Abstract
A double-blind multinational comparison of ranitidine 300 mg post evening meal (pem), ranitidine 300 mgnocte and cimetidine 800 mgnocte has been carried out in 1677 patients with endoscopically verified duodenal ulcer disease. Fifty-three percent of ulcers healed by two weeks during treatment with ranitidine 300 mg pem and 88% by four weeks, while the results for ranitidine 300 mgnocte were 50% and 86%, respectively, and 44% and 84% for cimetidine. The difference between ranitidine 300 mg pem and cimetidine was significant at two weeks (P=0.002, Mantel-Haenszel chi-squared test). The relative efficacy of the treatments was not dependent upon gender, smoking habit, alcohol intake, or ulcer frequency. However, the overall differences in healing between patients with small and large ulcers and patients with single and multiple ulcers were significantly different at weeks 2 and 4 (P<0.001). Significantly more patients treated with ranitidine (60%) had complete relief of epigastric pain than those treated with cimetidine (54%) (P<0.05). A meta-analysis of the four double-blind comparisons of ranitidine 300 mg pem (N=841) and 300 mgnocte (N=849), including the present study, failed to show the benefits of pem dosing, predicted from pharmacological studies.
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McIsaac RL, Dixon JS, Mills JG, Wood JR: Ranitidine in the treatment of duodenal ulcer disease: relationship between antisecretory effect and ulcer healing rate. Aliment Pharmacol Ther 5:227–243, 1991
Merki H, Witzel L, Harre K, Scheurle E, Neumann J, Röhmel J: Single dose treatment with H2-receptor antagonists: Is bedtime administration too late? Gut 28:451–454, 1987
Bauerfeind P, Cilluffo T, Emde C, Fimmel C, Kohler W, Gasser T, Blum AL: Reduction of gastric acidity with ranitidine or famotidine: Early evening dosage is more effective than late evening dosage. Digestion 37:217–222, 1987
Coppens JP, Warzee P, Schapira M, Fiasse R, Dive C: Single dose ranitidine: Influence of the time of administration on gastric acidity in normal subjects and in patients with duodenal ulcer. Gastroenterol Clin Biol 12:537–541, 1988
Orr WC, Finn AL, Allen M, Robinson MG, Wilson T: The timing of evening meal and ranitidine administration—effects on patterns of 24 hour intragastric acidity. Aliment Pharmacol Ther 2:541–549, 1988
Merki HS, Halter F, Wilder-Smith C, Allemann P, Witzel L, Kempf M, Roehmel J, Walt RP: Effect of food on H2-receptor blockade in normal subjects and duodenal ulcer patients. Gut 31:148–150, 1990
Merki H, Witzel L, Hüttemann W, Ansari A, Panijel M, Harre K, Heim J, Wolbergs E, Neumann HJ, Röhmel J: Early evening ranitidine administration promotes faster duodenal ulcer healing. Am J Gastroenterol 83(4):362–364, 1988
Rampal P, Montoya ML, Alberola B, Georges D, Pappo M: Ranitidine 300 mg od in acute duodenal ulcer: Administration after dinner or at bedtime? A French multicentre study. Gastroenterol Clin Biol 13:197–201, 1989
Schmidtke-Schrezenmeier G, Klingmann J, Pabst G, Geerke H, Koch EMW: Early evening doses of ranitidine in the therapy of duodenal ulcer. Z Gastroenterol 28:656–659, 1990
Deakin M, Glenny HP, Ramage JK, Mills JG, Burland WL, Williams JG: Large single daily dose of histamine H2-receptor antagonist for duodenal ulcer. How much and when? A clinical pharmacological study. Gut 28:566–572, 1987
Castelli G, Squassante L, Uleri S, Zanferrari G: Different dosage regimens of ranitidine in the short-term therapy of duodenal ulcer: a multicentre trial. Int J Clin Pharmacol Res 11:41–49, 1991
Leandro G, Zizzari S, Donnaloia R, Manghisi OG: Ranitidine vs cimetidine (in single administration) for the shortterm treatment of duodenal ulcer: An evaluation of efficacy and cost-benefit. Settim Ital Mal Dig 4:206, 1986
Klinger J, Maggiolo P, Arteaga H, Goic A: Treatment of duodenal and gastric ulcer with ranitidine or cimetidine in a single daily dose (nocte). Rev Med Chile 115:645–647, 1987
Al-Mofleh I, Mayet I, Al-Rashed R, Al-Faleh F, Al-Aska AK, Laajam MA: Efficacy of single-daily doses of H2-blockers in duodenal ulcer: Comparison of cimetidine and ranitidine in a double-blind controlled trial. Curr Ther Res 46:399–403, 1989
Akhtar MA, Rashid P, Khan MA: Treatment of acute duodenal ulcers with famotidine and its comparison with other H2 blockers. J Pak Med Assoc 40:136–137, 1990
Young MD, Lottes SR, Webb LA: An evaluation of cimetidine and ranitidine in the pain relief and acute healing of duodenal ulcer disease. Clin Ther 10:543–552, 1988
McCarthy DM: Smoking and ulcers—time to quit. N Engl J Med 311:726–728, 1984
Sontag S, Graham DY, Belsito A, Weiss J, Farley A, Grunt R, Cohen N, Kinnear D, Davis W, Archambault A, Achord J, Thayer W, Gillies R, Sidorov J, Sabesin M, Dyck W, Fleshler B, Cleator I, Wender J, Opekun A: Cimetidine, cigarette smoking, and recurrence of duodenal ulcer. N Engl J Med 311:689–693, 1984
Hunt RH, Chiverton SG: How does smoking harm the duodenum? Br Med J 296:864–865, 1988
Gibinski K, Nowak A, Butruk E, Habior A, Gabryelewicz A, Kosidlo S, Hasik J, Klinoewicz H, Marlioz K, Starzynska T: Seasonal prevention of duodenal recurrences with pirenzepine. Hepato-Gastroenterol 34:174–177, 1987
Kogut DG, Agrawal N, Collen MJ, Johnson JA: 300 mg ranitidine administered at 6 pm and at 10 pm in the treatment of duodenal ulcer disease. Gastroenterology 94(5 pt 2):A233, 1988
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Dixon, J.S., Ehsanullah, R.S.B., Mills, J.G. et al. Early evening dosing of ranitidine. Digest Dis Sci 38, 1459–1467 (1993). https://doi.org/10.1007/BF01308604
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DOI: https://doi.org/10.1007/BF01308604