Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, June 21, 1995                   TAG: 9506210098
SECTION: BUSINESS                    PAGE: B-6   EDITION: METRO 
SOURCE: SANDRA BROWN KELLY
DATELINE:                                 LENGTH: Medium

A NEW WEAPON IS OFFERED TO SUFFERERS OF HEARTBURN

The Food and Drug Administration this week gave approval for the company to market Tagamet as an over-the-counter treatment for heartburn and acid indigestion.

Not only does this give heartburn sufferers another option, it creates a huge financial opportunity for the manufacturer. It's estimated that 25 million people have heartburn daily, and SmithKline, the Philadelphia-based U.S. unit of the British drugmaker, hopes to help them. The anti-ulcer medication became the world's top-selling drug in 1981.

Tuesday, the company heated up the fax wires and overnight delivery service with material publicizing the FDA's OK and hailing the advantages of Tagamet HB, the name for the nonprescription version. Tagamet HB is due on the shelves by early fall, and you can bet it will be positioned near its competitor Pepcid, by Merck & Co., which also recently got approval for over-the-counter sales.

Tagamet, or its generic version, cimetidine, was the first drug of its kind and has an interesting history. In 1963, British researcher Dr. James Black was hired as chief of pharmacology at the Welwyn Research Institute in Welwyn Garden City, England. About the same time, Smith Kline & French laboratories, predecessor company to SmithKline, gave Welwyn money to develop anti-ulcer compounds.

Black, in his research on messenger-receptor chemistry, had developed a new class of drugs called beta blockers to control high blood pressure. He believed stomach acid could be controlled with a medicine that interfered with the production of acid.

This was a different theory than that of early anti-ulcer research, which focused on neutralizing stomach acid and resulted in Maalox in 1946 and Mylanta in 1961.

Tagamet was introduced in Great Britain in 1976 and in the United States a year later. In 1988, Black won the Nobel Prize for physiology or medicine for discovery of principles for drug treatment.

Other medicines that work like Tagamet are Zantac, Axid and Pepcid.

The over-the-counter drug is intended as a substitute for the drugs chronic heartburn sufferers already take, said Dr. Robert Palmer, a gastroenterologist who is on the drug company's staff. But people with new symptoms of heartburn should see a doctor before they start self-medicating.

Any long-term heartburn should be discussed with a doctor, too, because it can cause the lining of the esophagus to become inflamed. Tagamet HB will carry the instructions that anyone using it should see a physician.

The OTC version is for new customers, not for people already taking the drug for a stomach condition. Heartburn sufferers probably will continue to find the prescription version the most economical, even though a prescription of 100 tablets might cost as much as $80. It would take a volume of the over-the-counter version to match most prescribed dosages for prescription Tagamet, which are 300 and 400 milligrams.

And if you'd rather avoid medications as much as possible, SmithKline offers these tips about heartburn, which can be identified by a burning sensation and a feeling of fullness in the middle of the chest and a bitter acid taste in the mouth or throat.

nKnow that some products, such as fatty or greasy foods, whole-milk dairy products, chocolate and nuts relax the lower esophageal sphincter and can allow acid into the throat. Also, remember that alcohol, tomato products and citrus juices irritate the esophagus. And, beverages with caffeine, milk or cream produce stomach acid and gas.

nExercise can cause heartburn even if food has not been eaten recently.

nYou can ease discomfort of heartburn by elevating the head of your bed and by sleeping on your left side. That position helps because the stomach is lower, meaning it becomes more difficult for the acid to get into the esophagus.

Also, sometimes if you take a deep breath and forget about it, heartburn will go away. That bit of advice comes from me.

Kelly can be reached at 981-3393, or by writing her at P.O. Box 2491, Roanoke 24010-2491, or through electronic mail at sandrakinfi.net.