One hundred twenty-four patients with idiopathic gastric acid hypersecretion (basal
acid output greater than 10.0 meq/hr) were prospectively evaluated and treated with
ranitidine twice a day. Fifty-four patients (44%) required standard doses of
ranitidine 300 mg/day for adequate treatment, and the other 70 patients (56%) required increased doses of
ranitidine (mean 994 mg/day, range 600-3000 mg/day). Mean basal
acid outputs for these two groups were 14.0 and 16.6 meq/hr, respectively, which were not significantly different. Nevertheless, there was a significant correlation between basal
acid output and daily
ranitidine dose required for
therapy (r = 0.18, P = 0.05). The duration of
ranitidine therapy consisted of: < 1 year (N = 46), 1 year (N = 16), 2 years (N = 19), 3 years (N = 22), 4 years (N = 15), 5 years (N = 6). Only five patients required progressive increases in
ranitidine during the time of treatment, which consisted of an average of 0.5 dose adjustments per year. No side effects occurred with any of these high doses of
ranitidine. These results indicate that, as in
Zollinger-Ellison syndrome,
ranitidine is effective
therapy for patients with idiopathic gastric acid hypersecretion; however, markedly increased doses as large as 3000 mg/day may be required.