Drug therapy for peptic ulcer: drugs that act on the gastric mucosa.

Antacids, cimetidine, carbenoxolone, colloidal bismuth, and prostaglandins promote healing of gastric and duodenal ulcer at a rate nearly twice that of healing during placebo administration. These short-term, 4-12 week healing rates are nearly the same for each agent, with a 65 to 85% range. Drugs that appear to produce more sustained healing are carbenoxolone and colloidal bismuth, observations that must be confirmed. Carbenoxolone has the greatest frequency of side effects and the most potentially serious ones. The mechanism(s) of any action, beyond inhibition of acid secretion by cimetidine and prostaglandins, is not well understood. At present, only antacids and cimetidine are approved for long-term treatment of peptic ulcer in the United States. Colloidal bismuth and carbenoxolone are used in Europe, but have not been approved for use in the United States. Prostaglandins remain experimental with several studies being conducted.