To the Editor.
—The article by Dr Feldman1 compares the acid-reducing capacities of over-the-counter famotidine with calcium carbonate antacid. We have confidence in Feldman's overall findings as they pertain to the relative duration of effects of each agent on gastric acidity; however, one should exercise great caution before extrapolating the findings from a highly controlled, pharmacodynamic assessment of gastric acidity to an interpretation of clinically relevant symptom relief.The results of several large symptom-based heartburn studies contradict the reported delayed onset of famotidine's antisecretory action in the article by Feldman. These studies clearly demonstrated the efficacy of low-dose famotidine both in treating and in preventing heartburn symptoms in a far earlier time frame than suggested by Feldman's pharmacodynamic data. In 2 such studies2 (N. Laird, PhD, written communication, March 26, 1996), data collected from 1100 patients with heartburn demonstrated significant symptom relief (vs placebo) as early as 15
Decktor DL, Ciccone PE. Effects of Famotidine vs Antacid on Gastric Acidity: Onset of Action and Symptom Relief. JAMA. 1996;276(11):873-874. doi:10.1001/jama.1996.03540110027024