The Use of Cimetidine in the Newborn

Abstract

Although uncommon, reflux esophagitis and gastric and duodenal ulcer disease have all been reported to occur in the newborn period.1,2 Cimetidine, a competitive antagonist specific for the histamine H2-receptor, has been demonstrated effective in reducing gastric acidity in the adult. Its neonatal use has not been reported. The following cases suggest that cimetidine may be beneficial for the newborn with such disorders. CASE REPORTS Case 1 Baby L. weighed 740 gm at birth, was at 28 weeks gestation, and had prolonged, severe respiratory illness requiring ventilatory assistance. Repeated attempts at feedings, which began at 6 weeks of age, were associated with regurgitation, abdominal distention, and melenetic gastric aspirates. An upper gastrointestinal (GI) x-ray series confirmed reflux esophagitis. At 8 weeks of age cimetidine treatment was started at a dose of 10 mg/kg/day. The drug was continued for three weeks. Within one week of the initiation of cimetidine therapy, there was a significant reduction in the frequency of vomiting and abdominal distention and the upper GI bleeding disappeared. There were no neurologic abnormalities noted on serial examinations performed during cimetidine therapy. There were also no changes in renal and liver function studies, or hematologic values associated with drug use. Case 2 Baby G. was born at 27 weeks gestation and weighed 820 gm. He had severe respiratory distress and required ventilatory assistance. At 3 weeks of age, bronchopulmonary dysplasia was diagnosed by x-ray and by tracheal cytology. Because of clinical deterioration from this process, the baby was started on therapy with corticosteroids at 24 days of age.