Reduction of endoscopically assessed acute aspirin-induced gastric mucosal injury with cimetidine.

We studied the influence of cimetidine on the gastroscopically visible effects of a single 1296-mg dose of aspirin. An initial dose-response study in 48 subjects showed that 200- and 400-mg doses of cimetidine conferred a sufficient reduction in gastric mucosal injury to warrant further study. A second study showed that coadministration of a single 200- or 400-mg cimetidine tablet with the aspirin conferred the same degree of injury reduction as when cimetidine was given before the aspirin. Reduction in mucosal injury by a 200-mg cimetidine tablet, coadministered with four aspirin tablets, was then compared to placebo in a double-blind trial. A reduction of mucosal injury was observed in 14 of 20 (70%) subjects receiving cimetidine and 0 of 10 subjects receiving placebo (P less than 0.001). Two hundred milligrams of cimetidine is therefore a rational dose for further studies of the reduction of chronic aspirin-induced gastric mucosal injury.