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Cimetidine

Class: Histamine H2-Antagonists
VA Class: GA301
CAS Number: 51481-61-9
Brands: Tagamet

Medically reviewed by Drugs.com on Nov 23, 2020. Written by ASHP.

Introduction

Histamine H2 receptor antagonist.

Uses for Cimetidine

Duodenal Ulcer

Short-term treatment of active duodenal ulcer (endoscopically or radiographically confirmed).

Maintainence of healing and reduction in recurrence of duodenal ulcer.

Pathologic GI Hypersecretory Conditions

Long-term treatment of Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis.

Gastric Ulcer

Short-term treatment of active benign gastric ulcer.

Gastroesophageal Reflux (GERD)

Short-term treatment of erosive esophagitis (endoscopically diagnosed) in patients with GERD.

Treatment of symptomatic GERD.

Self-medication as initial therapy to achieve acid suppression, control symptoms, and prevent complications of less severe symptomatic GERD.

Upper GI Bleeding

Prevention of upper GI bleeding resulting from stress-related mucosal damage (erosive esophagitis, stress ulcers) in critically ill patients.

Treatment of upper GI bleeding secondary to hepatic failure, esophagitis, duodenal or gastric ulcers when hemorrhage is not caused by major blood vessel erosion.

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.

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.

Allergic Conditions and Urticarias†124 125 126 127 128 129 130 131 132 133 134 135 136 137

Cimetidine Dosage and Administration

Administration

Administer orally, IV, or IM.

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.

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.

Antacids may be given as necessary for pain relief, but not at the same time.

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.

For gastric ulcer treatment, administration once daily at bedtime is the regimen of choice because of convenience and decreased drug interaction potential.

For gastroesophageal reflux, once-daily dosing is not considered appropriate.

IM Administration

May be administered undiluted.

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).

Rate of Administration

Inject over ≥5 minutes.

Intermittent IV infusion

Reconstitution

Reconstitute ADD-Vantage vials according to manufacturer’s directions.

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).

No additional dilution required for commercially available infusion solution (300 mg cimetidine in 50 mL of 0.9% sodium chloride injection).

Rate of Administration

Over 15–20 minutes.

Continuous IV Infusion

Dilution

Dilute 900 mg in 100–1000 mL of a compatible IV solution (see Compatibility under Stability).

Rate of Administration

Over 24 hours.

Adjust rate to individual patient requirements.

Volume <250 mL: use controlled-infusion device (e.g., pump).

Dosage

Dosage of cimetidine hydrochloride expressed in terms of cimetidine.

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.

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.

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.

Adults

General Parenteral Dosage

Parenteral dosage regimens for GERD have not been established.

General parenteral dosage (in hospitalized patients with pathologic hypersecretory conditions or intractable ulcer, or for short-term use when oral therapy is not feasible):

IM

300 mg every 6–8 hours.

Intermittent Direct IV Injection

300 mg every 6–8 hours.

300 mg more frequently if increased daily dosage is necessary (i.e., single doses not >300 mg), up to 2400 mg daily.

Intermittent IV Infusion

300 mg every 6–8 hours.

300 mg more frequently if increased daily dosage is necessary (i.e., single doses not >300 mg), up to 2400 mg daily.

Continuous IV infusion

900 mg over 24 hours (37.5 mg/hour). 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.

Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral

Dosage of choice: 800 mg once daily at bedtime.

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: 1.6 g daily at bedtime.

Administer for 4–6 weeks unless healing is confirmed earlier. If not healed or symptoms continue after 4 weeks, additional 2–4 weeks of full dosage therapy may be beneficial. More than 6–8 weeks at full dosage is rarely needed.

Healing of active duodenal ulcers may occur in 2 weeks in some, and occurs within 4 weeks in most patients.

Other regimens (no apparent rationale for these other than familiarity of use) that have been used: 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.

Maintenance of Healing of Duodenal Ulcer
Oral

400 mg daily at bedtime. Efficacy not increased by higher dosages or more frequent administration.

Pathologic GI Hypersecretory Conditions
Zollinger-Ellison Syndrome
Oral

300 mg 4 times daily with meals and at bedtime.

Higher doses administered more frequently may be necessary; adjust dosage according to response and tolerance but in general, do not exceed 2400 mg daily.

Continue as long as necessary.

Continuous IV Infusion

Mean infused dose of 160 mg/hour (range: 40-600 mg/hour) in one study.

Gastric Ulcer
Oral

Preferred regimen: 800 mg once daily at bedtime.

Alternative regimen: 300 mg 4 times daily, with meals and at bedtime.

Monitor to ensure rapid progress to complete healing.

Studies limited to 6 weeks, efficacy for >8 weeks not established.

GERD

Once daily (at bedtime) not considered appropriate therapy.

Treatment of Symptomatic GERD†
Oral

300 mg 4 times daily has been used.

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.

Upper GI Bleeding
Prevention of Upper GI Bleeding
Continuous IV Infusion

50 mg/hour; loading dose not required.

Safety and efficacy of therapy beyond 7 days has not been established.

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).

Intermittent IV doses may be less effective in preventing upper GI bleeding than continuous IV infusion.

Treatment of Upper GI Bleeding†
Oral

1–2 g daily in 4 divided doses has been used.

IV

1–2 g daily in 4 divided doses has been used.

Heartburn, Acid Indigestion, or Sour Stomach
Heartburn (Self-medication)
Oral

200 mg once or twice daily, or as directed by clinician.

Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.

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.

Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.

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.

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.

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.

Maximum 300 mg per dose.

Maximum concentration 300 mg/20 mL.

Maximum injection rate: 20 mL over not less than 5 minutes (4 mL per minute).

Intermittent IV Infusion

Maximum 2.4 g daily.

Maximum 300 mg per dose.

Maximum concentration 300 mg/50 mL.

Maximum infusion rate: 15–20 minutes.

GERD
Short-term Treatment of Erosive Esophagitis
Oral

Safety and efficacy beyond 12 weeks of administration have not been established.

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.

Prevention of Heartburn (Self-medication)
Oral

Maximum 400 mg in 24 hours, but not continuously for >2 weeks except under clinician supervision.

Duodenal Ulcer
Intermittent Direct IV Injecton

Maximum 2.4 g daily.

Intermittent IV Infusion

Maximum 2.4 g daily.

Gastric Ulcer
Short-term treatment of Active Benign Gastric Ulcer
Oral

Safety and efficacy beyond 8 weeks have not been established.

Intermittent Direct IV Injection

Maximum 2.4 g daily.

Intermittent IV Infusion

Maximum 2.4 g daily.

Pathologic GI Hypersecretory Conditions (e.g., Zollinger-Ellison Syndrome)
Oral

Maximum usually 2.4 g daily.

Intermittent Direct IV Injection

Maximum 2.4 g daily.

Intermittent IV Infusion

Maximum 2.4 g daily.

Upper GI Bleeding
Prevention of Upper GI Bleeding
Continuous IV Infusion

Safety and efficacy beyond 7 days have not been established.

Special Populations

Renal Impairment

Severe (Clcr< 30 mL/minute)
Oral

300 mg every 12 hours.

Accumulation may occur; use lowest frequency of dosing compatible with adequate response.

Increase frequency to every 8 hours or more frequently (with caution) if required.

Presence of hepatic impairment may require further dosage reduction.

Direct IV Injection

300 mg every 12 hours.

Accumulation may occur; use lowest frequency compatible with adequate response.

Increase frequency to every 8 hours or more frequently (with caution) if required

Presence of hepatic impairment may require further dosage reduction.

Continuous IV Infusion

Prevention of Upper GI Bleeding: One-half recommended dosage (i.e., 25 mg/hour).

Hemodialysis

Decreases blood levels; administer at the end of hemodialysis and every 12 hours during interdialysis.

Hepatic Impairment

May require further dosage reduction in the presence of severe renal impairment.

Cautions for Cimetidine

Contraindications

  • Known hypersensitivity to cimetidine or any ingredient in the formulation.

Warnings/Precautions

General Precautions

Cardiovascular Effects

Rapid IV administration associated rarely with hypotension, cardiac arrhythmias; avoid.

Gastric Malignancy

Response to cimetidine does not preclude presence of gastric malignancy.

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. Usually occurs within 2–3 days after initiating cimetidine and resolves within 3–4 days after discontinuance.

Respiratory Effects

Administration of H2-receptor antagonists has been associated with an increased risk for developing certain infections (e.g., community-acquired pneumonia).

Specific Populations

Pregnancy

Category B.

Pregnant women should consult a clinician before using for self-medication.

Lactation

Distributed into milk. Generally, do not nurse during therapy with cimetidine.

Nursing women should consult a clinician before using for self-medication.

Pediatric Use

Safety and efficacy not established in children <16 years of age; do not use unless potential benefits outweigh risks.

Safety and efficacy for self-medication not established in children <12 years of age; do not use unless directed by a clinician.

Renal Impairment

Dosage adjustments necessary in patients with severe renal impairment. (See Renal Impairment under Dosage and Administration.)

Hepatic Impairment

Further dosage adjustments may be necessary in presence of severe renal impairment. (See Hepatic Impairment under Dosage and Administration.)

Immunocompromised Patients

Increased possibility of Strongyloides stercoralis hyperinfection with decreased gastric acidity.

Common Adverse Effects

Headache, dizziness, somnolence, diarrhea.

With ≥1 month of therapy: gynecomastia.

With IM therapy: transient pain at injection site.

Interactions for Cimetidine

Inhibits hepatic microsomal enzyme systems, decreases hepatic metabolism of some drugs. If necessary, adjust dosage of hepatically metabolized drugs when cimetidine therapy is initiated or discontinued.

Specific Drugs

Drug

Interaction

Comments

Alcohol

Possible increased blood alcohol concentrations, psychomotor impairment

Potential for psychomotor impairment controversial, but use caution during performance of hazardous tasks requiring mental alertness, physical coordination

Antacids

Decreased cimetidine absorption

Administer 1 hour before or after cimetidine in the fasting state, or 1 hour after cimetidine is taken with food.

Benzodiazepines

Potential for delayed elimination, increased blood concentrations of certain benzodiazepines (e.g., diazepam, chlordiazepoxide, triazolam)

Adjust dosage if needed

Calcium-channel blockers (e.g., nifedipine)

Potential for delayed elimination, increased blood concentrations of nifedipine

Adjust dosage if needed

Ketoconazole

Absorption of ketoconazole may be affected by altered gastric pH

Administer ≥2 hours before cimetidine

Lidocaine

Potential for delayed elimination, increased blood concentrations of lidocaine

Adverse effects reported, adjust dosage if needed

Metronidazole

Potential for delayed elimination, increased blood concentrations of metronidazole

Adjust dosage if needed

Myelosuppressive drugs (e.g., alkylating agents [e.g., carmustine], antimetabolites) and/or therapies (radiation)

May potentiate myelosuppression

Phenytoin

Potential for delayed elimination, increased blood concentrations of phenytoin

Adverse effects reported, adjust dosage if needed

Propranolol

Potential for delayed elimination, increased blood concentrations of propranolol

Adjust dosage if needed

Theophylline

Potential for delayed elimination, increased blood concentrations of theophylline

Adverse effects reported, adjust dosage if needed

Triamterene

Potential for delayed elimination, increased blood concentrations of triamterene

Consider potential of clinically important interaction

Tricyclic Antidepressants

Potential for delayed elimination, increased blood concentrations of certain tricyclic antidepressants

Adjust dosage if needed

Warfarin

Potential for delayed elimination, increased blood concentrations of warfarin

Monitor PT, adjust dosage if needed

Cimetidine Pharmacokinetics

Absorption

Bioavailability

Oral: 60–70%.

Onset

≥70% decrease in basal acid secretion within 45 minutes after single 300- or 400-mg IV dose in healthy males.

Duration

Dosage Regimen

Effect On Acid Secretion

Comments

Oral: 800 mg at bedtime in duodenal ulcer patients

Mean hourly nocturnal secretion decreased by 85% over 8 hours.

No effect on daytime acid secretion

Oral: 1600 mg at bedtime in duodenal ulcer patients

Mean hourly nocturnal secretion decreased by 100% over 8 hours, 35% decrease for additional 5 hours.

Moderate (<60%) 24-hour suppression

Oral: 400 mg twice daily in duodenal ulcer pateints

Nocturnal secretion decreased by 47–83% over 6–8 hours

Moderate (<60%) 24-hour suppression

Oral: 300 mg 4 times daily in duodenal ulcer patients

Nocturnal secretion decreased by 54% over 9 hours

Moderate (<60%) 24-hour suppression

Oral: Single 300-mg dose within 1 hour after meal in duodenal ulcer patients

Food-stimulated secretion decreased by 50% for 1 hour, then 75% for 2 hours.

Oral: 300-mg dose at breakfast in duodenal ulcer patients

Continued suppression for 4 hours, with partial suppression after lunch

Effect enhanced and maintained by additional 300-mg dose with lunch

Oral: 300-mg dose with food

Mean gastric pH 3.5–4 at 1 hour, 5.5–6.1 at 4 hours

Oral: Single dose 300 mg with food

Mean gastric pH: 3.5, 3.1, 3.8, 6.1 at hour 1, 2, 3, 4, respectively

Placebo mean gastric pH: 2.6, 1.6, 1.9, 2.2 at hour 1, 2, 3, 4, respectively

Oral: 300–400 mg in fasting state in duodenal ulcer patients

Anacidity for up to 8 hours

Oral: 300 mg in duodenal ulcer patients

Basal gastric acid output decreased by 90% for 4 hours

Meal-stimulated acid secretion by 66% for 3 hours

IV continuous infusion: mean dosage of 160 mg/hour (range:40-600 mg/hour) in pathologic hypersecretory conditions

Maintained secretion at ≤10 mEq/hour

IV continuous infusion (37.5 mg/hour or 900 mg daily) in patients with active or healed duodenal or gastric ulcer

Maintained gastric pH at >4 for >50% of the time at steady-state.

Intermittent injection: (300 mg every 6 hours or 1200 mg daily) in patients with active or healed duodenal or gastric ulcer

Maintained gastric pH at >4 for >50% of the time at steady-state.

IV: Single 300- or 400-mg dose in healthy males

≥70% decrease in basal acid secretion maintained for 4–4.5 hours

Food

Delays, slightly decreases absorption. However, administration with meals achieves maximum blood concentrations and antisecretory effect when stomach is no longer protected by food buffering effect.

Distribution

Extent

Widely distributed throughout the body.

Distributed into human milk.

Crosses the placenta in animals.

Plasma Protein Binding

15–20%.

Elimination

Metabolism

Metabolized to sulfoxide (major metabolite) and 5-hydroxymethyl derivatives in liver. More extensively metabolized after oral than parenteral administration.

Elimination Route

Excreted principally in urine. Single oral dose: 48% (unchanged) excreted in urine over 24 hours. IV or IM: about 75% (unchanged) excreted in urine within 24 hours. Single IV dose of radiolabeled cimetidine: 80–90% (50–73% unchanged, remainder as metabolites) excreted in urine over 24 hours. About 10% excreted in feces.

Half-life

2 hours.

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.

Special Populations

2.9 hours in patients with Clcr 20–50 mL/minute. 3.7 hours in patients with Clcr <20 mL/minute. 5 hours in anephric patients.

Stability

Storage

Oral

Liquid and Tablets

Tight, light-resistant containers at 15–30°C.

Parenteral

Injection

15–30°C. Protect from light. Do not refrigerate. Stable in most IV solutions for at least 3 days at room temperature in concentrations of 1.2–5 mg/mL, but use within 48 hours when diluted as directed.

Injection for IV infusion only

15–30°C. Protect from excessive heat; brief exposure up to 40°C does not adversely affect stability. Stable through the labeled expiration date when stored as recommended.

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

Actions

  • Inhibits basal and stimulated gastric acid secretion.

  • Competitively inhibits histamine at parietal cell H2 receptors.

  • Weak antiandrogenic effect.

Advice to Patients

  • Importance of patients informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs.

  • 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, but not at same time as oral cimetidine.

  • Importance of women informing clinician if they are or plan to become pregnant or plan to breast-feed.

  • Before self-medication, importance of consulting clinician if taking warfarin, theophylline, or phenytoin.

  • Importance of following dosage instructions when cimetidine is administered for self-medication, unless otherwise directed by a clinician.

  • Importance of promptly informing clinician of persistent abdominal pain or difficulty swallowing.

  • 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.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

* 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

Injection, for IV infusion only

150 mg (of cimetidine) per mL

Cimetidine Hydrochloride ADD-Vantage

Hospira

Cimetidine Hydrochloride in Sodium Chloride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

Injection, for IV infusion only

6 mg (of cimetidine) per mL (300, 900, or 1200 mg) in 0.9% Sodium Chloride

Cimetidine HCl in 0.9% Sodium Chloride Injection (available in flexible plastic container)

Hospira

6 mg (of cimetidine) per mL (300 mg) in 0.9% Sodium Chloride

AHFS DI Essentials™. © Copyright 2021, Selected Revisions December 1, 2009. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

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