Proton Pump Inhibitors vs. Zantac

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What's the Difference between Proton Pump Inhibitors and Zantac?

What are Proton Pump Inhibitors? What is Zantac?

Proton pump inhibitors (PPIs) are drugs that reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid that is responsible for most ulcers in the esophagus, stomach, and duodenum. Proton pump inhibitors are used to prevent and treat of acid-related conditions including esophageal duodenal and stomach ulcers, NSAID-associated ulcers, ulcers, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome. PPIs also are used in combination with antibiotics for getting rid of the bacterium Helicobacter pylori, that together with acid, causes ulcers. Other proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), dexlansoprazole (Dexilent), rabeprazole (Aciphex), pantoprazole (Protonix), esomeprazole (Nexium), and omeprazole/sodium bicarbonate (Zegerid).

Zantac (ranitidine) blocks the production of acid by acid-producing cells in the stomach that helps to prevent and heal acid-induced inflammation and ulcers. Excessive stomach acid can damage the esophagus, stomach, and duodenum and lead to inflammation and ulceration. Zantac is a H2 (histamine-2) blocker. Other drugs in this class include cimetidine (Tagamet), nizatidine (Axid), and famotidine (Pepcid).

What Drugs Interact with Proton Pump Inhibitors vs. Zantac?

PPIs

Proton pump inhibitors interact with few drugs.

  • The absorption into the body of some drugs is affected by the presence of acid in the stomach, and because PPIs reduce acid in the stomach, they may affect the absorption of these drugs. Specifically, PPIs reduce the absorption and concentration in the blood of ketoconazole (Nizoral) and increase the absorption and concentration of digoxin (Lanoxin). This may lead to reduced effectiveness of ketoconazole and an increase in digoxin toxicity.
  • Proton pump inhibitors can reduce the break-down of some drugs by the liver and lead to an increase in their concentration in the blood. Omeprazole (Prilosec) is more likely than the other PPIs to reduce the break-down of drugs by the liver. For example, omeprazole (Prilosec) may increase the concentration in the blood of diazepam (Valium), warfarin (Coumadin) and phenytoin (Dilantin).
  • Omeprazole (Prilosec, Prilosec OTC) reduces the effect of clopidogrel (Plavix) by blocking the conversion of clopidogrel to its active form. This combination should be avoided.

Zantac

Ranitidine, like other drugs that reduce stomach acid, may interfere with the absorption of drugs that require acid for adequate absorption. Examples include iron salts (for example iron sulphate), itraconazole (Sporanox), and ketoconazole (Nizoral, Extina, Xolegel, Kuric).

What Are the Side Effects of Proton Pump Inhibitors vs. Zantac?

PPIs

The most common side effects of proton pump inhibitors are:

Nevertheless, proton pump inhibitors generally are well tolerated.

PPIs may increase the risk of Clostridium difficile infection of the colon. High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Prolonged use also reduces absorption of vitamin B12 (cyanocobalamin).

Long-term use of PPIs has also been associated with low levels of magnesium (hypomagnesemia). Analysis of patients taking PPIs for long periods of time showed an increased risk of heart attacks.

Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.

Other serious side effects associate with PPIs include:

Zantac

Minor side effects occur and these are:

Other important, but rare, side effects include:

Summary

Proton pump inhibitors (PPIs) reduce the production of acid and are used to prevent and treat of acid-related conditions including ulcers and gastroesophageal reflux disease (GERD). Zantac (ranitidine) also blocks the production of acid by acid-producing cells in the stomach, but is in a drug class called H2 (histamine) blockers.

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Medically Reviewed on 3/20/2018
References
FDA Prescribing Information
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