Peptic Ulcer Healing With Ranitidine in Cimetidine Resistance

‘Difficult’ Duodenal Ulcer Patients: Clinical and Therapeutic Problems

“…The main definitions suggested by the various authors are: (a) duodenal ulcer unhealed af ter 3 months therapy with cimetidine, 1 g [5]; (b) failure of the ulcer to heal after 6 weeks therapy with cimetidine [6,7] and/or ranitidine at full dose; (c) a less than 25% reduction of the ulcer's maximum diameter as compared to initial ulcer size after 4 weeks treatment with cimetidine, 1 g/day (9); (d) no change in ulcer dimensions after 8 weeks therapy with full-dose H2-antagonists [ 10,11].…”

“…A certain number of trials have evaluated the possibility of replacing the H2-blocker with another agent of the same class (cimcti- [11] Cimetidine 78 Mazzacca et al [10] Cimetidine 77 Quatrini et al [6] Cimetidine 62 63-Corsini ct al. [31] Cimetidine 80 60' Ranitidine Amouretti et al [7] Cimetidine 60 712 dine instead of ranitidine and vice versa).…”

“…[31] Cimetidine 80 60' Ranitidine Amouretti et al [7] Cimetidine 60 712 dine instead of ranitidine and vice versa). In uncontrolled studies [10,11,30], in which ranitidine was substituted for cimetidine, there was an evident gain for ranitidine in terms of ulcer healing, though this has not been confirmed by subsequent controlled studies (table 4) [6, 7. 20].…”

The refractory ulcer

“…Transfer from cimetidine to a more potent antisecretory agent--ranitidine. There is evidence from uncontrolled trials that ranitidine is effective in the management of ulcers unresponsive to cimetidine [77][78][79][80][81][82][83]. These studies did not exclude the possibility that continuation of cimetidine, or even administration of a placebo for the additional period, may have produced the response attributed to ranitidine.…”