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Histamine-2-receptor antagonists are commonly used for esophageal reflux. It is unclear whether doses that suppress acid secretion over a 24-hour period are necessary to achieve relief or promote healing of esophagitis. This double-blind study randomized 338 patients with esophageal reflux and heartburn to receive either 20 mg of the H2 blocker famotidine twice daily, a single 40-mg dose of famotidine at bedtime, or placebo. Because famotidine suppresses acid secretion for about 12 hours, only the twice-daily regimen would be expected to provide acid suppression around the clock.
At 2, 6, and 12 weeks, the two famotidine groups had similar improvement in symptoms, and both regimens were significantly better than placebo. Twice-daily famotidi…