Use of microbleeding and an ultrathin endoscope to assess gastric mucosal protection by famotidine

Famotidine for the Prevention of Gastric and Duodenal Ulcers Caused by Nonsteroidal Antiinflammatory Drugs

“…Although much of the gastroduodenal damage associated with NSAIDs is due to the inhibition of prostaglandin synthesis, acid plays an important part, 17 and in studies in humans, high doses of acid-inhibiting drugs were needed to achieve substantial protection against acute gastric damage. 10,18 At a standard dose of 20 to 40 mg daily, which is approved for the healing of ulcers, famotidine is well tol-erated, 19,20 although there are fewer data on the higher dose we used (40 mg twice daily). We found the higher dose to be well tolerated.…”

“…8,9 Famotidine, a histamine H 2 -receptor antagonist, inhibits acid secretion and provides protection against mucosal injury in normal subjects receiving short courses of aspirin or naproxen, with high doses of famotidine more effective than low doses. 10,11 The efficacy and safety of the drug have not been established in patients with arthritis receiving long-term NSAID therapy.…”

Protection of human gastric mucosa against aspirin—enteric coating or dose reduction?

“…Although our study has covered short‐term changes in young healthy volunteers, it is likely that similar relationships would be seen for longer ingestion by older patients. Acute studies of protective strategies have shown that normal doses of H 2 antagonists do not prevent gastric erosions, 11 , 12 whilst higher doses, 12 proton pump inhibitors 13 and misoprostol 14 , 15 do. These results have been replicated in clinical studies of patients with arthritis taking NSAIDs on a long‐term basis 15 –24 .…”

The Role of Acid Regulation in the Treatment of NSAID-induced Mucosal Damage

“…150 mg. 30 minutes before the aspirin [15]. Famotidine also protected against aspirininduced microbleeding [16). Kimmey et al examined the effect of cimetidine on the num ber of mucosal haemorrhages visible at endo scopy 2 hours after a single dose of aspirin 117).…”