A comparison of the effects on intragastric acidity of bedtime or dinnertime administration of a once daily dose of famotidine

In order to assess whether dinnertime administration of a once daily dose of famotidine is more advantageous than a bedtime dose in suppressing evening and nocturnal gastric acidity, we gave nine patients with a past history of duodenal ulcer in double-blind, randomized fashion either (1) placebo at 6 p.m. and 10 p.m., (2) famotidine 40 mg at 6 p.m. (Fam 6) + placebo at 10 p.m. or (3) placebo at 6 p.m. + famotidine at 10 p.m. (Fam 10) on three separate occasions. Comparison of the 24-h median pH values showed that the two administrations of famotidine were superior to placebo, while Fam 6 was significantly more effective than Fam 10. The gain in acid suppression of Fam 6 with respect to Fam 10 was particularly evident from 6 p.m. to midnight. Although the antisecretory effectiveness of Fam 6 was lower than that of Fam 10 from 4 a.m. to 8 a.m., it remained clearly higher than that of placebo and ensured virtual anacidity (median pH=6.7) even in this time segment. We conclude that a once daily dose of famotidine at 6 p.m. is better than bedtime administration at covering the long period of continuous unbuffered intragastric acidity which extends from after the evening meal to breakfast.