Skip to main content

Drug Interactions between carvedilol and Leader Heartburn Relief

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

cimetidine carvedilol

Applies to: Leader Heartburn Relief (cimetidine) and carvedilol

MONITOR: H2 antagonists such as cimetidine increase plasma concentrations of some oral beta-blockers. The mechanism may be related to inhibition of CYP450 metabolism of hepatically metabolized beta-blockers, and/or inhibition of renal tubular secretion of others. The potential inhibition of CYP450 enzymes by other H2 antagonists (ranitidine, famotidine, nizatidine) is significantly less than that of cimetidine and is not expected to be clinically significant.

MANAGEMENT: Clinical monitoring of patient response and tolerance is recommended when cimetidine is added to or discontinued from a beta-blocker regimen.

References

  1. Durant PA, Joucken K (1984) "Bronchospasm and hypotension during cardiopulmonary bypass after preoperative cimetidine and labetalol therapy." Br J Anaesth, 56, p. 917-20
  2. Duchin KL, Stern MA, Willard DA, McKinstry DN (1984) "Kinetic interactions of nadolol and propranolol with cimetidine." Br J Clin Pharmacol, 17, p. 486-7
  3. Duchin KL, Stern MA, Willard DA, McKinstry DN (1984) "Comparison of kinetic interactions of nadolol and propranolol with cimetidine." Am Heart J, 108, p. 1084-6
  4. Houtzagers JJ, Streurman O, Regardh CG (1982) "The effect of pretreatment with cimetidine on the bioavailability and disposition of atenolol and metoprolol." Br J Clin Pharmacol, 14, p. 67-72
  5. Kirch W, Spahn H, Kohler H, et al. (1982) "Interaction of metoprolol, propranolol and atenolol with concurrent administration of cimetidine." Klin Wochenschr, 60, p. 1401-7
  6. Toon S, Davidson EM, Garstang FM, et al. (1988) "The racemic metoprolol H2-antagonist interaction." Clin Pharmacol Ther, 43, p. 283-9
  7. Somogyi AA, Bochner F, Sallustio BC (1992) "Stereoselective inhibition of pindolol renal clearance by cimetidine in humans." Clin Pharmacol Ther, 51, p. 379-87
  8. Spahn H, Kirch W, Hajdu P, et al. (1986) "Penbutolol pharmacokinetics: the influence of concomitant administration of cimetidine." Eur J Clin Pharmacol, 29, p. 555-60
  9. Rey E, Jammet P, d'Athis P, et al. (1987) "Effect of cimetidine on the pharmacokinetics of the new beta-blocker betaxolol." Arzneimittelforschung, 37, p. 953-6
  10. Daneshmend TK, Roberts CJ (1984) "The effects of enzyme induction and enzyme inhibition on labetalol pharmacokinetics." Br J Clin Pharmacol, 18, p. 393-400
  11. Kirch W, Rose I, Klingmann I, Pabst J, Ohnhaus EE (1986) "Interaction of bisoprolol with cimetidine and rifampicin." Eur J Clin Pharmacol, 31, p. 59-62
  12. Feely J, Wilkinson GR, Wood AJ (1981) "Reduction of liver blood flow and propranolol metabolism by cimetidine." N Engl J Med, 304, p. 692-5
  13. Asgharnejad M, Powell R, Donn K, Danis M (1987) "The effect of cimetidine dose timing on oral propranolol kinetics in adults." Clin Pharmacol Ther, 41, p. 203
  14. (2002) "Product Information. Tenormin (atenolol)." ICN Pharmaceuticals Inc
  15. (2002) "Product Information. Corgard (nadolol)." Bristol-Myers Squibb
  16. (2001) "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical
  17. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories
  18. Seffart G ed. (1991) "Drug Dosage in Renal Insufficiency." Dordrecht, South Holland, : Kluwer Academic Publishers
  19. Limbird LE eds., Gilman AG, Hardman JG (1995) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: McGraw-Hill
  20. Ishii Y, Nakamura K, Tsutsumi K, Kotegawa T, Nakano S, Nakatsuka K (2000) "Drug interaction between cimetidine and timolol ophthalmic solution: Effect on heart rate and intraocular pressure in healthy Japanese volunteers." J Clin Pharmacol, 40, p. 193-9
View all 20 references

Switch to consumer interaction data

Drug and food interactions

Minor

cimetidine food

Applies to: Leader Heartburn Relief (cimetidine)

Concurrent use of cimetidine and ethanol may result in increased ethanol concentrations. The mechanism appears to be due to inhibition of gastric alcohol dehydrogenase by cimetidine, leading to increased bioavailability of the alcohol and inhibition of hepatic metabolism of alcohol. The clinical significance of this interaction is limited. More importantly, patients requiring cimetidine for gastrointestinal disease should be counseled to avoid alcohol to prevent worsening of their disease. The other H-2 receptor antagonists appear to have minimal effects on the concentrations of alcohol.

References

  1. Feely J, Wood AJ (1982) "Effects of cimetidine on the elimination and actions of ethanol." JAMA, 247, p. 2819-21
  2. Hansten PD (1992) "Effects of H2-receptor antagonists on blood alcohol levels." JAMA, 267, p. 2469

Switch to consumer interaction data

Minor

cimetidine food

Applies to: Leader Heartburn Relief (cimetidine)

Caffeine effects may be increased in patients also taking cimetidine. The mechanism may be due to decreased caffeine metabolism induced by cimetidine. Although adequate clinical data are lacking, a reduction in dose or elimination of caffeine may be needed if excess CNS stimulation is observed.

References

  1. (2001) "Product Information. Tagamet (cimetidine)." SmithKline Beecham
  2. Broughton LJ, Rodgers HJ (1981) "Decreased systenuc clearance of caffeine due to cimetidine." Br J Clin Pharmacol, 12, p. 155-9

Switch to consumer interaction data

Minor

cimetidine food

Applies to: Leader Heartburn Relief (cimetidine)

H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.

References

  1. Bendayan R, Sullivan JT, Shaw C, Frecker RC, Sellers EM (1990) "Effect of cimetidine and ranitidine on the hepatic and renal elimination of nicotine in humans." Eur J Clin Pharmacol, 38, p. 165-9

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer