Objective:This double-blind, randomized, international, multicentre study was undertaken to determine the effect of a variable dose ranitidine regimen (300 mg four times daily for 7 days which was reduced to 300 mg at night for a further 21 days) on symptom relief and duodenal ulcer healing compared with the standard dose ranitidine regimen (300 mg at night for 28 days).Patients:The study included 223 patients with endoscopically-confirmed duodenal ulcers (ulcer diameter ≥ 5 mm).Results:After 2 weeks of treatment, complete ulcer healing was observed in 64 and 52% of patients for the variable dose and night-time regimens, respectively (P = 0.076). By 4 weeks, cumulative healing rates were 98 and 89%, respectively (P 0.01). A greater number of patients receiving the variable dose had complete relief from epigastric pain after 2 weeks compared with those on the standard dose (75 compared with 63%). By 4 weeks, 81 and 72% of patients were free from epigastric pain. Analysis of diary cards showed significant differences in the median time to the first pain-free day (2 compared with 5 days; P 0.001) and complete pain relief (4 compared with 6 days; P 0.05) between the two regimens, respectively.Conclusion:A higher dose of ranitidine for the first week of therapy can expedite pain relief and increase the frequency of duodenal ulcer healing after 4 weeks of treatment.
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