Intravenous pantoprazole versus famotidine for epigastric pain in the emergency department: A triple-blind randomized clinical trial

Objective: To compare the therapeutic efficacy of intravenous pantoprazole and famotidine for the treatment of epigastric pain in patients presenting to the emergency department. Methods: In this triple-blind randomized clinical trial, eligible patients presenting with epigastric pain were randomly assigned to receive intravenous pantoprazole or famotidine. Block randomization was used, and patients, treating physicians, and outcome assessors were blinded to treatment allocation. Pain intensity was assessed at baseline and at 30 and 60 minutes after drug administration. Results: Eighty patients were enrolled, with a mean age of 36.6 years (SD, 15.0), and 42.5% were male. Mean pain scores decreased significantly over time in both treatment groups. In the pantoprazole group, pain scores declined from 8.02±1.28 at baseline to 4.75±1.31 at 30 minutes and 1.62±1.29 at 60 minutes, whereas in the famotidine group scores decreased from 8.12±1.48 to 5.37±1.23 and 2.35±1.54, respectively. There was no significant difference in baseline pain scores between groups ( P =.92). Pantoprazole resulted in greater pain reduction compared with famotidine at both 30 minutes ( P =.04) and 60 minutes ( P =.05). Conclusions: Both medications were effective in relieving epigastric pain; however, pantoprazole provided greater and more sustained pain reduction, supporting its preferential use in emergency settings.