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cimetidine

Pronunciation

Generic Name: cimetidine (sye ME ti deen)
Brand Name: Tagamet, Tagamet HB

What is cimetidine?

Cimetidine is in a group of drugs called histamine receptor antagonists. Cimetidine works by decreasing the amount of acid your stomach produces.

Cimetidine is used to treat and prevent certain types of ulcer, and to treat conditions that cause the stomach to produce too much acid. Cimetidine is also used to treat gastroesophageal reflux disease (GERD), when stomach acid backs up into the esophagus and causes heartburn.

Cimetidine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about cimetidine?

Use this medication exactly as directed on the label, or as your doctor has prescribed it for you. Do not use more of the medication than recommended. Do not use the medication for longer than recommended.

Avoid taking antacids unless your doctor recommends them for heartburn pain. Follow your doctor's advice about the type of antacid to use and when to use it. You may not be able to take the antacid at the same time you take your dose of cimetidine.

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Taking cimetidine may make you more susceptible to virus that can cause pneumonia. This has occurred most often in elderly people and in those with diabetes, a weak immune system, or chronic lung disease. Before using cimetidine, tell your doctor if you have any of these conditions.

There are many other drugs that can interact with cimetidine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Heartburn can be confused with early symptoms of heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, dizziness, pain spreading to the arm or shoulder, sweating, nausea or vomiting, and a general ill feeling.

What should I discuss with my healthcare provider before taking cimetidine?

Heartburn can be confused with early symptoms of heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, dizziness, pain spreading to the arm or shoulder, sweating, nausea or vomiting, and a general ill feeling.

Taking cimetidine may make you more susceptible to virus that causes pneumonia. You may be more likely to develop pneumonia if you have certain health problems.

Ask a doctor or pharmacist if it is safe for you to take cimetidine if you have:

  • diabetes;

  • asthma or a chronic lung disorder;

  • a weak immune system;

  • bone marrow suppression;

  • kidney disease; or

  • liver disease.

Cimetidine is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not use this medication without telling your doctor if you are pregnant or plan to become pregnant during treatment.

Cimetidine passes into breast milk, and may be harmful to a nursing baby. Do not take cimetidine without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 16 years old unless your doctor has told you to.

How should I take cimetidine?

Use this medication exactly as directed on the label, or as your doctor has prescribed it for you. Do not use more of the medication than recommended. Do not use the medication for longer than recommended.

Cimetidine is usually taken with meals or at bedtime.

Take this medicine with a full glass of water.

To be sure you get the correct dose of the oral solution (liquid), measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not stop taking cimetidine without first talking to your doctor. It may take up to 8 weeks for an ulcer to heal.

Your ulcer may take longer to heal if you smoke cigarettes.

Store cimetidine at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, diarrhea, confusion, extreme weakness, or fainting.

What should I avoid while taking cimetidine?

If you also take ketoconazole (Nizoral), take it at least 2 hours before you take cimetidine.

Avoid taking antacids unless your doctor recommends them for heartburn pain. Follow your doctor's advice about the type of antacid to use and when to use it. You may not be able to take the antacid at the same time you take your dose of cimetidine.

Cimetidine side effects

Stop using cimetidine and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • cough, fever, chest congestion, trouble breathing;

  • red or blistering skin rash;

  • jaundice (yellowing of the skin or eyes);

  • easy bruising or bleeding, unusual weakness;

  • feeling faint, light-headed, disoriented, or confused;

  • urinating less than usual;

  • irregular heartbeat; or

  • a rash.

Less serious side effects may include:

  • feeling dizzy, depressed, or agitated;

  • breast swelling or tenderness (in men);

  • joint or muscle pain;

  • mild skin rash;

  • headache; or

  • diarrhea, nausea, or constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Cimetidine dosing information

Usual Adult Dose for Duodenal Ulcer:

Parenteral: 300 mg IV or IM every 6 to 8 hours. Alternatively, a continuous IV infusion may be administered at a rate of 37.5 to 50 mg/hour, or up to a maximum rate of 100 mg/hour (2.4 g/day).

Oral: 800 mg to 1600 mg once a day at bedtime. Alternatively, dosage regimens of 300 mg four times per day, with meals and at bedtime, or 400 mg twice daily, in the morning and at bedtime, have shown to be effective.

Usual Adult Dose for Duodenal Ulcer Prophylaxis:

Parenteral: 300 mg IV or IM once or twice a day.

Oral: 400 mg once a day at bedtime.

Usual Adult Dose for Erosive Esophagitis:

Parenteral: 300 mg IV or IM every 6 hours. Alternatively, a continuous IV infusion may be administered at a rate of 50 mg/hour initially, with 25 mg/hour incremental increases up to a maximum rate of 100 mg/hour (2.4 g/day).

Oral: 800 mg twice a day, or alternatively, 400 mg four times a day.

Usual Adult Dose for Stress Ulcer Prophylaxis:

Parenteral: 300 mg IV or IM every 6 hours. Alternatively, a continuous IV infusion may be administered at a rate of 50 mg/hour.

Usual Adult Dose for Upper GI Hemorrhage:

Continuous IV infusion at a rate of 50 mg/hour preceded by an IV bolus dose of 150 mg. Maximum daily dose should not exceed 2.4 g.

Usual Adult Dose for Zollinger-Ellison Syndrome:

Parenteral: 300 mg IV or IM every 6 hours. Alternatively, a continuous IV infusion may be administered at a rate of 50 mg/hour initially. Infusion rates have ranged from 40 to 600 mg/hour, but should not exceed a daily total of 2.4 g.

Oral: 300 mg 4 times a day with meals and at bedtime.

Usual Adult Dose for Gastric Ulcer:

Parenteral: 300 mg IV or IM every 6 hours. Alternatively, a continuous IV infusion may be administered at a rate of 50 mg/hour.

Oral: 800 mg once a day at bedtime, or 300 mg 4 times a day.

Usual Adult Dose for Gastroesophageal Reflux Disease:

Parenteral: 300 mg IV or IM every 6 hours. Alternatively, a continuous IV infusion may be administered at a rate of 50 mg/hour. Maximum daily dose should not exceed 2.4 g.

Oral: 800 mg twice a day, or 400 mg 4 times a day.

Usual Adult Dose for Dyspepsia:

200 mg orally right before (or up to 30 minutes) eating. Maximum per 24 hours: 2 doses.

Usual Pediatric Dose for Gastroesophageal Reflux Disease:

Neonatal: 5 to 10 mg/kg/day administered IV or IM in divided doses every 8 to 12 hours.

Infants: 10 to 20 mg/kg/day administered IV, IM, or oral in divided doses every 6 to 12 hours.

Children: 20 to 40 mg/kg/day administered IV, IM, or oral in divided doses every 6 hours.

Usual Pediatric Dose for Dyspepsia:

Greater than or equal to 12 years: 200 mg up to twice daily; may take 30 minutes prior to eating foods or beverages expected to cause heartburn or indigestion.

What other drugs will affect cimetidine?

Before taking this medication, tell your doctor if you are using any of the following medicines:

  • a blood thinner (warfarin or Coumadin);

  • clopidogrel (Plavix);

  • phenytoin (Dilantin);

  • nifedipine (Adalat);

  • metronidazole (Flagyl);

  • propranolol (Inderal);

  • chlordiazepoxide (Librium);

  • lidocaine (Xylocaine);

  • diazepam (Valium);

  • theophylline (Elixophyllin, Theo-24, Uniphyl); or

  • depression or anxiety medication such as amitriptyline (Elavil), imipramine (Tofranil), clomipramine (Anafranil), desipramine (Norpramin), nortripytyline (Aventyl).

This list is not complete and there are many other drugs that can interact with cimetidine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about cimetidine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.03. Revision Date: 2010-12-15, 5:01:39 PM.

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