Omeprazole in the acute treatment of gastric ulcer

Antisecretory drugs are known to be valuable in the treatment of gastric ulcer. Recent studies have shown that this also holds true for omeprazole, the most effective antisecretory drugs currently available. At 30-40 mg once daily omeprazole provides cumulative healing rates of up to 100% after 4-8 weeks. In one study, omeprazole, 20 mg, and ranitidine, 150 mg b.d., produced similar healing rates in the acute treatment of gastric ulcer, though there was a tendency towards more rapid healing with omeprazole. In a more recent multicentre study including more than 600 patients, significantly more ulcers healed after 4 weeks with omeprazole, both 20 mg and 40 mg once daily, than with ranitidine, 150 mg b.d. Omeprazole was also superior to ranitidine with respect to relief of night-time pain and in gastric ulcer healing during concomitant therapy with non-steroidal anti-inflammatory drugs. After omeprazole therapy, the proportion of patients in remission during the following half-year period was higher than after ranitidine, arguing against the hypothesis that rapid ulcer healing following more effective inhibition of acid secretion might be of lower quality. During acute therapy, no drug-specific serious side-effects occurred. Omeprazole is a valuable alternative in modern treatment of gastric ulcer, being superior to histamine H2-receptor antagonists.