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The Carbonate Affair: Chalk One Up

Charles B. Clayman, MD
JAMA. 1980;244(22):2554. doi:10.1001/jama.1980.03310220052030.
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Aluminum magnesium antacids have achieved widespread acceptance over the past 15 to 20 years. Before that, the Sippy regimen of milk and calcium magnesium antacids were the primary agents used in the treatment of acid-peptic disorders. Today, cimetidine has the spotlight. Comparing antacids with cimetidine in the treatment of peptic ulcer has not produced a clear-cut choice, but it has reawakened the present generation of physicians to the effectiveness of antacids.1,2

The clinical choice of a therapeutic agent, as always, is one that is individualized and balances benefits with adverse effects. In comparing the side effects of these agents, we note the low level of toxicity with the short-term use of cimetidine. Agranulocytosis, diminished sperm counts, and other antiandrogenic effects, as well as confusional states in the elderly (some with renal impairment), have been reported infrequently. We cannot yet speak of the potential adverse effects of cimetidine over the


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