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Abstract
The histamine (H2)-receptor antagonist famotidine was compared with ranitidine and cimetidine in its
ability to control gastric acid hypersecretion in 33 patients with gastric hypersecretory
states (32 patients with Zollinger-Ellison syndrome and one patient with idiopathic
hypersecretion). Equipotent doses of each drug were determined in nine patients and
used to determine relative onset of action, duration of action, and potency. Each
drug had a similar time course of onset with a maximal effect at three to four hours
after oral ingestion. The duration of action of famotidine was 30 percent longer than
that of either cimetidine or ranitidine. In terms of relative potency, famotidine
was nine times more potent than ranitidine and 32 times more potent than cimetidine.
Thirty-two patients underwent long-term famotidine treatment for up to 34 months (mean,
10 months) with a duration in 21 patients of at least six months, in nine patients
of at least 12 months, and in six patients of at least 24 months. The mean daily maintenance
dose with famotidine was 0.33 g per day (range, 0.05 to 0.8 g). Prior to famotidine
therapy, 27 patients were taking ranitidine and the mean daily dose required was 2.3
g per day (range, 0.6 to 5.4 g), whereas six patients were taking cimetidine and the
mean daily dose was 4.6 g per day (range, 1.2 to 9.0 g). Fourteen of the 32 patients
required an anticholinergic agent in addition to ranitidine or cimetidine to maintain
control, whereas only five patients required an anticholinergic agent with famotidine.
Gastric acid hypersecretion was controlled in seven patients with less frequent dosing
with famotidine than with cimetidine or ranitidine. Long-term treatment with famotidine
was not associated with any hematologic or biochemical toxicity or clinical side effects.
These results demonstrate that famotidine has a similar onset of action to other H2-receptor antagonists but has a 30 percent longer duration of action and is nine times
more potent than ranitidine and 32 times more potent than cimetidine. Famotidine is
safe and highly effective in the long-term treatment of gastric hypersecretory states.
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© 1986 Published by Elsevier Inc.