Cimetidine and acute upper gastrointestinal bleeding: a double-blind controlled trial

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 hours, the patients received intravenous cimetidine (200 mg four-hourly) or placebo, and for the following ten days, oral cimetidine (1 g/24 hr) or placebo. Eight-eight patients entered the trial of whom 45 (51%) were in the cimetidine-treated group. Six of the seven patients requiring surgery for life-threatening bleeding and four of the six patients who rebled were in the cimetidine-treated group. This study failed to demonstrate any advantage of using cimetidine routinely in the treatment of acute upper gastrointestinal bleeding.