Cimetidine and Acute Upper Gastrointestinal Bleeding: A Double-blind Controlled Trial

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Abstract
Patients presenting with acute upper gastrointestinal bleeding from a variety of lesions were admitted to a prospective double-blind controlled trial to determine if cimetidine reduces the severity of bleeding and/or the incidence of rebleeding. During the first 48 h, the patients received i.v. cimetidine (200 mg 4-hourly) or placebo, and for the following 10 days, oral cimetidine (1 g/24 h) or placebo. Patients (88) entered the trial of whom 45 (51%) were in the cimetidine-treated group. Six of the 7 patients requiring surgery for life-threatening bleeding, and 4 of the 6 patients who rebled were in the cimetidine-treated group. An advantage of using cimetidine routinely in the treatment of acute upper gastrointestinal bleeding was not demonstrated.