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Ranitidine vs. Omeprazole?

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  • Ranitidine vs. Omeprazole?

    I have a friend whose looking at treating her gelding for Ulcers, he's a "classic" case and her vet thinks its a good idea to try.

    She's curious about which is more effective, her vet is recommending the Ranitidine simply because its substantially cheaper....however I sent her the link to the Canadian source, so if the Omeprazole has better results, she'd like to start with that...but if its about teh same as the Ranitidine, then she will go with her vets supply.

    Opinions/experiences? She does post on COTH but cant get on during the day so asked me to post for her.

  • #2
    There are 3 parts to the answer:
    Cost, effectiveness and time.
    Ranitidine is cheap and it starts working right away. But optimal treatment is 3 times a day. It can work for twice daily, but 3 times is recommended.

    Omeprazole takes a few days to kick in. Our last episode the vet had me administer both ranitidine and omeprazole for the first 4 days, then drop the ranitidine because the omeprazole had reduced acid production. The beauty of omeprazole is that it can be dosed once a day.

    Omeprazole can be obtained cheaply. I use the Abler product, as do lots of others here, to good result. So the question really comes down to, how much time does your friend have? and can the ranitidine be administered at least twice, but preferably three, times a day?


    • #3
      Ranitidine is a histamine H2 receptor antagonist, while omeprazole is a proton-pump inhibitor. They work differently.

      ETA--Only omeprazole has been "proven" to effectively treat ulcers in a shorter period of time, but many have found successful results when feeding Ranitidine 3x/day over a longer period of time.
      Originally posted by rustbreeches
      [George Morris] doesn't always drink beer, but when he does, he prefers Dos Equis


      • #4
        I don't know if ranitidine is SUBSTANTIALLY cheaper--the average horse dose is 3000mg three times daily, and that's a LOT of pills. One really has to do the math when compared with omeprazole. Of course if the only option is the Merial products ($$$$$$$$$$) then ANYTHING is more cost effective. Most people here use buffered or coated omeprazole from other sources. There are a million threads on the topic.

        Omeprazole is more potent than H2 blockers, but H2 blockers are pretty darned effective, too.
        Click here before you buy.


        • #5
          I paid $35 for three weeks of ranitidine (3.3 g, three times a day). Ulcers went from grade 2-3 to <1 on re-scoping at the end of the three weeks. I bought the ranitidine at Costco, but you need a prescription to get the larger-dose pills. This meant "only" 11 pills per dosing.
          The Evil Chem Prof


          • #6
            I just started treating my horse with the ranitidine.

            It cost me $80 for a months supply for a 1200 lb horse.

            That would only get me 4 days worth of gastrogard.

            Sooo, ranitidine is worth the extra time to feed for me.

            On the days I can only feed him twice I just split the third set of pills into the 2 feedings.

            I grind mine, add a little water, oil and syrup in a syringe and feed 10 minutes before his grain. (what was recommended to me)


            • #7
              What Stryder said. Also don't let the price of some omeprazole scare you off; the Abler products are considerably cheaper than Gastrogard.


              • #8
                Thank everyone for the insight! This is "the friend" reading and responding now. I went and purchased OTC Omeprazole from Rite Aide to start right away. The barn doesn't mind doing 3x/day for Ranitidine if need be. (I'm very lucky that way). When I calculated Ranitidine versus Omeprazole at the pharmacy, it was only a $4 difference for 7 days of treatment and the Omep was 1x/day. I was told he can also have Tums 10 pills up to 3x/day until the Omep kicks in. He loved them when I tried them last night.

                Stryder- where do you get the Abler product? I ordered some of the Canadian Omeprazole paste online, but was informed that it can take 3-6 weeks in the event customs puts a hold on it. I just want to make sure he has something until we receive the paste.

                I appreciate the insight from everyone. Unfortunately at work I don't have internet access so searching previous threads was not possible. I will start doing that now.


                • #9
                  Since you are asking for a variety opinions, this is mine. If your barn is willing to feed Ranitidine 3x a day, and your horse eats it, that's what I would use. I know you said the difference is only $4 for a week of treatment, but are you sure you are doing the math correctly? You need to use an awful lot of OTC Omeprazole on a horse. Maybe I'm the one who is doing the math wrong, but that just doesn't sound right.


                  • #10
                    Ranitidine is high at rite aide. That's why the cost seemed similar. Go to Walmart. 1 week 2x d is 7.99
                    chaque pas est fait ensemble


                    • #11
                      Originally posted by anmoro View Post

                      Stryder- where do you get the Abler product? I ordered some of the Canadian Omeprazole paste online, but was informed that it can take 3-6 weeks in the event customs puts a hold on it. I just want to make sure he has something until we receive the paste.
                      I order it from abler.com. It does take a while to arrive, usually about 10-14 days for me, without expedited shipping. I keep it on hand. If your barn will dose ranitidine 3x a day, you are one lucky horse-owner. But make sure one of the math wizards here helps you calculate the amount of the active ingredient so you're getting enough in the horse. I am not that person.


                      • #12
                        FWIW, I just waited 7 weeks for my Abler shipment.
                        "No hour of life is wasted that is spent in the saddle" - Winston Churchill

                        Check out Central Virginia Horse Rescue


                        • #13
                          Bad thing about the abler stuff is you can't put water on it. My horse will not eat it.

                          I ended up selling mine to other cothers, ;(

                          I would try ranitidine first


                          • #14
                            Something is off with your math (you're probably way under dosing!)

                            It takes 114 (20mg) pills to equal to 2.28 grams of omeprozole in a full tube of gastrogard. Say you can get 28 pills generic for $15... That's about $60 a dose!! Even doing equal to a quarter tube is $15 daily.

                            As a side note, I get ranitidine alfalfa flavored powder from wedgewood for $140 for 300 grams. My horses are in the bigger side so I end up spending about 1.65 per dose and no pill counting!! I do twice a day, so a bit over $3 a day


                            • #15
                              ranitidine alfalfa flavored powder from wedgewood
                              Nice option to know about. I know you don't need one yourself, but is this a prescription item?
                              Click here before you buy.


                              • #16
                                In head to head studies for treatment of ulcers, omperazole/proton pump inhibitors are consistently more effective than H2 blockers.

                                For a long time the question was: but are H2 blockers (ranitidine) just as good at preventing ulcers? Newer studies coming out seem to also show that proton pump inhibitors like omeprazole are also more effective for prevention. This has lead some of the human consensus statements to change this year to recommending now PPI's over H2 blockers for both treatment AND prevention of ulcers.

                                I think this will be fascinating though as PPI's - perhaps because of their effectiveness and their metabolism via the cytochrome P450 process, also have more significant side effects and drug drug interactions. Only time (and large numbers of patients in prospective long term trials ) will show whether the new trend towards more PPI use will ultimately be an unfavorable cost:benefit.


                                • #17
                                  Sure, PPIs are more effective, but does every animal, everywhere, need maximal protection all the time? H2 blockers may be "less than" PPIs but they are probably "more than enough" for a good number of individuals.

                                  I try to use "just enough" whenever I can. Ideally, nothing.
                                  Click here before you buy.


                                  • #18
                                    Originally posted by Samotis View Post
                                    Bad thing about the abler stuff is you can't put water on it.
                                    Yes, you can put water on it but should not let it soak in water because this will eventually dissolve the enteric coating.

                                    But you sure as heck can add water or other liquid just prior to feeding. I have been mixing it with a big blob of applesauce prior to feeding and it works just fine.


                                    • #19
                                      Originally posted by deltawave View Post
                                      Sure, PPIs are more effective, but does every animal, everywhere, need maximal protection all the time? H2 blockers may be "less than" PPIs but they are probably "more than enough" for a good number of individuals.

                                      I try to use "just enough" whenever I can. Ideally, nothing.
                                      Well she did say treating an active ulcer and I don't know of any GI doctor that would recommend an H2 blocker for treatment especially now that cost-wise the PPI's are competitive. For prevention, I agree with you - the H2 blockers still totally have a role.


                                      • #20
                                        I don't think anybody has caught this yet, but OP or friend, whoever is reading...

                                        If you're buying OTC omeprazole pills at Costo or wherever, you CANNOT crush them to administer, the coating must remain in tact, like, swallowed whole, or thye will not work. Additionally, I agree with whoever said your math was off on OTC omeprazole...I did that cost calculation a while back at Walmart's prices and i twas actually MORE to buy OTC omeprazole pills there, than to buy GastroGard and administer 1 tube daily.

                                        You can crush Ranitidine pills, but NOT omeprazole pills. If you're planning on crushing them up, just feed your horse the dollar bills.
                                        "If you think nobody cares about you, try missing a couple payments..."