Generic Name: Cimetidine
Class: Histamine H2-Antagonists
VA Class: GA301
CAS Number: 51481-61-9
Introduction
Histamine H2 receptor antagonist.b
Uses for Tagamet
Duodenal Ulcer
Short-term treatment of active duodenal ulcer (endoscopically or radiographically confirmed).a b
Maintainence of healing and reduction in recurrence of duodenal ulcer.a b
Pathologic GI Hypersecretory Conditions
Long-term treatment of Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis.a b
Gastric Ulcer
Short-term treatment of active benign gastric ulcer.a b
Gastroesophageal Reflux (GERD)
Short-term treatment of erosive esophagitis (endoscopically diagnosed) in patients with GERD.118
Treatment of symptomatic GERD†.105 106 123 288
Self-medication as initial therapy to achieve acid suppression, control symptoms, and prevent complications of less severe symptomatic GERD†.288
Upper GI Bleeding
Prevention of upper GI bleeding resulting from stress-related mucosal damage (erosive esophagitis, stress ulcers) in critically ill patients.118 142 143 144 145 146 147 152 153 154 155 156 157 161 162 163 164 165 166 170 171 172 173 174 175 176 177 179 188 191
Treatment of upper GI bleeding† secondary to hepatic failure, esophagitis, duodenal or gastric ulcers when hemorrhage is not caused by major blood vessel erosion.b
Heartburn (pyrosis), Acid Indigestion (hyperchlorhydria), or Sour Stomach
Short-term self-medication for relief of heartburn symptoms in adults and adolescents≥12 years of age.c
Short-term self-medication for prevention of heartburn symptoms associated with acid indigestion (hyperchlorhydria) and sour stomach brought on by ingestion of certain foods and beverages in adults and children ≥12 years of age.c
Allergic Conditions and Urticarias†124 125 126 127 128 129 130 131 132 133 134 135 136 137
Tagamet Dosage and Administration
Administration
Administer orally, IV, or IM.118
Administer by IM or slow IV injection, or by intermittent or continuous IV infusion in hospitalized patients with pathological GI hypersecretory conditions or intractable duodenal ulcer, or when oral therapy is not feasible.118
Oral Administration
Administer with or without food; administration with food may delay and slightly decrease absorption, but achieves maximum antisecretory effect when stomach is no longer protected by food buffering effect. Administer oral tablets with water.b
Antacids may be given as necessary for pain relief, but not at the same time.a b
For duodenal ulcer treatment, administration once daily at bedtime is the regimen of choice because of a high healing rate, maximal pain relief, decreased drug interaction potential, and maximal compliance.117 118 119
For gastric ulcer treatment, administration once daily at bedtime is the regimen of choice because of convenience and decreased drug interaction potential.118
For gastroesophageal reflux, once-daily dosing is not considered appropriate.288
IM Administration
May be administered undiluted.a b
Intermittent Direct IV Injection
Dilution
Dilute 300 mg to 20 mL with 0.9% sodium chloride injection or other compatible IV solution before direct IV injection (see Compatibility under Stability).118
Rate of Administration
Inject over ≥5 minutes.118
Intermittent IV infusion
Reconstitution
Reconstitute ADD-Vantage vials according to manufacturer’s directions.118
Dilution
Dilute 300 mg in at least 50 mL of 0.9% sodium chloride injection or 5% dextrose injection or other compatible IV solution (see Compatibility under Stability).118
No additional dilution required for commercially available infusion solution (300 mg cimetidine in 50 mL of 0.9% sodium chloride injection).a
Rate of Administration
Over 15–20 minutes.118
Continuous IV Infusion
Dilution
Dilute 900 mg in 100–1000 mL of a compatible IV solution (see Compatibility under Stability).a b
Rate of Administration
Over 24 hours.a b
Adjust rate to individual patient requirements.a b
Volume <250 mL: use controlled-infusion device (e.g., pump).a b
Dosage
Dosage of cimetidine hydrochloride expressed in terms of cimetidine.118
Pediatric Patients
20–40 mg/kg daily in divided doses has been used in a limited number of children when potential benefits are thought to outweigh the possible risks.118
Heartburn, Acid Indigestion, or Sour Stomach
Heartburn Relief (Self-medication)
Oral
Adolescents ≥12 years of age: 200 mg once or twice daily, or as directed by a clinician.268
Prevention of Heartburn (Self-medication)
Oral
Adolescents ≥12 years of age: 200 mg once or twice daily or as directed by a clinician; administer immediately (or up to 30 minutes) before ingestion of causative food or beverage.c
Adults
General Parenteral Dosage
Parenteral dosage regimens for GERD have not been established.a
General parenteral dosage (in hospitalized patients with pathologic hypersecretory conditions or intractable ulcer, or for short-term use when oral therapy is not feasible):a
IM
300 mg every 6–8 hours.118
Intermittent Direct IV Injection
300 mg every 6–8 hours.118
300 mg more frequently if increased daily dosage is necessary (i.e., single doses not >300 mg), up to 2400 mg daily.118
Intermittent IV Infusion
300 mg every 6–8 hours.118
300 mg more frequently if increased daily dosage is necessary (i.e., single doses not >300 mg), up to 2400 mg daily.118
Continuous IV infusion
900 mg over 24 hours (37.5 mg/hour).a b See Pathologic GI Hypersecretory Conditions under Dosage: Adults.
For more rapid increase in gastric pH, a loading dose of 150 mg may be given as an intermittent infusion before continuous infusion.a b
Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral
Dosage of choice: 800 mg once daily at bedtime.117 118 119
Patients with ulcer >1 cm in diameter who are heavy smokers (i.e., ≥1 pack daily) when rapid healing (e.g., within 4 weeks) is considered important:118 1.6 g daily at bedtime.117 118 119
Administer for 4–6 weeks unless healing is confirmed earlier.117 118 If not healed or symptoms continue after 4 weeks, additional 2–4 weeks of full dosage therapy may be beneficial.118 More than 6–8 weeks at full dosage is rarely needed.118
Healing of active duodenal ulcers may occur in 2 weeks in some, and occurs within 4 weeks in most patients.117 118 119 120 121 122
Other regimens (no apparent rationale for these other than familiarity of use) that have been used:117 118 300 mg 4 times daily with meals and at bedtime; 200 mg 3 times daily and 400 mg at bedtime; 400 mg twice daily in the morning and at bedtime.b
Maintenance of Healing of Duodenal Ulcer
Oral
400 mg daily at bedtime.118 Efficacy not increased by higher dosages or more frequent administration.b
Pathologic GI Hypersecretory Conditions
Zollinger-Ellison Syndrome
Oral
300 mg 4 times daily with meals and at bedtime.118
Higher doses administered more frequently may be necessary;a b adjust dosage according to response and tolerance but in general, do not exceed 2400 mg daily.a
Continue as long as necessary.118
Continuous IV Infusion
Mean infused dose of 160 mg/hour (range: 40-600 mg/hour) in one study.a
Gastric Ulcer
Oral
Preferred regimen: 800 mg once daily at bedtime.118
Alternative regimen: 300 mg 4 times daily, with meals and at bedtime.118
Monitor to ensure rapid progress to complete healing.a b
Studies limited to 6 weeks, efficacy for >8 weeks not established.118
GERD
Once daily (at bedtime) not considered appropriate therapy.288
Treatment of Symptomatic GERD†
Oral
300 mg 4 times daily has been used.105 106 123
Treatment of Erosive Esophagitis
Oral
800 mg twice daily or 400 mg 4 times daily (e.g., before meals and at bedtime) for up to 12 weeks.118
Upper GI Bleeding
Prevention of Upper GI Bleeding
Continuous IV Infusion
50 mg/hour; loading dose not required.118
Safety and efficacy of therapy beyond 7 days has not been established.118
Alternative dosage: Some clinicians recommend 300-mg IV loading dose over 5–20 minutes, then continuous IV infusion at 37.5–50 mg/hour; titrate with 25-mg/hour increments up to 100 mg/hour based on gastric pH (e.g., to maintain a pH of at least 3.5–4).118 143 144 173 174 176 188
Intermittent IV doses may be less effective in preventing upper GI bleeding than continuous IV infusion.155 172 173 174 175 176 177 178 188 189 191
Treatment of Upper GI Bleeding†
Oral
1–2 g daily in 4 divided doses has been used.b
IV
1–2 g daily in 4 divided doses has been used.b
Heartburn, Acid Indigestion, or Sour Stomach
Heartburn (Self-medication)
Oral
200 mg once or twice daily, or as directed by clinician.268
Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.c
Prevention of Heartburn (Self-medication)
Oral
200 mg once or twice daily or as directed by a clinician; administer immediately (or up to 30 minutes) before ingestion of causative food or beverage.c
Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.c
Prescribing Limits
Pediatric Patients
Heartburn, Acid Indigestion, or Sour Stomach
Heartburn (Self-Medication)
Oral
Adolescents ≥12 years of age: Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.c
Prevention of Heartburn (Self-medication)
Oral
Adolescents ≥12 years of age: Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.c
Adults
General Parenteral Dosage
General parenteral dosage (hospitalized patients with pathologic hypersecretory conditions or intractable duodenal ulcer, or short-term use when oral therapy is not feasible):
Direct IV injection
Maximum 2.4 g daily.a
Maximum 300 mg per dose.a
Maximum concentration 300 mg/20 mL.a
Maximum injection rate: 20 mL over not less than 5 minutes (4 mL per minute).a
Intermittent IV Infusion
Maximum 2.4 g daily.a
Maximum 300 mg per dose.a
Maximum concentration 300 mg/50 mL.a
Maximum infusion rate: 15–20 minutes.a
GERD
Short-term Treatment of Erosive Esophagitis
Oral
Safety and efficacy beyond 12 weeks of administration have not been established.a
Heartburn, Acid Indigestion, or Sour Stomach
Heartburn Relief (Self-medication)
Oral
Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.c
Prevention of Heartburn (Self-medication)
Oral
Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.c
Duodenal Ulcer
Intermittent Direct IV Injecton
Maximum 2.4 g daily.a
Intermittent IV Infusion
Maximum 2.4 g daily.a
Gastric Ulcer
Short-term treatment of Active Benign Gastric Ulcer
Oral
Safety and efficacy beyond 8 weeks have not been established.118
Intermittent Direct IV Injection
Maximum 2.4 g daily.a
Intermittent IV Infusion
Maximum 2.4 g daily.a
Pathologic GI Hypersecretory Conditions (e.g., Zollinger-Ellison Syndrome)
Oral
Maximum usually 2.4 g daily.118
Intermittent Direct IV Injection
Maximum 2.4 g daily.a
Intermittent IV Infusion
Maximum 2.4 g daily.a
Upper GI Bleeding
Prevention of Upper GI Bleeding
Continuous IV Infusion
Safety and efficacy beyond 7 days have not been established.a
Special Populations
Renal Impairment
Severe (Clcr< 30 mL/minute)
Oral
300 mg every 12 hours.118
Accumulation may occur; use lowest frequency of dosing compatible with adequate response.118
Increase frequency to every 8 hours or more frequently (with caution) if required.118
Presence of hepatic impairment may require further dosage reduction.118
Direct IV Injection
300 mg every 12 hours.118
Accumulation may occur; use lowest frequency compatible with adequate response.118
Increase frequency to every 8 hours or more frequently (with caution) if required118
Presence of hepatic impairment may require further dosage reduction.118
Continuous IV Infusion
Prevention of Upper GI Bleeding: One-half recommended dosage (i.e., 25 mg/hour).118
Hemodialysis
Decreases blood levels; administer at the end of hemodialysis and every 12 hours during interdialysis.b
Hepatic Impairment
May require further dosage reduction in the presence of severe renal impairment.118
Cautions for Tagamet
Contraindications
Warnings/Precautions
General Precautions
Cardiovascular Effects
Rapid IV administration associated rarely with hypotension, cardiac arrhythmias; avoid.a b
Gastric Malignancy
Response to cimetidine does not preclude presence of gastric malignancy.118
CNS Effects
Reversible confusional states reported, especially in geriatric (i.e., ≥50 years) and severely ill (e.g., hepatic or renal disease, organic brain syndrome) patients.118 b Usually occurs within 2–3 days after initiating cimetidine and resolves within 3–4 days after discontinuance.118 b
Respiratory Effects
Administration of H2-receptor antagonists has been associated with an increased risk for developing certain infections (e.g., community-acquired pneumonia).302 303
Specific Populations
Pregnancy
Category B.a
Pregnant women should consult a clinician before using for self-medication.268
Lactation
Distributed into milk.118 Generally, do not nurse during therapy with cimetidine.118
Nursing women should consult a clinician before using for self-medication.268
Pediatric Use
Safety and efficacy not established in children <16 years of age; do not use unless potential benefits outweigh risks.118
Safety and efficacy for self-medication not established in children <12 years of age; do not use unless directed by a clinician.c
Renal Impairment
Dosage adjustments necessary in patients with severe renal impairment.118 (See Renal Impairment under Dosage and Administration.)
Hepatic Impairment
Further dosage adjustments may be necessary in presence of severe renal impairment.118 (See Hepatic Impairment under Dosage and Administration.)
Immunocompromised Patients
Increased possibility of Strongyloides stercoralis hyperinfection with decreased gastric acidity.118 269 270
Common Adverse Effects
Headache,118 144 dizziness, somnolence, diarrhea.118
With ≥1 month of therapy: gynecomastia.118 b
With IM therapy: transient pain at injection site.118
Interactions for Tagamet
Inhibits hepatic microsomal enzyme systems, decreases hepatic metabolism of some drugs.118 If necessary, adjust dosage of hepatically metabolized drugs when cimetidine therapy is initiated or discontinued.b
Specific Drugs
Drug
|
Interaction
|
Comments
|
|---|
Alcohol
|
Possible increased blood alcohol concentrations,256 257 258 259 260 261 263 264 265 psychomotor impairment256 257 258 259 260 261 267
|
Potential for psychomotor impairment controversial, 256 257 258 259 260 261 267 but use caution during performance of hazardous tasks requiring mental alertness, physical coordination257 258 261
|
Antacidsb
|
Decreased cimetidine absorptionb
|
Administer 1 hour before or after cimetidine in the fasting state, or 1 hour after cimetidine is taken with food.a b
|
Benzodiazepines118
|
Potential for delayed elimination, increased blood concentrations of certain benzodiazepines (e.g., diazepam, chlordiazepoxide, triazolam)118
|
Adjust dosage if needed b
|
Calcium-channel blockers (e.g., nifedipine)a
|
Potential for delayed elimination, increased blood concentrations of nifedipine118
|
Adjust dosage if needed b
|
Ketoconazole118
|
Absorption of ketoconazole may be affected by altered gastric pH118
|
Administer ≥2 hours before cimetidine118
|
Lidocaine118
|
Potential for delayed elimination, increased blood concentrations of lidocaine118
|
Adverse effects reported, adjust dosage if needed b
|
Metronidazole118
|
Potential for delayed elimination, increased blood concentrations of metronidazole118
|
Adjust dosage if neededb
|
Myelosuppressive drugs (e.g., alkylating agents [e.g., carmustine], antimetabolites) and/or therapies (radiation)b
|
May potentiate myelosuppressionb
|
|
Phenytoin118
|
Potential for delayed elimination, increased blood concentrations of phenytoin118
|
Adverse effects reported, adjust dosage if needed b
|
Propranolol118
|
Potential for delayed elimination, increased blood concentrations of propranolol118
|
Adjust dosage if needed b
|
Theophylline118
|
Potential for delayed elimination, increased blood concentrations of theophylline118
|
Adverse effects reported, adjust dosage if needed b
|
Triamterene108
|
Potential for delayed elimination, increased blood concentrations of triamterene118
|
Consider potential of clinically important interaction108
|
Tricyclic Antidepressants118
|
Potential for delayed elimination, increased blood concentrations of certain tricyclic antidepressants118
|
Adjust dosage if neededb
|
Warfarin118
|
Potential for delayed elimination, increased blood concentrations of warfarin118
|
Monitor PT, adjust dosage if neededb
|
Tagamet Pharmacokinetics
Absorption
Bioavailability
Oral: 60–70%.b
Onset
≥70% decrease in basal acid secretion within 45 minutes after single 300- or 400-mg IV dose in healthy males.100
Duration
Dosage Regimen
|
Effect On Acid Secretion
|
Comments
|
|---|
Oral: 800 mg at bedtime in duodenal ulcer patients118
|
Mean hourly nocturnal secretion decreased by 85% over 8 hours.118
|
No effect on daytime acid secretion118
|
Oral: 1600 mg at bedtime in duodenal ulcer patients 118
|
Mean hourly nocturnal secretion decreased by 100% over 8 hours, 35% decrease for additional 5 hours.118
|
Moderate (<60%) 24-hour suppression118
|
Oral: 400 mg twice daily in duodenal ulcer pateints118
|
Nocturnal secretion decreased by 47–83% over 6–8 hours 118
|
Moderate (<60%) 24-hour suppression118
|
Oral: 300 mg 4 times daily in duodenal ulcer patients118
|
Nocturnal secretion decreased by 54% over 9 hours118
|
Moderate (<60%) 24-hour suppression118
|
Oral: Single 300-mg dose within 1 hour after meal in duodenal ulcer patientsa
|
Food-stimulated secretion decreased by 50% for 1 hour, then 75% for 2 hours.a
|
|
Oral: 300-mg dose at breakfast in duodenal ulcer patientsa
|
Continued suppression for 4 hours, with partial suppression after luncha
|
Effect enhanced and maintained by additional 300-mg dose with luncha
|
Oral: 300-mg dose with foodb
|
Mean gastric pH 3.5–4 at 1 hour, 5.5–6.1 at 4 hoursb
|
|
Oral: Single dose 300 mg with fooda
|
Mean gastric pH: 3.5, 3.1, 3.8, 6.1 at hour 1, 2, 3, 4, respectivelya
|
Placebo mean gastric pH: 2.6, 1.6, 1.9, 2.2 at hour 1, 2, 3, 4, respectivelya
|
Oral: 300–400 mg in fasting state in duodenal ulcer patientsb
|
Anacidity for up to 8 hoursb
|
|
Oral: 300 mg in duodenal ulcer patientsb
|
Basal gastric acid output decreased by 90% for 4 hoursb
|
Meal-stimulated acid secretion by 66% for 3 hoursb
|
IV continuous infusion: mean dosage of 160 mg/hour (range:40-600 mg/hour) in pathologic hypersecretory conditionsb
|
Maintained secretion at ≤10 mEq/hourb
|
|
IV continuous infusion (37.5 mg/hour or 900 mg daily) in patients with active or healed duodenal or gastric ulcerb
|
Maintained gastric pH at >4 for >50% of the time at steady-state.b
|
|
Intermittent injection: (300 mg every 6 hours or 1200 mg daily) in patients with active or healed duodenal or gastric ulcerb
|
Maintained gastric pH at >4 for >50% of the time at steady-state.b
|
|
IV: Single 300- or 400-mg dose in healthy males
|
≥70% decrease in basal acid secretion maintained for 4–4.5 hours100
|
|
Food
Delays, slightly decreases absorption.b However, administration with meals achieves maximum blood concentrations and antisecretory effect when stomach is no longer protected by food buffering effect.b
Distribution
Extent
Widely distributed throughout the body.b
Distributed into human milk.b
Crosses the placenta in animals.b
Plasma Protein Binding
15–20%.b
Elimination
Metabolism
Metabolized to sulfoxide (major metabolite) and 5-hydroxymethyl derivatives in liver.a b More extensively metabolized after oral than parenteral administration.a
Elimination Route
Excreted principally in urine.a b Single oral dose: 48% (unchanged) excreted in urine over 24 hours.a IV or IM: about 75% (unchanged) excreted in urine within 24 hours.a Single IV dose of radiolabeled cimetidine: 80–90% (50–73% unchanged, remainder as metabolites) excreted in urine over 24 hours.b About 10% excreted in feces.b
Half-life
2 hours.a
After IV administration in children 4.1–15 years of age: Apparent biphasic decline of plasma cimetidine and cimetidine sulfoxide concentrations with half-lives of 1.4 and 2.6 hours, respectively.102
Special Populations
2.9 hours in patients with Clcr 20–50 mL/minute.b 3.7 hours in patients with Clcr <20 mL/minute.b 5 hours in anephric patients.b
Stability
Storage
Oral
Liquid and Tablets
Tight, light-resistant containers at 15–30°C.b
Parenteral
Injection
15–30°C.b Protect from light.b Do not refrigerate.b Stable in most IV solutions for at least 3 days at room temperature in concentrations of 1.2–5 mg/mL,b but use within 48 hours when diluted as directed.118 b
Injection for IV infusion only
15–30°C.b Protect from excessive heat; brief exposure up to 40°C does not adversely affect stability.b Stable through the labeled expiration date when stored as recommended.118
Compatibility
For information on systemic interactions resulting from concomitant use, see Interactions.
Parenteral
Solution CompatibilityHID
Compatible
|
|---|
Amino acids 3.5, 5.5, or 8.5% with electrolytes
|
Amino acids 5.5 or 8.5%
|
Dextrose 5% with Ascor-B-Sol
|
Dextrose 5% and Electrolyte #48
|
Dextrose 5% and Electrolyte #75
|
Dextrose 5% in Ringer’s injection, lactated
|
Dextrose 5% in sodium chloride 0.2, 0.45, or 0.9%
|
Dextrose 10% in sodium chloride 0.9%
|
Dextrose 5% in water
|
Dextrose 10% in water
|
Dextrose 5% in water with vitamins
|
Fructose 5% and Electrolyte #48
|
Fructose 5% and Electrolyte #75
|
Invert sugar 5% in water
|
Invert sugar 10% in water
|
Ionosol B in dextrose 5% in water
|
Ionosol MB in dextrose 5% in water
|
Ionosol T in dextrose 5% in water
|
Mannitol 10% in water
|
Normosol M, 900 cal
|
Normosol M in dextrose 5% in water
|
Normosol M and Surbex T in dextrose 5% in water
|
Normosol R
|
Normosol R, pH 7.4
|
Normosol R in dextrose 5% in water
|
Plasma-Lyte 56 in dextrose 5% in water
|
Plasma-Lyte M in dextrose 5% in water
|
Ringer’s injection
|
Ringer’s injection, lactated
|
Sodium bicarbonate 5%
|
Sodium chloride 0.9%
|
Drug Compatibility
Admixture CompatibilityHID
Compatible
|
|---|
Acetazolamide sodium
|
Amikacin sulfate
|
Aminophylline
|
Atracurium besylate
|
Cefoxitin sodium
|
Chlorothiazide sodium
|
Ciprofloxacin
|
Clindamycin phosphate
|
Colistimethate sodium
|
Dexamethasone sodium phosphate
|
Digoxin
|
Epinephrine HCl
|
Erythromycin lactobionate
|
Ethacrynate sodium
|
Flumazenil
|
Furosemide
|
Gentamicin sulfate
|
Insulin, regular
|
Isoproterenol HCl
|
Lidocaine HCl
|
Lincomycin HCl
|
Meropenem
|
Metaraminol bitartrate
|
Methylprednisolone sodium succinate
|
Midazolam HCl
|
Norepinephrine bitartrate
|
Penicillin G potassium
|
Phytonadione
|
Polymyxin B sulfate
|
Potassium chloride
|
Protamine sulfate
|
Quinidine gluconate
|
Sodium nitroprusside
|
Tacrolimus
|
Vancomycin HCl
|
Verapamil HCl
|
Vitamin B complex
|
Vitamin B complex with C
|
Incompatible
|
|---|
Amphotericin B
|
Variable
|
|---|
Ampicillin sodium
|
Cefazolin sodium
|
Metoclopramide HCl
|
Y-Site CompatibilityHID
Compatible
|
|---|
Acyclovir sodium
|
Amifostine
|
Aminophylline
|
Anakinra
|
Anidulafungin
|
Atracurium besylate
|
Aztreonam
|
Bivalirudin
|
Cisplatin
|
Cladribine
|
Clarithromycin
|
Cyclophosphamide
|
Cytarabine
|
Dexmedetomidine HCl
|
Diltiazem HCl
|
Docetaxel
|
Doxorubicin HCl
|
Doxorubicin HCl liposome injection
|
Enalaprilat
|
Esmolol HCl
|
Etoposide phosphate
|
Fenoldopam mesylate
|
Filgrastim
|
Fluconazole
|
Fludarabine phosphate
|
Foscarnet sodium
|
Gallium nitrate
|
Gemcitabine HCl
|
Granisetron HCl
|
Haloperidol lactate
|
Heparin sodium
|
Hetastarch in lactated electrolyte injection (Hextend)
|
Hetastarch in sodium chloride 0.9%
|
Idarubicin HCl
|
Inamrinone lactate
|
Labetalol HCl
|
Levofloxacin
|
Linezolid
|
Melphalan HCl
|
Meropenem
|
Methotrexate sodium
|
Midazolam HCl
|
Milrinone lactate
|
Nicardipine HCl
|
Ondansetron HCl
|
Oxaliplatin
|
Paclitaxel
|
Pancuronium bromide
|
Pemetrexed disodium
|
Piperacillin sodium–tazobactam sodium
|
Propofol
|
Remifentanil HCl
|
Sargramostim
|
Tacrolimus
|
Teniposide
|
Theophylline
|
Thiotepa
|
Topotecan HCl
|
Vecuronium bromide
|
Vinorelbine tartrate
|
Zidovudine
|
Incompatible
|
|---|
Allopurinol sodium
|
Amphotericin B cholesteryl sulfate complex
|
Amsacrine
|
Cefepime HCl
|
Indomethacin sodium trihydrate
|
Lansoprazole
|
Warfarin sodium
|
ActionsActions
Inhibits basal and stimulated gastric acid secretion.b
Competitively inhibits histamine at parietal cell H2 receptors.b
Weak antiandrogenic effect.b
Advice to Patients
Importance of patients informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs.289
Importance of taking antacids on an empty stomach 1 hour before or 1 hour after oral administration of cimetidine, or 1 hour after the drug is taken with food,b but not at same time as oral cimetidine.a b
Importance of women informing clinician if they are or plan to become pregnant or plan to breast-feed.289
Before self-medication, importance of consulting clinician if taking warfarin, theophylline, or phenytoin.268
Importance of following dosage instructions when cimetidine is administered for self-medication, unless otherwise directed by a clinician.c
Importance of promptly informing clinician of persistent abdominal pain or difficulty swallowing.268
Importance of informing patients of other important precautionary information. (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Cimetidine
Routes
|
Dosage Forms
|
Strengths
|
Brand Names
|
Manufacturer
|
|---|
Oral
|
Solution
|
300 mg/mL*
|
Cimetidine Hydrochloride Oral Solution
|
Actavis, Duramed, Endo, Hi-Tech, Morton Grove, Pharmaceutical Associates, Teva
|
|
|
|
Tagamet (with parabens, povidone, and propylene glycol)
|
GlaxoSmithKline
|
|
Tablets, film-coated
|
200 mg*
|
Tagamet HB 200
|
GlaxoSmithKline
|
|
|
|
Tagamet HB (with povidone)
|
GlaxoSmithKline
|
|
|
300 mg*
|
Tagamet (with povidone and propylene glycol)
|
GlaxoSmithKline
|
|
|
400 mg*
|
Tagamet Tiltab (with povidone and propylene glycol)
|
GlaxoSmithKline
|
|
|
800 mg*
|
Tagamet Tiltab (with povidone and propylene glycol; scored)
|
GlaxoSmithKline
|
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Cimetidine Hydrochloride
Routes
|
Dosage Forms
|
Strengths
|
Brand Names
|
Manufacturer
|
|---|
Oral
|
Solution
|
300 mg (of cimetidine) per 5 mL*
|
Tagamet HCl (with alcohol 2.8% parabens and propylene glycol)
|
GlaxoSmithKline
|
Parenteral
|
Injection
|
150 mg (of cimetidine) per mL
|
Cimetidine Hydrochloride Injection
|
Endo, Hospira, Sicor
|
|
