Efficacy of cimetidine for gastric acid suppression in pediatric patients.
The efficacy of oral cimetidine for gastric acid suppression in pediatric patients was examined in a double-blind study. Twenty-seven patients with gastroesophageal reflux-related gastrointestinal symptoms, pulmonary symptoms, or both were given randomly determined doses of cimetidine. Response was evaluated by continuous intragastric monitoring with a pH probe. Twenty-three patients were given cimetidine doses of 5,7.5, and 10 mg/kg; eight of these patients were also given additional doses of 15 mg/kg. Four patients received only 10 and 15 mg/kg, because of previous poor clinical response to the lower dosages. The onset of gastric pH greater than 4 was delayed more than 2 hours in 50% of patients with responses to the 5 mg/kg dose. Of the patients with responses to the 10 mg/kg dose, 75% had showed a rise in gastric pH greater than 4 within 2 hours. With respect to the duration of gastric acid suppression, 70% of patients receiving 5 mg/kg doses and 52% of those receiving 7.5 mg/kg doses did not have a sustained a response for more than 2 hours, whereas 75% of patients receiving 10 mg/kg doses had gastric acid suppression for longer than 2 hours. Of the patients receiving 15 mg/kg doses, 75% had a response for more than 2 hours; 50% of these patients had a response for more than 3 hours. We conclude that recommended doses of cimetidine for children may not be optimal for adequate gastric acid suppression.
Lambert
J
J
Department of Pediatrics, Boston Floating Hospital, New England Medical Center, Tufts University School of Medicine, Massachusetts.
Mobassaleh
M
M
Grand
R J
RJ
D000284:Administration, Oral; D002648:Child; D002927:Cimetidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D011899:Ranitidine / Q000627:therapeutic use
D002927:Cimetidine; D011899:Ranitidine