11/11/2025
Omeprazole vs Ranitidine: What is the Right Approach for Treating Stomach Ulcers in Horses?
Gastric ulcers are one of the most common health issues affecting performance horses in Australia. From racehorses to pleasure mounts, many horses experience some degree of gastric irritation due to stress, feeding practices, travel, or training intensity. When it comes to treatment, two medications often come up in conversation, omeprazole and ranitidine. While omeprazole has long been regarded as the “go-to” ulcer treatment, there’s good reason for horse owners and veterinarians to take another look at ranitidine as an effective, practical, and often underappreciated option.
How do they work?
Both omeprazole and ranitidine are designed to reduce acid production in the horse’s stomach, but they do so in different ways.
Omeprazole is a proton pump inhibitor (PPI), meaning it blocks the final step of acid secretion in the stomach lining. It is highly effective at reducing acid for an extended period and is widely used in ulcer treatment programs. However, omeprazole doesn’t act immediately, and its long-term use has been associated with potential drawbacks, such as rebound acid hypersecretion, once treatment stops.
Ranitidine, on the other hand, is a histamine (H2) receptor blocker, which works by reducing acid production earlier in the process. While its duration of action is shorter, meaning it needs to be given more frequently, ranitidine offers a gentler and more flexible approach to managing gastric health without dramatically altering the stomach’s natural pH balance.
Ranitidine has been safely and effectively used in horses for decades. One of its key advantages lies in its well-tolerated and reversible action. Unlike omeprazole, ranitidine does not completely suppress stomach acid. This is important, as horses rely on some level of gastric acidity for proper digestion and protection against harmful bacteria. By maintaining a more natural stomach environment, ranitidine supports digestive balance and reduces the risk of acid “rebound” when treatment stops.
Ranitidine is also fast-acting, which can make it especially useful for managing horses during stressful periods such as travel, competition, or dietary changes. For horses prone to recurrent ulcers or sensitive to PPIs, ranitidine provides a safe, proven alternative.
Another important factor for many horse owners is cost and accessibility. Depending on formulation and dosing, ranitidine can be a more economical choice, particularly for long-term management or when treating multiple horses.
What is the best approach?
While omeprazole remains an effective treatment, particularly for severe ulceration, ranitidine has a valuable role in both treatment and prevention. Some veterinarians recommend using ranitidine after an omeprazole course to help the stomach transition back to normal acid production smoothly. Others prefer ranitidine as a first-line treatment for mild to moderate ulcers, or as ongoing maintenance for horses under high stress.
In combination with good management, including frequent forage feeding, reduced grain intake, access to turnout, and minimising stress, ranitidine can help restore and maintain gastric comfort without the potential side effects of longer-term PPI use.
Omeprazole and ranitidine both have their place in equine gastric care, but ranitidine deserves renewed attention as a reliable, cost-effective, and horse-friendly option. For many horses, it offers the perfect balance between effective ulcer control and maintaining natural digestive health.
Before starting any treatment, it’s important to consult your veterinarian to determine the best option for your horse’s individual needs!
Omeprazole vs Ranitidine: What is the Right Approach for Treating Stomach Ulcers in Horses? Gastric ulcers are one of the most common health issues affecting performance horses in Australia. From racehorses to pleasure mounts, many horses experience some
