Adult Dosing
Duodenal ulcer, active
- 300 mg IM/IV q6-8 hrs x 6 wks
- Max: 2400 mg/day
Active benign gastric ulcer
- 300 mg IM/IV q6-8 hrs (with meals and at bedtime) x 6 wks
- Max: 2400 mg/day
Pathological hypersecretory conditions
- 300-600 mg IM/IV q6 hrs (with meals and at bedtime)
- Max: 2400 mg/day
Upper GI bleed prophylaxis
- 50 mg/hr IV (25 mg/hr if CrCl <30 mL/min)
- Max: 7 days
Pediatric Dosing
- Note: Safety and effectiveness in pediatric patients <16 yrs of age have not been established
Treatment of duodenal and gastric ulcers, GERD, hypersecretory states [Not FDA approved]
Child (Not FDA approved)
- 20-40 mg/kg/day IM/IV divided q6 hrs
[Outline]
- Rare cases of anaphylaxis as well as rare episodes of hypersensitivity have been reported
- IM/IV therapy is indicated if oral therapy is not feasible
- Rare instances of cardiac arrhythmias and hypotension have been reported following rapid IV administration
- Reversible CNS effects including mental confusion, psychosis, depression, agitation, anxiety, hallucinations, and disorientation have occurred
- Reversible confusional states have occurred in critically ill patients; patients
50 yrs and those with pre-existing hepatic and/or renal impairment are at an increased risk - Symptomatic relief with cimetidine does not preclude gastric malignancy
- It may cause nausea, dizziness, drowsiness, headache and diarrhea
Cautions: Use cautiously in
- Renal impairment (refer dose adjustment section)
- Hepatic impairment (refer dose adjustment section)
- Chronic pulmonary disease
- Immunocompromised states
- Debilitated individuals
- Diabetes mellitus
- Elderly population
Pregnancy Category:B
Breastfeeding: This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776). Limited information indicates that cimetidine is excreted in breastmilk in small amounts and would produce infant serum levels much less than those with direct dosages to the neonates. Due to the potential to cause hepatic enzyme inhibition, other drugs may be preferred. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 15 September 2010).
