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Leader Heartburn Relief Disease Interactions

There are 4 disease interactions with Leader Heartburn Relief (cimetidine).

Major

Cimetidine (applies to Leader Heartburn Relief) liver disease

Major Potential Hazard, Moderate plausibility.

Cimetidine is partially metabolized by the liver, and to a greater extent when administered orally than when given intravenously. Although dosage reductions are generally not necessary, therapy with cimetidine should be administered cautiously in patients with liver disease. Hepatotoxicity has been associated with cimetidine use. In addition, liver disease appears to be a risk factor for cimetidine-related central nervous system toxicity, which may include mental confusion, agitation, psychosis, depression, anxiety, hallucinations, and disorientation. These effects are usually reversible within 3 to 4 days after discontinuation of therapy.

References

  1. Taylor DC, Cresswell PR, Bartlett DC (1978) "The metabolism and elimination of cimetidine, a histamine H2-receptor antagonist, in the rat, dog and man." Drug Metab Dispos, 6, p. 21-30
  2. del Arbol LR, Moreira V, Moreno A, et al. (1980) "Bridging hepatic necrosis associated with cimetidine." Am J Gastroenterol, 74, p. 267-9
  3. Lorenzini I, Jezequel AM, Orlandi F (1981) "Cimetidine-induced hepatitis: electron microscopic observations and clinical pattern of liver injury." Dig Dis Sci, 26, p. 275-80
  4. Delpre G, Kadish U, Livni E (1982) "Hepatitis following cimetidine administration." Am J Med Sci, 283, p. 153-6
  5. Van Steenbergen W, Vanstapel MJ, Desmet V, et al. (1985) "Cimetidine-induced liver injury: report of three cases." J Hepatol, 1, p. 359-68
  6. Schwartz JT, Gyorkey F, Graham DY (1986) "Cimetidine hepatitis." J Clin Gastroenterol, 8, p. 681-6
  7. Lewis JH (1987) "Hepatic effects of drugs used in the treatment of peptic ulcer disease." Am J Gastroenterol, 82, p. 987-1003
  8. Boyd PT, Lepre F, Dickey JD (1989) "Chronic active hepatitis associated with cimetidine." Br Med J, 298, p. 324-5
  9. Ziemniak JA, Bernhard H, Schentag JJ (1983) "Hepatic encephalopathy and altered cimetidine kinetics." Clin Pharmacol Ther, 34, p. 375-82
  10. Gugler R, Muller-Liebenau B, Somogyi A (1982) "Altered disposition and availability of cimetidine in liver cirrhotic patients." Br J Clin Pharmacol, 14, p. 421-30
  11. Grahnen A, Jameson S, Loof L, Tyllstrom J, Lindstrom B (1984) "Pharmacokinetics of cimetidine in advanced cirrhosis." Eur J Clin Pharmacol, 26, p. 347-55
  12. Bianchi Porro G, Lazzaroni M, Lodola E (1983) "Blood levels of cimetidine in patients with liver cirrhosis." Int J Clin Pharmacol Ther Toxicol, 21, p. 374-7
  13. Hashimoto F, Davis RL, Egli D (1994) "Hepatitis following treatments with famotidine and then cimetidine." Ann Pharmacother, 28, p. 37-9
  14. (2001) "Product Information. Tagamet (cimetidine)." SmithKline Beecham
View all 14 references
Major

H2 antagonists (applies to Leader Heartburn Relief) GI bleeding

Major Potential Hazard, Moderate plausibility. Applicable conditions: Gastrointestinal Hemorrhage

Histamine H2 receptor antagonists should not be used in the presence of vomit with blood, or bloody or black stools. These might be serious conditions and the diagnosis needs to be ruled out.

References

  1. (2002) "Product Information. Pepcid (famotidine)." Merck & Co., Inc
  2. (2002) "Product Information. Axid (nizatidine)." Lilly, Eli and Company
  3. (2001) "Product Information. Tagamet (cimetidine)." SmithKline Beecham
  4. (2001) "Product Information. Tritec (ranitidine bismuth citrate)." Glaxo Wellcome
  5. (2002) "Product Information. Zantac 75 (ranitidine)." Pfizer U.S. Pharmaceuticals
View all 5 references
Moderate

Cimetidine (applies to Leader Heartburn Relief) hemodialysis

Moderate Potential Hazard, High plausibility.

Cimetidine is partially removed by hemodialysis and should be administered after dialysis.

References

  1. Larsson R, Erlanson P, Bodemar G, Norlander B, Fransson L, Strouth L (1982) "Pharmacokinetics of cimetidine and its sulphoxide metabolite during haemodialysis." Eur J Clin Pharmacol, 21, p. 325-30
  2. Bjaeldager PA, Jensen JB, Nielsen LP, Larsen NE, Hvidberg EF (1983) "Pharmacokinetics of cimetidine in patients undergoing hemodialysis." Nephron, 34, p. 159-63
  3. Pizzella KM, Moore MC, Schultz RW, Walshe J, Schentag JJ (1980) "Removal of cimetidine by peritoneal dialysis, hemodialysis, and charcoal hemoperfusion." Ther Drug Monit, 2, p. 273-81
  4. (2001) "Product Information. Tagamet (cimetidine)." SmithKline Beecham
View all 4 references
Moderate

Cimetidine (applies to Leader Heartburn Relief) renal dysfunction

Moderate Potential Hazard, High plausibility.

Cimetidine and its metabolites are primarily eliminated by the kidney. The daily dosage should initially be reduced in patients with moderate to severe renal impairment (CrCl < 50 mL/min). If necessary, the daily dosage may be increased with caution. Renal dysfunction also appears to be a risk factor for cimetidine-related central nervous system toxicity, which may include mental confusion, agitation, psychosis, depression, anxiety, hallucinations, and disorientation. These effects are generally reversible within 3 to 4 days after discontinuation of therapy.

References

  1. Larsson R, Bodemar G, Kagedal B (1979) "The effect of cimetidine, a new histamine H2-receptor antagonist, on renal function." Acta Med Scand, 205, p. 87-9
  2. Seidelin R (1980) "Cimetidine and renal failure." Postgrad Med J, 56, p. 440-1
  3. Larsson R, Erlanson P, Bodemar G, Walan A, Bertler A, Fransson L, Norlander B (1982) "The pharmacokinetics of cimetidine and its sulphoxide metabolite in patients with normal and impaired renal function." Br J Clin Pharmacol, 13, p. 163-70
  4. Guay DR, Matzke GR, Bockbrader HN, Dancik J (1983) "Comparison of bioavailability and pharmacokinetics of cimetidine in subjects with normal and impaired renal function." Clin Pharm, 2, p. 157-62
  5. Larsson R, Norlander B, Bodemar G, Walan A (1981) "Steady-state kinetics and dosage requirements of cimetidine in renal failure." Clin Pharmacokinet, 6, p. 316-25
  6. (2001) "Product Information. Tagamet (cimetidine)." SmithKline Beecham
  7. Gladziwa U, Klotz U (1994) "Pharmacokinetic optimisation of the treatment of peptic ulcer in patients with renal failure." Clin Pharmacokinet, 27, p. 393-408
View all 7 references

Leader Heartburn Relief drug interactions

There are 461 drug interactions with Leader Heartburn Relief (cimetidine).

Leader Heartburn Relief alcohol/food interactions

There are 3 alcohol/food interactions with Leader Heartburn Relief (cimetidine).

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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