Carbenoxolone sodium in the treatment of gastric ulcer with special reference to side-effects.

Abstract

EDITORIAL SYNOPSIS This paper indicates the need for close clinical and biochemical observation of the patient during treatment with carbenoxolone.In 1962, Doll, Hill, Hutton, and Underwood reported the results of a clinical trial of a triterpenoid liquorice compound, carbenoxolone sodium (Biogastrone), in the treatment of gastric and duodenal ulcer. They suggested that carbenoxolone sodium promotes the healing of gastric ulcers. The results in patients with duodenal ulcer were not significantly different from those receiving placebo tablets. Of 58 patients who were given the active drug in a dose of 100 mg. three times daily for four weeks, 10 (17 %) developed oedema. In 1965, Doll, Hill, and Hutton, in a further series, re-affirmed the value of carbenoxolone sodium in promoting the reduction in size of gastric ulcers. Twenty-four patients were treated as out-patients using doses of 75 to 100 mg. three times daily of carbenoxolone sodium. In this series, a liability to fluid retention was again noted: 21 % of patients developed oedema of the ankles and showed a rapid gain in weight. During the later stages of the second trial the blood pressure was recorded weekly and in a number of patients significant elevation of the systolic and diastolic blood pressure was noted. The mean maximum increase of pressure over the pretreatment reading was 20 mm.Hg systolic and 12 mm.Hg diastolic for the carbenoxolone sodium group. In one patient the increase in diastolic pressure was 30 mm.Hg.This communication describes our experience using carbenoxolone sodium in doses of 100 mg. three times daily and 50 mg. three times daily in the treatment of patients with gastric ulcer. Special attention was paid to the incidence of side-effects. METHODA double-blind pilot trial of carbenoxolone sodium was carried out in 12 patients with gastric ulcer. Only patients in whom the profile of the gastric ulcer niche was greater than 10 sq.mm. in area (Doll et al., 1962) were included in the trial. Six patients received the active drug in a dose of 100 mg. three times daily and six received inert placebo tablets. A further four patients were given carbenoxolone sodium in a dose of 100 mg. three times daily. All subjects were in-patients and the drug therapy was given for a maximum period of one month. Patients were allowed up to go to the lavatory, took a light ward diet, and were encouraged to take freely milk and antacid (colloidal aluminium hydroxide) whenever dyspeptic symptoms occurred. They were advised to stop smoking cigarettes. Progress was recorded at weekly intervals, by full clinical examination, by barium meal examination, and in many by fibroscopy. Also at weekly intervals serum electrolytes and urea were measured; liver function tests were carried out and routine blood examinations were made (haemoglobin, packed cell volume, and white blood count). There were weekly electrocardiograms and chemical analyses of the urine. The weight was recorded at least once weekly, and more frequently if indicated. The blood pressure was recorde...

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