cimetidine

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cimetidine

 [si-met´ĭ-dēn]
an antagonist of histamine H2receptors, inhibiting the action of histamine at cell surface receptors of the gastric parietal cells and reducing basal gastric acid secretion and secretion stimulated by food, histamine, gastrin, caffeine, and insulin. It is used for the short-term (two months) treatment and, at reduced dosage, the long-term prevention of peptic ulcers, for the relief of symptoms associated with hyperacidity, such as heartburn and acid indigestion, and for the treatment of gastroesophageal reflux disease, upper gastrointestinal bleeding, and pathological hypersecretory conditions such as zollinger-ellison syndrome. Treatment of peptic ulcer with cimetidine brings prompt relief and speeds ulcer healing. Antacids are also taken as needed for relief of pain. Cimetidine is used as the base or the hydrochloride salt, administered orally, intramuscularly, or intravenously.

cimetidine

Apo-Cimetidine (CA), Dyspamet (UK), Galenmet (UK), Novo-Cimetine (CA), Nu-Cimet (CA), Tagamet HB

Pharmacologic class: Histamine2-receptor antagonist

Therapeutic class: Antiulcer drug

Pregnancy risk category B

Action

Competitively inhibits histamine action at histamine2-receptor sites of gastric parietal cells, thereby inhibiting gastric acid secretion

Availability

Oral liquid: 200 mg/5 ml, 300 mg/5 ml

Tablets: 200 mg, 300 mg, 400 mg, 600 mg, 800 mg

Indications and dosages

Active duodenal ulcer (short-term therapy)

Adults and children older than age 16: 800 mg P.O. at bedtime, or 300 mg P.O. q.i.d. with meals and at bedtime, or 400 mg P.O. b.i.d. Maintenance dosage is 400 mg P.O. at bedtime.

Active benign gastric ulcer (short-term therapy)

Adults and children older than age 16: 800 mg P.O. at bedtime or 300 mg P.O. q.i.d. with meals and at bedtime

Gastric hypersecretory conditions (such as Zollinger-Ellison syndrome); intractable ulcers

Adults and children older than age 16: 300 mg P.O. q.i.d. with meals and at bedtime

Erosive gastroesophageal reflux disease

Adults and children older than age 16: 1,600 mg P.O. daily in divided doses (800 mg b.i.d. or 400 mg q.i.d.) for 12 weeks

Heartburn; acid indigestion

Adults and children older than age 16: 200 mg (two tablets of over-the-counter product only) P.O. up to b.i.d. Give maximum dosage no longer than 2 weeks continuously, unless directed by prescriber.

Dosage adjustment

• Renal impairment

Off-label uses

• Acetaminophen overdose
• Adjunctive therapy in burns
• Barrett's esophagus
• Renal cancer
• Anaphylaxis

Contraindications

• Hypersensitivity to drug
• Alcohol intolerance

Precautions

Use cautiously in:
• renal impairment
• elderly patients
• pregnant or breastfeeding patients.

Administration

• Give with meals.

Adverse reactions

CNS: confusion, dizziness, drowsiness, hallucinations, agitation, psychosis, depression, anxiety, headache

GI: diarrhea

GU: reversible erectile dysfunction, gynecomastia

Interactions

Drug-drug.Calcium channel blockers, carbamazepine, chloroquine, lidocaine, metformin, metronidazole, moricizine, pentoxifylline, phenytoin, propafenone, quinidine, quinine, some benzodiazepines, some beta-adrenergic blockers (chlordiazepoxide, diazepam, midazolam), sulfonylureas, tacrine, theophylline, triamterene, tricyclic antidepressants, valproic acid, warfarin: decreased metabolism of these drugs, possible toxicity

Drug-diagnostic tests.Creatinine, transaminases: increased levels

Parathyroid hormone: decreased level Skin tests using allergenic extracts: false-negative results (drug should be discontinued 24 hours before testing)

Drug-food.Caffeine-containing foods and beverages (such as coffee, chocolate): increased cimetidine blood level, increased risk of toxicity

Drug-herbs.Pennyroyal: change in formation rate of herb's toxic metabolite

Yerba maté: decreased yerba maté clearance, possible toxicity

Drug-behaviors.Alcohol use: increased blood alcohol level

Smoking: reversed cimetidine effects

Patient monitoring

• Monitor creatinine levels in patients with renal insufficiency or failure.
• Assess elderly or chronically ill patients for confusion (which usually resolves once drug therapy ends).

Patient teaching

• Inform patient with gastric ulcer that ulcer may take up to 2 months to heal. Advise him not to discontinue therapy, even if he feels better, without first consulting prescriber. Ulcer may recur if therapy ends too soon.
• Advise patient not to take over-the-counter cimetidine for more than 2 weeks continuously, except with prescriber's advice and supervision.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

ci·met·i·dine

(si-met'i-dēn),
A histamine analogue and antagonist used to treat peptic ulcer and hypersecretory conditions by blocking histamine H2 receptor sites, thus inhibiting gastric acid secretion.

cimetidine

/ci·met·i·dine/ (si-met´ĭ-dēn) a histamine H2 receptor antagonist, which inhibits gastric acid secretion; used as the base or the monohydrochloride salt in the treatment and prophylaxis of gastric or duodenal ulcers, gastroesophageal reflux disease, upper gastrointestinal bleeding, and conditions associated with gastric hypersecretion.

cimetidine

(sĭ-mĕt′ĭ-dēn′, -dīn′)
n.
A histamine receptor antagonist, C10H16N6S, that inhibits acid secretion in the stomach and is used to treat duodenal and gastric ulcers and gastroesophageal reflux disease.

cimetidine

[simet′idēn]
an H2-receptor antagonist.
indications It is prescribed to inhibit the production and secretion of acid in the stomach in the treatment of gastroesophageal reflux disease, pancreatitis, duodenal ulcers, and hypersecretory conditions. It is also used in the treatment of warts.
contraindication Known hypersensitivity to this drug prohibits its use.
adverse effects Among the more serious adverse reactions are diarrhea, dizziness, rash, confusion (usually in elderly patients given large doses), and gynecomastia. Cimetidine inhibits several forms of cytochrome P450 and, therefore, has effects on many other drugs.

cimetidine

Tagamet Clinical therapeutics An H2-receptor antagonist used to treat peptic ulcer disease Adverse reactions Diarrhea, headache, drowsiness, fatigue, muscle pain, constipation; rarely mental confusion, agranulocytosis, gynecomastia, impotence, allergic reactions, myalgias, tachycardia, arrhythmias, interstitial nephritis, mild ↑ in creatinine. See Histamine receptor antagonists.

ci·met·i·dine

(si-met'i-dēn)
A histamine analogue and antagonist used to treat peptic ulcer and hypersecretory conditions by blocking histamine H2 receptor sites, thus inhibiting gastric acid secretion.

cimetidine

A histamine H-2 receptor antagonist drug used to limit acid production in the stomach in cases of peptic ulcer. The drug is on the WHO official list. Brand names are Tagamet, Dyspamet, Galenamet, and Zita.

ci·met·i·dine

(si-met'i-dēn)
Histamine analogue and antagonist used to treat peptic ulcer and hypersecretory conditions.

cimetidine (simet´idēn´),

n brand names: Tagamet, Apo-Cimetidine;
drug class: H2-histamine receptor antagonist;
action: inhibits histamine at H2-histamine receptor site in parietal cells, which inhibits gastric acid secretion;
uses: short-term treatment of duodenal and gastric ulcers by the control of hyperacidity.

cimetidine

a histamine H2-receptor antagonist that inhibits the action of histamine at cell surface receptors of the gastric parietal cells and reduces basal gastric acid secretion and secretion stimulated by food, histamine, gastrin and insulin. It is used for short-term treatment of peptic ulcer and for treatment of pathological hypersecretory conditions.