-H2 drugs are worse in this respect. It is possible that because they are less effective in reducing stomach acid, the effects may be less severe, but there is no evidence of this.

And about not taking anything, you know. And you know whether taking Zantac is enough for you. Certainly, taking nothing is the easiest way to avoid the side effects of medication. But not sleeping well because of reflux can also affect the quality of life of those who suffer from it.

You may have to take it for the rest of your life, but at least you will have tried to do otherwise. You will have proven that, in your situation, the use of this type of medication is really necessary. You should also know that gastroesophageal reflux disease, over time, increases the risk of developing esophagitis, and even Barrett's esophagus (the presence of pre-cancerous cells in the esophagus). It is therefore necessary to try to control it (either by modifying the diet, or if insufficient by adding medication).

We look forward to seeing you,

Alexandre Chagnon, pharmacist