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Dr. David
Dr. David, Board Certified Physician
Category: Medical
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I am a 68 to male in good health. I have been taking Nexium

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I am a 68 to male in good health. I have been taking Nexium 40 mg daily for the past 9 years or so. It works fine. However, I became concerned about Nexium due to some recent medical literature about the real potential cardiac effects for long-term users of PPIs. In this regard, I asked my gastro Dr for something other than Nexium for my indigestion/heartburn. He gave me an Rx for 300 mg Ranitidine to be taken twice a day in lieu of Nexium. When filling the Rx, my pharmacist remarked that taking 600mg ranitidine a day seemed kind of high. What are your thoughts ?
Hello, this is Dr. David. I have read your question and I'm ready to help.

long term nexium does have risks for dropping your magnesium level (hypomagnesemia) and atrophic gastritis.

you should ask your doctors to check your magnesium level and calcium levels and to check your heart.

the usual prescription dose for ranitidine is 150mg twice a day. or you can take 300mg at night time only for severe stomach ulcers.

I would double check with your doctor with a phone call. ranitidine doesn't get prescribed much anymore. it is sold over the counter as zantac 75mg. so your doctor may have forgotten the usual maximun dose for it.

also make sure you have had testing for H Pylori to make sure you don't have this stomach bacterial infection which can worsen stomach acid production

let me know if you have questions.
Customer: replied 4 years ago.

My magnesium and B-12 were recently checked and are okay. I have had an asymptomatic heart arrhythmia for years and I want to keep it that way. That is my concern about PPIs. ( My gastro Dr did not want me to stop the Nexium). Do you suggest that PPIs would be safe for me to use? And do you recommend that the max dosage for Zantac should not exceed 150 mg twice a day? Thank you.

there are some increased risks for heart attack with long term use of nexium.

but this has to be balanced with how bad your stomach acid production is

but ranitidine is an antihistamine blocker and shouldn't be used more than 300mg a day usually
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