Famotidine V. Omeprazole For Acid Reduction In Dogs

[MerlinsMum]

In a different thread, Chris (greysmom) mentioned that:

 

>>>NOTE<<< Dr Brown told me today - and this was news to me, though probably not to others - that the only acid reducer that works in dogs is omeprazole. The other drugs - famotidine and ranitidine - don't do anything at all for them. She said most vets don't know this either since it's based on new research just from the last year or so.

 

I find this rather disconcerting, since Merlin has been on famotidine pretty much nonstop since the end of March, when he had his first IBD flare-up. I have often wondered whether continuing to give him Pepcid was even doing anything, since he has continued to have flare-ups and only increasing the dose of Metronidazole he takes daily seemed to help. I have an appointment with the vet next week, so I am definitely going to bring this up.

 

I think I may have found a reference to the study in question: Omeprazole v. Famotidine. Problem is, it's a TINY study, nowhere near big enough to be conclusive, unless of course I am mistaken and the study I posted a link to is something different. Can anyone shed any more light on this?

 

Thanks! (I'll leave the rant about causing vomit and diarrhea in perfectly healthy dogs for another day...)

Edited September 29, 2011 by MerlinsMum

[krissy]

Omeprazole is more potent, and it also takes longer to kick in I believe. We often give famotidine for the first little while that we give omeprazole so the dog is covered by the famotidine until the omeprazole kicks in and becomes effective. I'll have to look up some newer papers on famotidine. That must have literally just come out in the last couple of months because I'm still in school and the moment there are murmurs about anything someone usually mentions it to us (mostly just to further confuse us I think).

[Guest RiverCityGang]

Kerry, I can't comment on how these three work for dogs because fortunately, I have not had a dog with stomach problems. Fingers crossed it stays that way!

 

But for myself, omeprazole is the only one of the three that works. I have had prescriptions for each of them. The omeprazole works so well for me that even though my script is for 2 per day, one keeps my acid under control. Ranitidine did nothing for me and famotidine worked only as long as I was very careful what I ate, and even then the Tums and Rolaids stayed close by.

 

I sure hope you get an answer from your vet that will work for Merlin!

[greymatters]

In a different thread, Chris (greysmom) mentioned that:

 

>>>NOTE<<< Dr Brown told me today - and this was news to me, though probably not to others - that the only acid reducer that works in dogs is omeprazole. The other drugs - famotidine and ranitidine - don't do anything at all for them. She said most vets don't know this either since it's based on new research just from the last year or so.

...

I think I may have found a reference to the study in question: Omeprazole v. Famotidine. Problem is, it's a TINY study, nowhere near big enough to be conclusive, unless of course I am mistaken and the study I posted a link to is something different. Can anyone shed any more light on this?

It's true that the "n" is tiny in the study that you referenced above, but it seems there have been several studies looking at this in the past 5-10 years. Here are two that might be relevant:

 

Omeprazole also showed superior effects to famotidine in a larger study in 52 sled dogs and in another small study in 12 beagles. What caught my attention is the conclusion from the beagle study that "Twice daily administration of a suspension of omeprazole was the only regimen tested that approached the potential therapeutic efficacy for acid-related disease when assessed by criteria used for human patients." Maybe this is what greysmom's vet was referring to ?

 

My (quick) reading of the published findings is that both drugs show efficacy, but omeprazole works better. Our boy's GI issues aren't too severe yet, and we're hoping to keep it that way. So this is definitely one of those things I will discuss with the vet at our next visit. Thanks for bringing it up again, and I hope your Merlin is feeling better soon .

[greysmom]

I will ask Dr Brown the next time I speak with her. She is a internal medicine specialist at the hospital/e-vet where Dorie was admitted (and where Dude is being treated for osteo), and I would expect her to be up on all the latest research.

 

She didn't cite a specific study, only said that most vets wouldn't know about the information since it was very new within the last year. She then stated that neither famotidine or ranitidine were effective for controlling stomach acd in dogs, and only omeprazole should be used.

 

I have to say, I have not seen any specific results from giving two of mine famotidine nearly every day for several months. I started them both on the omeprazole so I'll see if there's any appreciable difference in the coming days.

[Batmom]

I saw the study on a fly-by but haven't had a chance to read in detail. I wouldn't say on the basis of what I read that only omeprazole should be used, or that famotidine is without effect entirely.

[Guest Swifthounds]

Given the relative strength of the stomach acid of a dog, I would be surprised if much of anything safe for humans had any significant effect on stomach acid. I also can't imagine long term use would be any better for dogs than it is for people.

[BatterseaBrindl]

In horses, Omeprazole is the only effective drug to use for gastic ulcers.

I have a horse with ulcers and he has always done well on the Omeprazole.

 

I have never had a dog with gastric issues ... thank goodness.

[Batmom]

Given the relative strength of the stomach acid of a dog, I would be surprised if much of anything safe for humans had any significant effect on stomach acid. I also can't imagine long term use would be any better for dogs than it is for people.

 

Actually, the acidity of dog and people stomachs is quite similar. The latest omeprazole vs. famotidine study even cites literature noting that dogs' stomach pH is higher (less acidic) for longer periods during the day than people's.

 

I guess the moral of that story is, don't throw up on the rug!

 

[Batmom]

P.S. The latest study was very small -- 6 dogs. It focused on the amount of time pH was raised above a certain level. Omeprazole, at doses higher than are normally prescribed, raised pH above the studied level for a longer period of time than famotidine.

 

I honestly would have to read around a bit more to assess. It isn't necessarily the case that raising pH higher for longer is universally -- for all dogs/people or all conditions -- a good thing. Digestion of different items requires different pH; for example, proteins and lipids (fats) are optimally digested at different pHs. IIRC also, omeprazole has a higher rate of adverse side effects; not sure about drug interactions.

 

As with anything else, if the med you're using isn't having the desired effect, ask about alternatives .

[greysmom]

This does have a bearing too as regards the cost. One reason I opted for famotidine in the first place was because it's relatively cheap - much cheaper than omeprazole, especially if you have multiple dogs.

[Jackandgrey]

This does have a bearing too as regards the cost. One reason I opted for famotidine in the first place was because it's relatively cheap - much cheaper than omeprazole, especially if you have multiple dogs.

 

Absolutely the cost is an issue. Also I would want to know who sponsored the study.

[greymatters]

This does have a bearing too as regards the cost. One reason I opted for famotidine in the first place was because it's relatively cheap - much cheaper than omeprazole, especially if you have multiple dogs.

 

Absolutely the cost is an issue. Also I would want to know who sponsored the study.

Good point about the cost - I once went to our vet armed with a report about another drug, and his response was "interesting...of course, nobody would be able to afford it!" That said, the authors of the new study make a point of comparing omeprazole tablets (manufactured for humans) with the veterinary paste formulation used for horses, and note that (in their opinion) the paste is "inexpensive" and could easily be reformulated for dosing in dogs.

 

As to the science, having had a chance to read the study in its entirety I must say that IMO the data are fairly compelling, even given the very small sample size. I wouldn't necessarily discount famotidine based on these results (as the authors point out, the small numbers and high variability make the apparent lack of efficacy harder to interpret), but the omeprazole effects seem impressive in any case.

 

Also, a *very* good point about the funding sources - this is something I always look at in drug studies. FWIW, this study does not appear to have been sponsored by the manufacturers of either the omeprazole tablets (they used generic) or the veterinary paste (Gastrogard, made by Merial). The funding acknowledgment reads "The authors thank...the Comparative Gastroenterology Society, Waltham, Merck-Merial Veterinary Scholars Program, and GlaxoSmithKline for their financial support." The Merck-Merial program is a training grant for vet students, and I think the only acid-reducer that Glaxo makes these days is ranitidine (Zantac).

 

Thanks again for bringing this up - our boy is experiencing a recurrence of his GI issues now and omeprazole is definitely something I will look into.

[krissn333]

Omeprazole is a $4 prescription at most pharmacies (even though they also sell it OTC). If you want to give it, just ask your vet to write a script for it instead