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To the Editor.—
The introduction of cimetidine for the treatment of duodenal ulcer and pathological hypersecretory conditions represents an important therapeutic breakthrough. We came across two statements made by Charles B. Clayman, MD, in his "Evaluation of Cimetidine (Tagamet)" (238:1289, 1977) that we feel deserve comment. Dr Clayman states, "Cimetidine does cross the placenta and is excreted in maternal milk." To date, we are not aware of any studies to document the excretion of cimetidine in human breast milk. While it has been shown that cimetidine is excreted in the maternal milk of certain animal species (Dr Hoppe, personal communication, Sept 28, 1977), the implication that the same is true in humans is misleading in the absence of supporting studies.In addition, Dr Clayman states, "In general, 200 to 300 mg [of cimetidine] is administered orally with or immediately after meals and at bedtime for three to six weeks." However,
Karpow S, Gotz V, Lauper RD. Cimetidine. JAMA. 1978;239(5):402. doi:10.1001/jama.1978.03280320018006