Morning versus evening dose: a comparison of three H2-receptor blockers in duodenal ulcer healing.

In a prospective, randomized, single-blind, single-center, controlled study, we compared the effectiveness of single doses of cimetidine 800 mg, ranitidine 300 mg, and famotidine-40 mg given either as evening or morning doses for duodenal ulcer healing. One hundred eighty-six male patients with endoscopically confirmed duodenal ulcer were treated for 6 wk, and ulcer healing was endoscopically evaluated. The duodenal ulcer healing rate for each of the three H2-receptor antagonists was always less after morning administration than was achieved with the respective evening regimen: 59% versus 86% for cimetidine, 83% versus 94% for ranitidine, and 93% versus 97% for famotidine, but the difference was statistically significant for cimetidine only. This study confirms the importance of nocturnal therapy for duodenal ulcer healing. The importance is obscured when H2-receptor antagonists with higher potency and long duration of action are used.