Comparison of misoprostol and cimetidine in the treatment of gastric ulcer.

The efficacy of misoprostol (a synthetic analogue of prostaglandin E1) and cimetidine in the treatment of gastric ulcer was evaluated. Thirty-two patients with endoscopically proven gastric ulcer were randomized, in a double-blind manner, in one of three groups that received four daily doses of either misoprostol, 50 or 200 micrograms, or cimetidine, 300 mg. Ulcer healing was assessed endoscopically after 4 weeks of treatment. The three groups were fairly comparable in their alcohol and caffeine intake, previous ulcer history and ulcer size. A relatively high proportion of patients in the cimetidine-treated group was smokers. Only one patient was withdrawn from the study. On the misoprostol low dose, healing of the ulcer was observed in 20% of the patients. In contrast, healing on the high dose of misoprostol (70%) was not significantly different from that on cimetidine (73%). No important clinical side effects were observed in any of the patients. These results (part of a multicenter, international study) suggest that the divided daily dose of 800 micrograms misoprostol is safe and effective in the short-term treatment of gastric ulcer.