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September 18, 1996

Effects of Famotidine vs Antacid on Gastric Acidity: Onset of Action and Symptom Relief-Reply

Author Affiliations

Veterans Affairs Medical Center Dallas, Tex

JAMA. 1996;276(11):874. doi:10.1001/jama.1996.03540110028025

In Reply.  —As indicated in the acknowledgment section of my article, this study was designed with help from Dr Decktor himself. The study was a pharmacodynamic investigation in normal volunteers and not a symptom-relief study in patients with heartburn. Drs Decktor and Ciccone cite internal documents that suggest the onset of action of 10 mg of famotidine for significant heartburn relief may be more rapid than the onset of action for significant acid reduction in my pharmacodynamic study. Apparent onset of action is related not only to experimental design, but also to sample size. In my pharmacodynamic study (n=18) and that of Laskin et al1 (n=2), apparent onset of action with 10 mg of famotidine was approximately 90 minutes. In the personal communication and internal report referred to by Decktor and Ciccone, sample size was much larger, perhaps making it easier to show significant differences between placebo and famotidine at earlier