PCaution when used during lactation : Caution when used during pregnancy

LCI  : Contraindicated in lactation

Molecule Info

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Indication(s) & Dosage

Cimetidine is a histamine H2-receptor antagonist which rapidly inhibits both basal and stimulated gastric secretion of acid and reduces pepsin output.

Cimetidine is indicated in the treatment of duodenal and benign gastric ulceration, including that associated with non-steroidal anti-inflammatory agents, recurrent and stomal ulceration , oesophageal reflux disease and other conditions where reduction of gastric acid by Cimetidine has been shown to be beneficial: persistent dyspeptic symptoms with or without ulceration, particularly meal-related upper abdominal pain, including such symptoms associated with non-steroidal anti-inflammatory agents; the prophylaxis of gastrointestinal haemorrhage from stress ulceration in seriously ill patients ; before general anaesthesia in patients thought to be at risk of acid aspiration (Mendelson's Syndrome), particularly obstetric patients during labour ; to reduce malabsorption and fluid loss in the short bowel syndrome; and in pancreatic insufficiency to reduce degradation of enzyme supplements. Cimetidine is also recommended in the management of the Zollinger-Ellison syndrome.

Benign gastric and duodenal ulceration
Adult: Initially, 800 mg as a single daily dose given at bedtime for at least 4 wk for duodenal ulcers and 6 wk for gastric ulcers. Maintenance: 400 mg once daily at bedtime or bid.

Stress ulceration of upper gastrointestinal tract
Adult: 200-400 mg every 4-6 hr.

Prophylaxis of acid aspiration during general anaesthesia
Adult: 400 mg is given orally 90-120 minutes before induction of anaesthesia or at the start of labour and up to 400 mg may be given every 4 hr if necessary.

Gastro-oesophageal reflux disease
Adult: 400 mg 4 times daily or 800 mg bid for 4-8 wk.

Zollinger-Ellison syndrome
Adult: 300-400 mg 4 times daily, increase dose if necessary.

Non-ulcer dyspepsia
Adult: Up to 200 mg 4 times daily.

Prophylaxis of nocturnal heartburn
Adult: 100 mg at night.

Pancreatic insufficiency
Adult: 800-1600 mg daily in 4 divided doses, to be taken 60-90 minutes before meals.


Intravenous
Stress ulceration of upper gastrointestinal tract
Adult: 200 mg every 4-6 hr.

Special Populations: Renal impairment: Dose reduction based on creatinine clearance as follows-

CrCl (ml/min)

Dosage Recommendation

30-50

200 mg 4 times daily.

15-30

200 mg tid.

0-15

200 mg bid.

Administration

Should be taken with food.

Overdosage

Overdosage may lead to respiratory failure and tachycardia that may be controlled by assisted respiration and admin of a β-blocker.

Contraindications

Hypersensitivity, lactation.

Special Precautions

Impaired renal and hepatic function. Age >50 yr; CV impairment. Pregnancy.

Adverse Drug Reaction(s)

Diarrhoea, dizziness, tiredness, rash, headache, CNS disturbances, arthralgia, myalgia, gynaecomastia, alopoecia, blood dyscrasias, nephritis, hepatitis, pancreatitis, granulocytopenia, hypersensitivity reactions.

Drug Interactions

Absorption reduced by antacids. May potentiate anticoagulants, phenytoin, theophylline, benzodiazepines, β-blockers, lidocaine. Procainamide clearance is reduced. Reduced absorption of ketoconazole and itraconazole. May enhance gastric mucosal irritation when taken with ethanol. Avoid concurrent use with clopidogrel.

Food Interaction

Absorption delayed.

Pregnancy Category (FDA)

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Pharmacology

Cimetidine competitively inhibits histamine at H2-receptors of the gastric parietal cells resulting in decreased gastric acid secretion, gastric volume and hydrogen ion concentration. It is a potent inhibitor of metabolism in the hepatic mixed-function oxidase systems. It is also used in patients with pancreatic insufficiency to reduce the breakdown of pancreatic enzyme supplements.
Onset: 1 hr.
Duration: 4-6 hr.
Absorption: Readily absorbed from the GI tract; peak plasma concentrations after 1-3 hr. Food delays the rate and slightly decreases extent of absorption.
Distribution: Widely distributed in the body; crosses the placental barrier and appears in breast milk. Protein-binding: 20%.
Metabolism: Partially hepatic; converted to the sulfoxide and to hydroxymethylcimetidine.
Excretion: Urine (as unchanged); 2 hr (elimination half-life).

ATC Classification

A02BA01 - cimetidine; Belongs to the class of H2-receptor antagonists. Used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).

Brand/Product Info


Total Products : 1 
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
G-CIMETIDINE Gonoshasthaya Pharmaceuticals Ltd Cimetidine 200mg/2ml Injection 25 amps: 107.25 MRP

Gen. MedInfo

Why do I need Cimetidine?

Cimetidine is a gastric medicine.

It is used to treat conditions caused by excessive acidity in your stomach, such as stomach ulcers and reflux disease (also known as "heartburn", in which food or acid from your stomach backs up into your mouth, leaving a sour or bitter taste).

Cimetidine can also be used to relieve stomach irritation and ulceration caused by certain painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs).

Cimetidine treats these conditions by reducing the amount of acid your stomach makes.

How do I take Cimetidine?

Take Cimetidine exactly as directed by your doctor. Do not take more or less than instructed by your doctor.

You may need to take Cimetidine for some time before the full benefits can be felt.

Cimetidine may be taken with food or at bedtime.

Do not take Cimetidine for more than 2 weeks unless directed by your doctor. If your gastric problems persist for more than 2 weeks, consult your doctor.

What to do if I have forgotten to take Cimetidine?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

Remember to take your medicine regularly. If you often forget to take your medicine, let your doctor know.

What to take note of while taking Cimetidine?

Alert your doctor if you are pregnant or breastfeeding. Do not breastfeed while you are being treated with Cimetidine.

Alert your doctor if you have liver or kidney disease.

Do not take Cimetidine for a long period of time unless instructed by your doctor. Let your doctor know if your gastric problem seems to be getting worse or if there is no improvement even with Cimetidine.

Do not give Cimetidine to children unless instructed by the doctor.

What side effects could appear?

Diarrhoea (usually mild), headache, confusion, nervousness are some of the more common side effects with Cimetidine. These are usually temporary and should go away when Cimetidine is stopped.

Cimetidine may cause dizziness. If you feel dizzy, do not drive or take part in any activity in which you need to be alert.

Let your doctor know if any side effects bother you or if they do not go away.

Less commonly, Cimetidine may cause other side effects. Consult your doctor if you experience unusual problems while being treated with Cimetidine.

Can I take this with other medicines?

Alert your doctor if you are taking any other medicines, especially those listed here:

- warfarin (a blood-thinning medicine)
- phenytoin (an epilepsy medicine)
- theophylline (an asthma medicine)
- nifedipine, isradipine, diltiazem, amiodarone (heart or blood pressure medicines)
- diazepam, amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, chlordiazepoxide (sleeping pills or mood medicines)
- metronidazole (an antibiotic)
- ketoconazole, itraconazole (antifungal medicines)

Alert your doctor if you are taking a blood-thinning medicine called clopidogrel. 

Do not take antacids together with Cimetidine. If you must take antacids, take them at least 1 hour before or 2 hours after you have taken Cimetidine.

Always inform your doctor if you are taking any other medicines, including herbal tonics, supplements and medicines that you buy without a prescription.

What special dietary instructions to follow?

Avoid alcohol and caffeine.

How to store Cimetidine?

Store in a cool, dry place away from the reach of children.
Medicines must be used within the expiry date.

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