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Pronunciation
(sye MET i deen)
Generic Available (U.S.)
Yes
U.S. Brand Names
Canadian Brand Names
Pharmacologic Category
Pharmacologic Category Synonyms
Use: Labeled Indications
Short-term treatment of active duodenal ulcers and benign gastric ulcers; maintenance therapy of duodenal ulcer; treatment of gastric hypersecretory states; treatment of gastroesophageal reflux disease (GERD)
OTC labeling: Prevention or relief of heartburn, acid indigestion, or sour stomach
Use: Unlabeled/Investigational
Part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence
Pregnancy Risk Factor
B
Pregnancy Considerations
Teratogenic effects were not observed in animal reproduction studies; therefore, cimetidine is classified as pregnancy category B. Cimetidine crosses the placenta. An increased risk of congenital malformations or adverse events in the newborn has generally not been observed following maternal use of cimetidine during pregnancy. Histamine H2 antagonists have been evaluated for the treatment of gastroesophageal reflux disease (GERD), as well as gastric and duodenal ulcers during pregnancy. Although if needed, cimetidine is not the agent of choice. Histamine H2 antagonists may be used for aspiration prophylaxis prior to cesarean delivery.
Lactation
Enters breast milk/not recommended (AAP rates “compatible”; AAP 2001 update pending)
Breast-Feeding Considerations
Cimetidine is excreted into breast milk. The concentration of cimetidine in maternal serum in comparison to breast milk is highly variable. Breast-feeding is not recommended by the manufacturer. Consider the renal function of the breast-feeding infant.
Contraindications
Hypersensitivity to cimetidine, any component of the formulation, or other H2 antagonists
Warnings/Precautions
Concerns related to adverse effects:
• Confusion: Reversible confusional states, usually clearing within 3-4 days after discontinuation, have been linked to use. Increased age (>50 years) and renal or hepatic impairment are thought to be associated.
Disease-related concerns:
• Gastric malignancy: Relief of symptoms does not preclude the presence of a gastric malignancy.
• Hepatic impairment: Use with caution in patients with hepatic impairment; dosage adjustment recommended.
• Renal impairment: Use with caution in patients with renal impairment; dosage adjustment recommended.
Concurrent drug therapy issues:
• Drugs metabolized through P450 system: Dosage should be adjusted in patients receiving drugs metabolized through the P450 system.
Special populations:
• Elderly: May be inappropriate in this age group due to risk of confusion and other CNS effects (Beers Criteria).
Other warnings/precautions:
• OTC labeling: Should not be taken by individuals experiencing painful swallowing, vomiting with blood, or bloody or black stools; medical attention should be sought. A healthcare provider should be consulted prior to use when pain in the stomach, shoulder, arms or neck is present; if heartburn has occurred for >3 months; or if unexplained weight loss, or nausea and vomiting occur. Frequent wheezing, shortness of breath, lightheadedness, or sweating, especially with chest pain or heartburn, should also be reported. Consultation of a healthcare provider should occur by patients if also taking theophylline, phenytoin, or warfarin; if heartburn or stomach pain continues or worsens; or if use is required for >14 days. OTC cimetidine is not approved for use in patients <12 years of age.
Adverse Reactions
1% to 10%:
Central nervous system: Headache (2% to 4%), dizziness (1%), somnolence (1%), agitation
Endocrine & metabolic: Gynecomastia (<1% to 4%)
Gastrointestinal: Diarrhea (1%)
Frequency not defined:
Cardiovascular: AV block, bradycardia, hypotension, tachycardia, vasculitis
Central nervous system: Confusion, fever
Dermatologic: Alopecia, erythema multiforme, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, rash
Endocrine & metabolic: Edema of the breasts, sexual ability decreased
Gastrointestinal: Nausea, pancreatitis, vomiting
Hematologic: Agranulocytosis, aplastic anemia, hemolytic anemia (immune-based), neutropenia, pancytopenia, thrombocytopenia
Hepatic: ALT increased, AST increased, hepatic fibrosis (case report)
Neuromuscular & skeletal: Arthralgia, myalgia, polymyositis
Renal: Creatinine increased, interstitial nephritis
Miscellaneous: Anaphylaxis, pneumonia (causal relationship not established)
Metabolism/Transport Effects
Substrate of P-glycoprotein; Inhibits CYP1A2 (moderate), 2C9 (weak), 2C19 (moderate), 2D6 (moderate), 2E1 (weak), 3A4 (moderate)
Drug Interactions
Alfentanil: Cimetidine may increase the serum concentration of Alfentanil. Risk C: Monitor therapy
Amiodarone: Cimetidine may increase the serum concentration of Amiodarone. Management: Consider alternatives to cimetidine. If this combination cannot be avoided, monitor for increased amiodarone concentrations/effects with cimetidine initiation/dose increase or decreased concentrations/effects with cimetidine discontinuation/dose decrease. Risk D: Consider therapy modification
Anticonvulsants (Hydantoin): Cimetidine may decrease the metabolism of Anticonvulsants (Hydantoin). Exceptions: Ethotoin. Risk D: Consider therapy modification
Atazanavir: H2-Antagonists may decrease the absorption of Atazanavir. Management: Specific dose limitations and administration guidelines exist; consult full interaction monograph or atazanavir prescribing information. Risk D: Consider therapy modification
Benzodiazepines (metabolized by oxidation): Cimetidine may decrease the metabolism of Benzodiazepines (metabolized by oxidation). Risk C: Monitor therapy
Bromazepam: Cimetidine may increase the serum concentration of Bromazepam. Management: Consider use of bromazepam with an H2-antagonist that is not a potent CYP inhibitor (e.g., ranitidine) or alternatively, consider use of cimetidine with a benzodiazepine that does not undergo oxidative metabolism (e.g., lorazepam). Risk D: Consider therapy modification
Budesonide (Systemic, Oral Inhalation): CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Budesonide (Systemic, Oral Inhalation). Management: Consider reducing the oral budesonide dose when used together with a CYP3A4 inhibitor. This interaction is likely less severe with orally inhaled budesonide. Monitor patients closely for signs/symptoms of corticosteroid excess. Risk D: Consider therapy modification
Calcium Channel Blockers: Cimetidine may decrease the metabolism of Calcium Channel Blockers. Exceptions: AmLODIPine; Clevidipine; NiCARdipine. Risk D: Consider therapy modification
CarBAMazepine: Cimetidine may increase the serum concentration of CarBAMazepine. The serum carbamazepine concentration might return to normal within one week of starting cimetidine. Risk C: Monitor therapy
Carmustine: Cimetidine may decrease the metabolism of Carmustine. Risk C: Monitor therapy
Carvedilol: Cimetidine may increase the serum concentration of Carvedilol. Risk C: Monitor therapy
Cefditoren: H2-Antagonists may decrease the serum concentration of Cefditoren. Management: Concomitant use of cefditoren with H2-antagonists and antacids is not recommended. Consider alternative methods to control acid reflux (eg, diet modification) or alternative antimicrobial therapy if use of H2-antagonists can not be avoided. Risk D: Consider therapy modification
Cefpodoxime: H2-Antagonists may decrease the absorption of Cefpodoxime. Separate oral doses by at least 2 hours. Risk C: Monitor therapy
Cefuroxime: H2-Antagonists may decrease the absorption of Cefuroxime. Separate oral doses by at least 2 hours. Risk C: Monitor therapy
Cisapride: Cimetidine may increase the serum concentration of Cisapride. Management: Consider alternatives to cimetidine. If this combination cannot be avoided, monitor for toxic effects of cisapride if cimetidine is initiated/dose increased, or decreased efficacy if cimetidine is discontinued/dose decreased. Risk D: Consider therapy modification
Clopidogrel: CYP2C19 Inhibitors (Moderate) may decrease serum concentrations of the active metabolite(s) of Clopidogrel. Risk X: Avoid combination
CloZAPine: Cimetidine may increase the serum concentration of CloZAPine. Management: Consider use of an alternative H2 antagonist. Monitor for increased toxic effects of clozapine if cimetidine is initiated/dose increased, or decreased effects if cimetidine is discontinued/dose decreased. Risk D: Consider therapy modification
Colchicine: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Colchicine. Management: Reduce colchicine dose as directed when using with a moderate CYP3A4 inhibitor, and increase monitoring for colchicine-related toxicity. Use extra caution in patients with impaired renal and/or hepatic function. Risk D: Consider therapy modification
CYP1A2 Substrates: CYP1A2 Inhibitors (Moderate) may decrease the metabolism of CYP1A2 Substrates. Risk C: Monitor therapy
CYP2C19 Substrates: CYP2C19 Inhibitors (Moderate) may decrease the metabolism of CYP2C19 Substrates. Risk C: Monitor therapy
CYP2D6 Substrates: CYP2D6 Inhibitors (Moderate) may decrease the metabolism of CYP2D6 Substrates. Exceptions: Tamoxifen. Risk C: Monitor therapy
CYP3A4 Substrates: CYP3A4 Inhibitors (Moderate) may decrease the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
Dasatinib: H2-Antagonists may decrease the absorption of Dasatinib. Risk D: Consider therapy modification
Delavirdine: H2-Antagonists may decrease the serum concentration of Delavirdine. Management: Chronic therapy with H2-antagonists should be avoided in patients who are being treated with delavirdine. The clinical significance of short-term H2-antagonist therapy with delavirdine is uncertain, but such therapy should be undertaken with caution. Risk X: Avoid combination
Dexmethylphenidate: H2-Antagonists may increase the absorption of Dexmethylphenidate. Specifically, H2-antagonists may interfere with the normal release of drug from the extended-release capsules (Focalin XR brand), which could result in both increased absorption (early) and decreased delayed absorption. Risk C: Monitor therapy
Dofetilide: Cimetidine may increase the serum concentration of Dofetilide. This is likely via inhibition of dofetilide renal tubular secretion (primarily) and inhibition of dofetilide metabolism. Risk X: Avoid combination
Epirubicin: Cimetidine may increase the serum concentration of Epirubicin. Risk X: Avoid combination
Eplerenone: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Eplerenone. Management: A lower starting dose of eplerenone (25 mg once daily for adults) is recommended in patients with hypertension who are also taking drugs that are moderate inhibitors of CYP3A4. Risk D: Consider therapy modification
Erlotinib: H2-Antagonists may decrease the serum concentration of Erlotinib. Risk X: Avoid combination
Everolimus: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Everolimus. Management: Everolimus dose reductions are required for patients being treated for subependymal giant cell astrocytoma or renal cell carcinoma. See prescribing information for specific dose adjustment and monitoring recommendations. Risk D: Consider therapy modification
Fesoterodine: CYP2D6 Inhibitors may increase serum concentrations of the active metabolite(s) of Fesoterodine. Risk C: Monitor therapy
Fosamprenavir: H2-Antagonists may decrease the serum concentration of Fosamprenavir. Cimetidine may also inhibit the metabolism of the active metabolite amprenavir, making its effects on fosamprenavir/amprenavir concentrations difficult to predict. Risk C: Monitor therapy
Gefitinib: H2-Antagonists may decrease the serum concentration of Gefitinib. Risk C: Monitor therapy
Halofantrine: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Halofantrine. Risk D: Consider therapy modification
Indinavir: H2-Antagonists may decrease the serum concentration of Indinavir. Risk C: Monitor therapy
Iron Salts: H2-Antagonists may decrease the absorption of Iron Salts. Exceptions: Ferric Gluconate; Ferumoxytol; Iron Dextran Complex; Iron Sucrose. Risk C: Monitor therapy
Itraconazole: H2-Antagonists may decrease the serum concentration of Itraconazole. Management: When this combination is used, the itraconazole should be administered with a cola beverage (8 ounces). Itraconazole oral suspension may be less sensitive to this interaction. Monitor patient response to itraconazole closely. Risk D: Consider therapy modification
Ketoconazole: H2-Antagonists may decrease the serum concentration of Ketoconazole. Management: Administer oral ketoconazole at least 2 hours prior to use of any H2-receptor antagonist. Monitor patients closely for signs of inadequate clinical response to ketoconazole. Risk D: Consider therapy modification
Ketoconazole (Systemic): H2-Antagonists may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer oral ketoconazole at least 2 hours prior to use of any H2-receptor antagonist. Monitor patients closely for signs of inadequate clinical response to ketoconazole. Risk D: Consider therapy modification
Lurasidone: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Lurasidone. Risk D: Consider therapy modification
Mesalamine: H2-Antagonists may diminish the therapeutic effect of Mesalamine. Histamine H2-Antagonist-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Consider avoiding concurrent administration of high-dose histamine H2-receptor antagonists with sustained-release mesalamine products. Risk D: Consider therapy modification
MetFORMIN: Cimetidine may increase the serum concentration of MetFORMIN. Risk D: Consider therapy modification
Methylphenidate: H2-Antagonists may increase the absorption of Methylphenidate. Specifically, H2-antagonists may interfere with the normal release of drug from the extended-release capsules (Ritalin LA brand), which could result in both increased absorption (early) and decreased delayed absorption. Risk C: Monitor therapy
Moclobemide: Cimetidine may decrease the metabolism of Moclobemide. Risk D: Consider therapy modification
Nebivolol: CYP2D6 Inhibitors (Moderate) may increase the serum concentration of Nebivolol. Risk C: Monitor therapy
Nelfinavir: H2-Antagonists may decrease the serum concentration of Nelfinavir. Concentrations of the active M8 metabolite may also be reduced. Risk C: Monitor therapy
Nicotine: Cimetidine may increase the serum concentration of Nicotine. Risk C: Monitor therapy
Pentoxifylline: Cimetidine may increase the serum concentration of Pentoxifylline. Risk C: Monitor therapy
P-Glycoprotein Inducers: May decrease the serum concentration of P-Glycoprotein Substrates. P-glycoprotein inducers may also further limit the distribution of p-glycoprotein substrates to specific cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.). Risk C: Monitor therapy
P-Glycoprotein Inhibitors: May increase the serum concentration of P-Glycoprotein Substrates. P-glycoprotein inhibitors may also enhance the distribution of p-glycoprotein substrates to specific cells/tissues/organs where p-glycoprotein is present in large amounts (e.g., brain, T-lymphocytes, testes, etc.). Risk C: Monitor therapy
Pimecrolimus: CYP3A4 Inhibitors (Moderate) may decrease the metabolism of Pimecrolimus. Risk C: Monitor therapy
Posaconazole: H2-Antagonists may decrease the serum concentration of Posaconazole. Management: Avoid concurrent use whenever possible. Monitor patients closely for decreased antifungal effects if this combination is used. Consider using a noninteracting antifungal as appropriate. Risk D: Consider therapy modification
Pramipexole: Cimetidine may increase the serum concentration of Pramipexole. Risk C: Monitor therapy
Praziquantel: Cimetidine may increase the serum concentration of Praziquantel. Risk C: Monitor therapy
Procainamide: Cimetidine may decrease the excretion of Procainamide. Risk D: Consider therapy modification
Propafenone: Cimetidine may increase the serum concentration of Propafenone. Risk C: Monitor therapy
QuiNIDine: Cimetidine may increase the serum concentration of QuiNIDine. Management: Consider alternatives to cimetidine. If the combination cannot be avoided, monitor for increased quinidine concentrations/toxicity with cimetidine initiation/dose increase, or decreased concentrations/effects with cimetidine discontinuation/dose decrease. Risk D: Consider therapy modification
QuiNINE: Cimetidine may increase the serum concentration of QuiNINE. Risk D: Consider therapy modification
Ranolazine: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Ranolazine. Management: Limit the ranolazine adult dose to a maximum of 500 mg twice daily in patients concurrently receiving moderate CYP3A4 inhibitors (e.g., diltiazem, verapamil, erythromycin, etc.). Risk D: Consider therapy modification
Roflumilast: Cimetidine may increase serum concentrations of the active metabolite(s) of Roflumilast. Cimetidine may increase the serum concentration of Roflumilast. Risk C: Monitor therapy
Salmeterol: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Salmeterol. Risk C: Monitor therapy
Saquinavir: H2-Antagonists may increase the serum concentration of Saquinavir. Risk C: Monitor therapy
Saxagliptin: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Saxagliptin. Risk C: Monitor therapy
Selective Serotonin Reuptake Inhibitors: Cimetidine may decrease the metabolism of Selective Serotonin Reuptake Inhibitors. Risk D: Consider therapy modification
Sulfonylureas: Cimetidine may increase the serum concentration of Sulfonylureas. Risk C: Monitor therapy
Tamoxifen: CYP2D6 Inhibitors (Moderate) may decrease the metabolism of Tamoxifen. Specifically, CYP2D6 inhibitors may decrease the formation of highly potent active metabolites. Management: Consider alternatives with less of an inhibitory effect on CYP2D6 activity when possible. Risk D: Consider therapy modification
Theophylline Derivatives: Cimetidine may decrease the metabolism of Theophylline Derivatives. Exceptions: Dyphylline. Risk D: Consider therapy modification
Thioridazine: CYP2D6 Inhibitors may decrease the metabolism of Thioridazine. Risk X: Avoid combination
Tolvaptan: CYP3A4 Inhibitors (Moderate) may increase the serum concentration of Tolvaptan. Risk X: Avoid combination
Tricyclic Antidepressants: Cimetidine may decrease the metabolism of Tricyclic Antidepressants. Risk C: Monitor therapy
Vitamin K Antagonists (eg, warfarin): Cimetidine may enhance the anticoagulant effect of Vitamin K Antagonists. Risk D: Consider therapy modification
Zaleplon: Cimetidine may decrease the metabolism of Zaleplon. Risk D: Consider therapy modification
ZOLMitriptan: Cimetidine may increase the serum concentration of ZOLMitriptan. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Ethanol: Avoid ethanol (may enhance gastric mucosal irritation).
Food: Cimetidine may increase serum caffeine levels if taken with caffeine. Cimetidine peak serum levels may be decreased if taken with food.
Herb/Nutraceutical: St John's wort may decrease cimetidine levels.
Storage
Tablet: Store between 15°C and 30°C (59°F to 86°F). Protect from light.
Mechanism of Action
Competitive inhibition of histamine at H2 receptors of the gastric parietal cells resulting in reduced gastric acid secretion, gastric volume and hydrogen ion concentration reduced
Pharmacodynamics/Kinetics
Onset of action: 1 hour
Duration: 80% reduction in gastric acid secretion for 4-5 hours after 300 mg dose
Absorption: Rapid
Distribution: 1.3 L/kg
Protein binding: 20%
Metabolism: Partially hepatic, forms metabolites
Bioavailability: 60% to 70%
Half-life elimination: Neonates: 3.6 hours; Children: 1.4 hours; Adults: 2 hours
Time to peak, serum: Oral: 1-2 hours
Excretion: Primarily urine (48% as unchanged drug); feces (some)
Dosage
Oral:
Children: 20-40 mg/kg/day in divided doses every 6 hours
Children ≥12 years and Adults: Heartburn, acid indigestion, sour stomach (OTC labeling): 200 mg up to twice daily; may take 30 minutes prior to eating foods or beverages expected to cause heartburn or indigestion
Adults:
Short-term treatment of active ulcers: 300 mg 4 times/day or 800 mg at bedtime or 400 mg twice daily for up to 8 weeks
Note: Higher doses of 1600 mg at bedtime for 4 weeks may be beneficial for a subpopulation of patients with larger duodenal ulcers (>1 cm defined endoscopically) who are also heavy smokers (≥1 pack/day).
Duodenal ulcer prophylaxis: 400 mg at bedtime
Gastric hypersecretory conditions: 300-600 mg every 6 hours; dosage not to exceed 2.4 g/day
Gastroesophageal reflux disease: 400 mg 4 times/day or 800 mg twice daily for 12 weeks
Helicobacter pylori eradication (unlabeled use): 400 mg twice daily; requires combination therapy with antibiotics
Dosing adjustment/interval in renal impairment: Children and Adults:
Clcr 10-50 mL/minute: Administer 50% of normal dose
Clcr <10 mL/minute: Administer 25% of normal dose
Hemodialysis: Slightly dialyzable (5% to 20%); administer after dialysis
Dosing adjustment/comments in hepatic impairment: Usual dose is safe in mild liver disease but use with caution and in reduced dosage in severe liver disease; increased risk of CNS toxicity in cirrhosis suggested by enhanced penetration of CNS
Administration: Oral
Administer with meals so that the drug's peak effect occurs at the proper time (peak inhibition of gastric acid secretion occurs at 1 and 3 hours after dosing in fasting subjects and approximately 2 hours in nonfasting subjects. This correlates well with the time food is no longer in the stomach offering a buffering effect). Stagger doses of antacids with cimetidine.
Monitoring Parameters
CBC, gastric pH, occult blood with GI bleeding; monitor renal function to correct dose.
Patient Education
Take with meals. Avoid excess alcohol. May cause headache, dizziness, agitation, nausea, vomiting, or diarrhea. Report chest pain or palpitations; CNS changes (confusion, agitation); persistent diarrhea, nausea, vomiting, or heartburn; black tarry stools or coffee ground-like emesis; rash; unusual bleeding or bruising; sore throat; or fever; or unexplained weight loss.
Geriatric Considerations
Patients diagnosed with PUD should be evaluated for Helicobacter pylori. H2 blockers are the preferred drugs for treating PUD in elderly due to cost and ease of administration. These agents are no less or more effective than any other therapy. The preferred agents, due to favorable pharmacokinetic, side effect and drug interaction profiles are ranitidine, famotidine, and nizatidine. Due to the potential for confusion and drug interactions, cimetidine has been identified by a panel of experts as a drug to avoid in the elderly. Consider evaluating creatinine clearance before initiating H2-blocker therapy.
This medication is considered to be potentially inappropriate in this patient population (Beers Criteria severity: Low).
Cardiovascular Considerations
Cimetidine has extensive drug interactions, particularly with antiarrhythmics (lidocaine, phenytoin, procainamide, quinidine) and may also increase the likelihood of theophylline and cyclosporine toxicity. Because of inhibition of warfarin metabolism, cimetidine may increase INR in patients on anticoagulation therapy.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause agitation or drowsiness; rare reports of confusion
Mental Health: Effects on Psychiatric Treatment
Rare reports of agranulocytosis; use caution with clozapine and carbamazepine; may inhibit the metabolism of TCAs and benzodiazepines; monitor for adverse effects
Nursing: Physical Assessment/Monitoring
Use caution in presence of renal impairment. Monitor for CNS changes, agitation, and gastric bleeding regularly during therapy.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, oral, as hydrochloride [strength expressed as base]: 300 mg/5 mL (237 mL, 473 mL)
Tablet, oral: 200 mg, 300 mg, 400 mg, 800 mg
Tagamet HB 200®: 200 mg
Pricing: U.S. (www.drugstore.com)
Solution (Cimetidine HCl)
300 mg/5 mL (237): $35.55
Tablets (Cimetidine)
200 mg (30): $18.88
300 mg (180): $29.99
400 mg (90): $29.99
800 mg (30): $17.99
Extemporaneously Prepared
Note: Commercial oral solution is available (strength expressed as base: 60 mg/mL)
A 60 mg/mL oral suspension may be made with tablets. Place twenty-four 300 mg tablets in 5 mL of sterile water for ~3-5 minutes to dissolve film coating. Crush tablets in a mortar and reduce to a fine powder. Add 10 mL of glycerin and mix to a uniform paste; mix while adding Simple Syrup, NF in incremental proportions to almost 120 mL; transfer to a calibrated bottle, rinse mortar with vehicle, and add quantity of vehicle sufficient to make 120 mL. Label "shake well" and "refrigerate". Stable for 17 days.
Nahata MC, Pai VB, and Hipple TF, Pediatric Drug Formulations, 5th ed, Cincinnati, OH: Harvey Whitney Books Co, 2004.
References
American Academy of Pediatrics Committee on Drugs, "Transfer of Drugs and Other Chemicals Into Human Milk," Pediatrics, 2001, 108(3):776-89.
Burkhart KK, Janco N, Kulig KW, et al, “Cimetidine as Adjunctive Treatment for Acetaminophen Overdose,” Hum Exp Toxicol, 1995, 14(3):299-304.
Chey WD and Wong B, “American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection,” Am J Gastroenterol, 2007 102(8):1808-25.
Fennerty MD and Higbee M, “Drug Therapy of Gastrointestinal Disease,” Geriatric Pharmacology, Bressler R and Katz MD, eds, New York, NY: McGraw-Hill, 1993, 585-608.
Fick DM, Cooper JW, Wade WE, et al “Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults,” Intern Med, 2003, 163(22):2716-24.
Garcia Rodriguez LA and Jick H, “Risk of Gynaecomastia Associated With Cimetidine, Omeprazole, and Other Antiulcer Drugs,” BMJ, 1994, 308(6927):503-6.
Inoue A, Teramae H, Hisa T, et al, “Fixed Drug Eruption Due to Cimetidine,” Acta Derm Venereol, 1995, 75(3):250.
Kahrilas PJ, Shaheen NJ, Vaezi MF, et al, “American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease,” Gastroenterology, 2008, 135(4):1383-91.
Koren G and Zemlickis DM, “Outcome of Pregnancy After First Trimester Exposure to H2-Receptor Antagonists,” Am J Perinatol, 1991, 8(1):37-8.
Krenzelok EP, Litovitz T, Lippold KP, et al, “Cimetidine Toxicity: An Assessment of 881 Cases,” Ann Emerg Med, 1987, 16(11):1217-21.
Lambert J, Mobassaleh M, and Grand RJ, “Efficacy of Cimetidine for Gastric Acid Suppression in Pediatric Patients,” J Pediatr, 1992, 120(3):474-8.
Lloyd CW, Martin WJ, and Taylor BD, “The Pharmacokinetics of Cimetidine and Metabolites in a Neonate,” Drug Intell Clin Pharm, 1985, 19(3):203-5.
Lloyd CW, Martin WJ, Taylor BD, et al, “Pharmacokinetics and Pharmacodynamics of Cimetidine and Metabolites in Critically Ill Children,” J Pediatr, 1985, 107(2):295-300.
Penston J and Wormsley G, “Adverse Reactions and Interactions With H2-Receptor Antagonists,” Med Toxicol Adverse Drug Exp, 1986, 1(3):192-216.
Sawyer D, Conner CS, and Scalley, “Cimetidine: Adverse Reactions and Acute Toxicity,” Am J Hosp Pharm, 1981, 38(2):188-97.
Somogyi A and Gugler R, “Clinical Pharmacokinetics of Cimetidine,” Clin Pharmacokinet, 1983, 8(6):463-95.
Somogyi A and Muirhead M, “Pharmacokinetic Interactions of Cimetidine 1987,” Clin Pharmacokinet, 1987, 12(5):321-66.
International Brand Names
Lexi-Comp.com
Last full review/revision May 2011
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