EARLY EVENING DOSING OF RANITIDINE - COMPARISON WITH NIGHTTIME DOSINGOF RANITIDINE OR CIMETIDINE IN DUODENAL ULCERATION

A double-blind multinational comparison of ranitidine 300 mg post even ing meal (pem), ranitidine 300 mg nocte and cimetidine 800 mg nocte ha s been carried out in 1677 patients with endoscopically verified duode nal ulcer disease. Fifty-three percent of ulcers healed by two weeks d uring treatment with ranitidine 300 mg pem and 88% by four weeks, whil e the results for ranitidine 300 mg nocte were 50% and 86%, respective ly, and 44% and 84% for cimetidine. The difference between ranitidine 300 mg pem and cimetidine was significant at two weeks (P = 0.002, Man tel-Haenszel chi-squared test). The relative efficacy of the treatment s was not dependent upon gender, smoking habit, alcohol intake, or ulc er frequency. However, the overall differences in healing between pati ents with small and large ulcers and patients with single and multiple ulcers were significantly different at weeks 2 and 4 (P < 0.001). Sig nificantly more patients treated with ranitidine (60%) had complete re lief of epigastric pain than those treated with cimetidine (54%) (P < 0.05). A meta-analysis of the four double-blind comparisons of ranitid ine 300 mg pem (N = 841) and 300 mg nocte (N = 849), including the pre sent study, failed to show the benefits of pem dosing, predicted from pharmacological studies.