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Updated 11 February 2013

Cimetidine

Cimetidine is prescribed to treat ulcers of the stomach and duodenum (the first part of the small intestine that connects to the stomach).

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Cimetidine is the active ingredient of Adco-Cimetidine, Bio-Cimetidine, Cimlok, Cinadine, Hexamet, Lenamet, Lenamet-OTC, Lesacid, Micro-Cimetidine, Sabax-Cimetidine, Secadine and Tagamet.

General Information

Cimetidine is prescribed to treat ulcers of the stomach and duodenum (the first part of the small intestine that connects to the stomach). It is also effective in treating gastro oesophageal reflux, the backward flow of stomach acid contents into the oesophagus (the tube that connects the mouth to the stomach). Cimetidine is furthermore prescribed for patients with Zollinger-Ellison syndrome, a rare condition associated with a tumour, creating high levels of stomach acid secretion.

Cimetidine may interact with liver enzymes responsible for breaking down various other medications. Because of this, levels of these medications may become toxic in the body, causing a variety of side effects. If you are taking any other medication, consult your doctor or pharmacist before combining it with cimetidine.

How does cimetidine work?

Cimetidine blocks the release of stomach acid by binding to histamine receptors in the cells of the stomach wall. By reducing levels of gastric acid, it promotes healing of ulcers and acid-related inflammation. Cimetidine also blocks the synthesis of the digestive enzyme pepsin, which together with gastric acid, causes duodenal ulceration.

Fast facts

Drug schedule: Schedule 2 (some 200 mg products); Schedule 4

Available as: Cimetidine is available as tablets and injection.

What does it do? Cimetidine has an acid reducing effect in the stomach.

Overdose risk: Low

Dependence risk: Low

Is cimetidine available as a generic? Yes

Is cimetidine available on prescription only? Yes

User information

Onset of effect: Within 1 hour

Duration of action: Up to 6 hours

Dietary advice: Avoid foods that cause irritation of the stomach, such as citrus fruit and juice, caffeine and carbonated drinks.

Stopping this medicine: Do not discontinue this medication without consulting your doctor, even if you begin to feel better. Symptoms may recur with premature stoppage.

Prolonged use: Cimetidine is not generally used continuously for longer than 2 months. Only continue for longer on the advice of your doctor.

Special precautions

Consult your doctor before using this drug if:

  • You are allergic to cimetidine or similar drugs
  • You have kidney or liver disease
  • You are taking other medication.

Pregnancy: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.

Breastfeeding: Avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: Safety and efficacy of this medication have not been established for children under the age of 16.

Elderly: Caution is advised in the elderly, as adverse reactions may be more likely. A reduced dose may be needed.

Driving and hazardous work: Avoid such activities until you know how this medication affects you.

Alcohol: Avoid, as alcohol may aggravate the condition being treated.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Headache

x

x

Fatigue

x

x

Dizziness/drowsiness

x

x

Nausea/vomiting

x

x

Abdominal pain/diarrhoea

x

x

Blurred vision

x

x

Decreased libido

x

x

Swelling of breasts (men)

x

x

Hallucinations

x

x

Depression

x

x

Insomnia

x

x

Skin rash/irritation

x

x

Heart palpitations

x

x

Fever/chills

x

x

Unusual Bruising

x

x

Interactions

Drug interactions

Antacids

Separate doses by 2 hours.

Drugs for heart rhythm disturbance

Increased risk of drug toxicity

Warfarin

Increased risk of warfarin toxicity

Drugs fro epilepsy

Increased risk of drug toxicity

Antifungals

Reduced effect of antifungal. Take 2 hours apart.

Antihistamines

Increased risk of drug toxicity

Antimalarial drugs

Increased risk of drug toxicity

Sildenafil

Increased risk of sildenafil toxicity

Benzodiazepines

Increased risk of drug toxicity

Theophylline

Increased risk of drug toxicity

Antipsychotic drugs

Increased risk of drug toxicity

Beta blockers

Increased risk of drug toxicity

Caffeine

Increased stimulant properties of caffeine

Metformin

Increased risk of metformin toxicity

Moclobemide

Increased risk of moclobemide toxicity

Opioids

Increased risk of drug toxicity

Oral antidiabetic drugs

Increased risk of drug toxicity

Tricyclic antidepressants

Increased risk of drug toxicity

Food interactions

Avoid foods that cause irritation of the stomach, such as citrus fruit and juice, caffeine and carbonated drinks.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults:

200 mg 3 times a day, 400 mg twice a day or 800 mg at night

Children:

20-40 mg/kg/day in 4 divided doses as directed by paediatrician (10-20 mg/kg/day in neonates)

Interesting fact

Smoking may increase stomach acid secretion and should preferably be stopped before treatment with cimetidine starts.

 
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