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H2 Receptor Antagonists

Arch Intern Med. 1990;150(11):2408. doi:10.1001/archinte.1990.00390220136031.
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To the Editor. —I read with interest the review article by Lipsy et al1 on histamine 2 receptor antagonists that appeared in the April issue of the Archives. I applaud the concise and usable nature with which the information was presented. I would like to add an additional piece of information to their review. The authors state that "ranitidine does not seem to cause... gynecomastia...." I am aware of a single case of ranitidine-associated gynecomastia reported by Tosi and Cagnoli.2 These authors describe a patient with painful gynecomastia associated with ranitidine therapy. The patient was a 69-year-old man with rheumatoid arthritis and a history of peptic ulcer disease. He was being treated with triamcinolone, diclofenac, and ranitidine daily. After 8 days of ranitidine therapy (150 mg/d), he had palpable, tender gynecomastia. The ranitidine therapy was discontinued and symptoms resolved over the next 15 days. He was later rechallenged


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