The effect of histamine H2 receptor antagonists on platelet aggregation in man.

The in vivo and in vitro effects on the aggregatory response of human platelets to ADP and collagen of a series of imidazole and non-imidazole histamine H2 receptor antagonists, and imidazole derivatives, have been studied. Bolus i.v. administration of the antagonists cimetidine and oxmetidine was without effect. However, inhibition of platelet aggregation was observed in vitro with oxmetidine, metiamide and to a lesser extent burimamide, but not with cimetidine or the non-imidazole antagonist ranitidine. Of the imidazole derivatives only imidazole and its 1-methyl analogue significantly affected platelet aggregation. The relationship between potency as a histamine H2 receptor antagonist, the presence of an imidazole ring structure and the antiaggregatory effectiveness of these compounds is discussed. Although certain antagonists clearly inhibit platelet aggregation in vitro, effects are only seen at drug concentrations exceeding those achieved under normal therapeutic conditions; thus the clinical significance of these observations remains to be determined.