Drug interactions between cimetidine and Lexapro
| Results for the following 2 drugs: |
|---|
| cimetidine |
| Lexapro (escitalopram) |
Interactions between your selected drugs
cimetidine ↔ escitalopram
Applies to:cimetidine and Lexapro (escitalopram)
MONITOR: Coadministration with cimetidine may increase the plasma concentrations of escitalopram. The proposed mechanism is cimetidine inhibition of the metabolic clearance of escitalopram via CYP450 2C19, 2D6, and 3A4. In study subjects, administration of a single 20 mg dose of escitalopram on day 4 of treatment with cimetidine 400 mg twice daily for 5 days resulted in increases of escitalopram peak plasma concentration (Cmax) and systemic exposure (AUC) by approximately 20% and 70%, respectively. High plasma levels of escitalopram may increase the risk of side effects including serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.
MANAGEMENT: Caution is advised if escitalopram must be used in combination with cimetidine. Pharmacologic response to escitalopram should be monitored more closely whenever cimetidine is added to or withdrawn from therapy, and the escitalopram dosage adjusted as necessary. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Alternatively, other H2-receptor antagonists such as famotidine, nizatidine, or ranitidine may be considered, since they are unlikely to interfere with the metabolism of escitalopram.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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