DANIEL B. FISHBEIN, M.D.; JOSEPH E. MCDADE, Ph.D.
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To the editor: We regret that Dr. Souza Lima's review (1) was incomplete and his deductions were invalid. The evidence from worldwide clinical experience shows that hepatitis is rarely associated with H2-antagonists and that the clinical characteristics are similar with ranitidine and cimetidine. Ranitidine was not hepatotoxic in rodents treated for over 2 years at doses 800 times higher than therapeutic ones. The clinical case reports also indicate a hypersensitivity reaction, rather than direct liver toxicity.
The relative rate of occurrence of hepatitis with the two drugs can best be estimated from comparative clinical trials. The Glaxo research organization has
FISHBEIN DB, MCDADE JE. H2-Antagonists and Hepatitis. Ann Intern Med. ;105:803. doi: 10.7326/0003-4819-105-5-803_1
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Published: Ann Intern Med. 1986;105(5):803.
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