Summary
In order to assess whether dinnertime administration of a once daily dose of famotidine is more advantageous than a bedtime dose in suppressing evening and nocturnal gastric acidity, we gave nine patients with a past history of duodenal ulcer in double-blind, randomized fashion either (1) placebo at 6 p.m. and 10 p.m., (2) famotidine 40 mg at 6 p.m. (Fam 6) + placebo at 10 p.m. or (3) placebo at 6 p.m. + famotidine at 10 p.m. (Fam 10) on three separate occasions.
Comparison of the 24-h median pH values showed that the two administrations of famotidine were superior to placebo, while Fam 6 was significantly more effective than Fam 10. The gain in acid suppression of Fam 6 with respect to Fam 10 was particularly evident from 6 p.m. to midnight.
Although the antisecretory effectiveness of Fam 6 was lower than that of Fam 10 from 4 a.m. to 8 a.m., it remained clearly higher than that of placebo and ensured virtual anacidity (median pH=6.7) even in this time segment.
We conclude that a once daily dose of famotidine at 6 p.m. is better than bedtime administration at covering the long period of continuous unbuffered intragastric acidity which extends from after the evening meal to breakfast.
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References
Bauerfeind P, Cilluffo T, Emde C, Fimmel CJ, Kohler W, Gasser T, Blum AL (1987) Reduction of gastric acidity with ranitidine or famotidine: early evening dosage is more effective than late evening dosage. Digestion 37: 217–222
Capurso L, Dal Monte PR, Mazzeo E, Menardo G, Morettini A, Saggioro A, Tafner G (1984) Comparison of cimetidine 800 mg once daily and 400 mg twice daily in acute duodenal ulceration. Br Med J 289: 1418–1420
Dragstedt LR, Owens FM (1943) Supradiaphragmatic section of the vagus nerves in treatment of duodenal ulcer. Proc Soc Exp Biol (NY) 53: 152–154
Fimmel CJ, Etienne A, Cilluffo T, v. Ritter C, Gasser T, Rey GP, Caradonna-Moscatelli P, Sabbatini F, Pace F, Buhler HW, Bauerfeind P, Blum AL (1985) Long-term ambulatory gastric pH monitoring: validation of a new method and effect of H2-receptor antagonists. Gastroenterology 88: 1842–1851
Gledhill T, Howard OM, Buck M, Paul A, Hunt RH (1983) Single nocturnal dose of an H2-receptor antagonist for the treatment of duodenal ulcer. Gut 24: 904–908
Howard JM, Chremos AN, Collen MJ, McArthur KE, Cherner JA, Maton PN, Ciarleglio CA, Cornelius MJ, Gardner JD, Jensen RT (1986) Famotidine, a new potent long-acting histamine H2-receptor antagonist: Comparison with cimetidine and ranitidine in the treatment of Zollinger-Ellison syndrome. Gastroenterology 88: 1026–1033
Howden CW, Jones DD, Hunt RH (1985) Nocturnal doses of H2-receptor antagonists for duodenal ulcer. Lancet 1: 647–648
Ireland A, Colin-Jones DG, Gear P, Golding PL, Ramage JK, Williams JG, Leicester RS, Smith CL, Ross G, Bamforth J, Degard CJ, Gledhill T, Hunt RH (1984) Ranitidine 150 mg twice daily vs 300 mg nightly in the treatment of duodenal ulcers. Lancet 2: 274–276
Levin E, Kirsner JB, Palmer WL, Butler C (1948) A comparison of the nocturnal gastric secretion in patients with duodenal ulcer and in normal individuals. Gastroenterology 10: 952–964
Merki H, Witzel L, Harre K, Schewcle E, Bauerfeind P, Blum AL, Röhmel S (1986) Circadian pattern of intragastric acidity in duodenal ulcer (DU) patients. A comparison with healthy controls (HC). Gastroenterology 90: 1549
Merki H, Witzel L, Harre K, Schewcle E, Neumann J, Röhmel J (1987) Single dose treatment with H2-receptor antagonists: Is bedtime administration too late? Gut 28: 451–454
Moore JG, Halberg F (1986) Circadian rhythm of gastric acid secretion in men with active duodenal ulcer. Dig Dis Sci 31: 1185–1191
Orr WC, Hall WH, Stahl ML, Durkin MG, Whitsett TL (1976) Sleep patterns and gastric acid secretion in duodenal ulcer disease. Arch Int Med 136: 655–660
Pounder RE, Hunt RH, Vincent SH, Milton-Thompson GJ, Misiewicz JJ (1977) 24-hour intragastric acidity and nocturnal acid secretion in patients with duodenal ulcer during oral administration of cimetidine and atropine. Gut 18: 85–90
Reynolds JR, Walt RP, Hardcastle JD, Clark AG, Smart HL, Langman MJS (1986) 24-hour intragastric pH: Continuous monitoring or nasogastric aspiration? Digestion 33: 219–224
Savarino V, Mela GS, Scalabrini P, Di Timoteo E, Magnolia MR, Percario G, Celle G (1986a) Famotidine and ranitidine control of 24-h intragastric acidity after single bedtime administration; a study using continuous pH monitoring. Br J Clin Pharmacol 22: 749–750
Savarino V, Mela GS, Scalabrini P, Magnolia MR, Di Timoteo E, Percario G, Celle G (1986b) Continuous 24-hour intragastric pH monitoring: focus on reproducibility in duodenal ulcer patients. A preliminary report. Gastroenterol Clin Biol 10: 826–830
Savarino V, Mela GS, Scalabrini P, Magnolia MR, Percario G, Di Timoteo E, Celle G (1987a) 24-h comparison between pH values of continuous intraluminal recording and simultaneous gastric aspiration. Scand J Gastroenterol 22: 135–140
Savarino V, Picciotto A, Magnolia MR, Scalabrini P, Mela GS, Celle G (1987b) Single bedtime dose of famotidine: Assessment of its antisecretory action by 24-hour intragastric pH monitoring. J Clin Pharmacol 27: 790–793
Walt RP, Male PJ, Rawlings J, Hunt RH, Milton-Thompson GJ, Misiewicz JJ (1981) Comparison of the effects of ranitidine, cimetidine and placebo on the 24-hour intragastric acidity and nocturnal acid secretion in patients with duodenal ulcer. Gut 22: 49–54
Walt R (1986) Twenty-four-hour intragastric acidity analysis for the future. Gut 27: 1–9
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Savarino, V., Mela, G.S., Scalabrini, P. et al. A comparison of the effects on intragastric acidity of bedtime or dinnertime administration of a once daily dose of famotidine. Eur J Clin Pharmacol 35, 203–207 (1988). https://doi.org/10.1007/BF00609254
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DOI: https://doi.org/10.1007/BF00609254