Effect of cimetidine on gastrointestinal symptoms in patients taking nonsteroidal anti-inflammatory drugs. A large double-blind placebo controlled study.

The effect of cimetidine on gastrointestinal (GI) symptoms in patients taking non-steroidal anti-inflammatory drugs was studied in a multicentre, double-blind, placebo-controlled 4 week trial. Five hundred and seventy osteoarthritis patients received cimetidine 400 mg bid or placebo. Seventy-nine % in the cimetidine group had no GI symptoms at week 4 compared to 72% in the placebo group (p = 0.07). Only 5.6% in the cimetidine group reported heartburn compared to 19.2% in the placebo group. Diarrhoea was more pronounced in cimetidine treated patients; 18.5% compared to 2.7%. In a subgroup of patients with previous GI discomfort on NSAID therapy (N = 123), 63% reported disappearance of symptoms in the cimetidine group compared to 45% in the placebo group (p = 0.05). In patients with GI symptoms starting NSAID therapy and in patients on NSAID with a heartburn problem, cimetidine seems to be of value.

[1]  G. Tildesley,et al.  Ranitidine in the treatment of gastric and duodenal ulcers associated with non-steroidal anti-inflammatory drugs. , 1993, British journal of rheumatology.

[2]  D. Graham,et al.  Misoprostol Compared with Sucralfate in the Prevention of Nonsteroidal Anti-inflammatory Drug-induced Gastric Ulcer: A Randomized, Controlled Trial , 1991 .

[3]  D. Jackson,et al.  Ranitidine in the treatment of non-steroidal anti-inflammatory drug associated gastric and duodenal ulcers. , 1991, Gut.

[4]  S. Roth,et al.  PREVENTION OF NSAID-INDUCED GASTRIC ULCER WITH MISOPROSTOL: MULTICENTRE, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL , 1988, The Lancet.

[5]  M. Ligumsky,et al.  Cimetidine decreases indomethacin induced duodenal mucosal damage in patients with acute musculoskeletal disorders. , 1988, Gut.

[6]  G. Tildesley,et al.  Prevention of gastroduodenal damage induced by non-steroidal anti-inflammatory drugs: controlled trial of ranitidine. , 1988, BMJ.

[7]  E. Swabb,et al.  Double-blind, placebo-controlled endoscopic comparison of the mucosal protective effects of misoprostol versus cimetidine on tolmetin-induced mucosal injury to the stomach and duodenum. , 1988, Gastroenterology.

[8]  J. Bijlsma,et al.  Treatment of endoscopy‐negative NSAID‐induced upper gastrointestinal symptoms with cimetidine: an international multicentre collaborative study , 1988, Alimentary pharmacology & therapeutics.

[9]  J. Sharp,et al.  Ranitidine protects against gastroduodenal mucosal damage associated with chronic aspirin therapy. , 1987, Archives of internal medicine.

[10]  S. Roth,et al.  Cimetidine therapy in nonsteroidal anti-inflammatory drug gastropathy. Double-blind long-term evaluation. , 1987, Archives of internal medicine.

[11]  R. Welch,et al.  Reduction of aspirin-induced gastrointestinal bleeding with cimetidine. , 1978, Gastroenterology.

[12]  F. D. Rooij,et al.  Diagnosis and Treatment of Acute Intermittent Porphyria , 1989 .

[13]  K. Giercksky Mucosal protection by H2 antagonists against injury by non-steroidal anti-inflammatory agents. , 1989, Scandinavian journal of gastroenterology. Supplement.