Ichiro Yoshikawa, MD; Ikuo Murata, MD; Makoto Otsuki, MD
Yoshikawa I, Murata I, Otsuki M. Over-the-Counter Availability of H2-Receptor Antagonists and Gastric Cancer. Ann Intern Med. 2000;133:659. doi: 10.7326/0003-4819-133-8-200010170-00026
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Published: Ann Intern Med. 2000;133(8):659.
TO THE EDITOR:
Prescription medications have been switched to over-the-counter status with increasing frequency. One of the most important categories transferred to over-the-counter status is the H2-receptor antagonist. However, these drugs may mask the symptom of gastric cancer. Taylor and colleagues (1) reported that relief of the symptoms of malignant gastric ulcers by cimetidine may delay diagnosis and appropriate treatment.
A 63-year-old Japanese man had received H2-receptor antagonists for gastric ulcer when he was 50 years of age. He self-diagnosed his condition as recurrent gastric ulcer and took over-the-counter H2-receptor antagonists. His symptom was immediately relieved with the maximum daily dosage of the drug, and it recurred after he discontinued using the medication. The patient purchased the medication many times at several different pharmacies. He took the drug for 4 months continuously, disregarding warnings on the label. His family advised him to consult a physician, and he presented to our hospital.
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