cimetidine

sye-ME-ti-deen

Therapeutic Classification: antiulcer agents

Pharmacologic Classification: histamine h2 antagonists

REMS

Short-term treatment of active duodenal ulcers and benign gastric ulcers.
Maintenance therapy for duodenal ulcers after healing of active ulcer(s).
Gastroesophageal reflux disease (GERD).
Heartburn, acid indigestion, and sour stomach (OTC use).
Gastric hypersecretory states (Zollinger-Ellison syndrome).

Inhibits the action of histamine at the H₂-receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion.

Therapeutic effects:

Healing and prevention of ulcers.
Decreased symptoms of GERD.
Decreased secretion of gastric acid.

Absorption: Well absorbed following oral administration.

Distribution: Well distributed to tissues.

Metabolism/Excretion: 30% metabolized by the liver; remainder is eliminated unchanged by the kidneys.

Half-Life: 2 hr.

ROUTE	ONSET	PEAK	DURATION
PO	30 min	45–90 min	4–5 hr

Contraindicated in:

Hypersensitivity;
Lactation: Lactation.

Use Cautiously in:

Renal impairment (more susceptible to adverse CNS reactions; ↑ dose interval recommended for severe renal impairment);
OB: Safety not established in pregnancy;
Geri: Older adults are more susceptible to adverse CNS reactions (↓ dose).

CV: ARRHYTHMIAS

Endo: gynecomastia

GI: constipation, diarrhea, hepatitis, nausea

GU: ↓sperm count, erectile dysfunction

Hemat: anemia, AGRANULOCYTOSIS, APLASTIC ANEMIA, neutropenia, thrombocytopenia

Neuro: confusion, dizziness, drowsiness, hallucinations, headache

Misc: hypersensitivity reactions

Drug-drug:

May ↑ levels and risk of toxicity of CYP3A4 substrates, including benzodiazepines (especially chlordiazepoxide, diazepam, and midazolam), some beta blockers (labetalol, metoprolol, propranolol ),caffeine, calcium channel blockers, carbamazepine, chloroquine, lidocaine, metronidazole, pentoxifylline, phenytoin, propafenone, quinidine, quinine, metformin, sulfonylureas, theophylline, triamterene, tricyclic antidepressants, and warfarin.
May ↑ levels and risk of toxicity of succinylcholine, flecainide, procainamide, carmustine, and fluorouracil.
May ↓ absorption and effectiveness of ketoconazole.
Antacids and sucralfate may ↓ absorption and effectiveness.

Drug-Natural Products:

May ↑ levels and risk of toxicity of caffeine-containing herbs, including cola nut, guarana, mate, tea, and coffee.

PO (Adults ): Short-term treatment of active ulcers: 300 mg 4 times daily or 800 mg at bedtime or 400–600 mg twice daily (not to exceed 2.4 g/day). Duodenal ulcer prophylaxis: 300 mg twice daily or 400 mg at bedtime. GERD: 800–1600 mg/day in divided doses. Gastric hypersecretory conditions: 300–600 mg every 6 hr (up to 12 g/day have been used). OTC use: up to 200 mg may be taken twice daily (for no more than 2 wk).
PO (Children ): Short-term treatment of active ulcers: 20–40 mg/kg/day in 4 divided doses.

Renal Impairment

PO (Adults ): 300 mg every 8–12 hr; further adjustment may be required for concurrent hepatic impairment.
PO (Children ): 10–15 mg/kg/day given in divided doses every 8–12 hr.

(Generic available)

Tablets: 200 mg^OTC; 300 mg; 400 mg; 800 mg
Oral solution: 300 mg/5 mL

Assess for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate.
Geri: Assess older adults routinely for confusion. Report promptly.

Lab Test Considerations:

Monitor CBC with differential periodically during therapy.
- Antagonize effects of pentagastrin and histamine during gastric acid secretion testing. Avoid administration for 24 hr preceding the test.
- May cause false-negative results in allergy skin tests. Histamine antagonists should be discontinued 24 hr prior to testing.
- May ↑ transaminases and creatinine.

Avoid administration of antacids within 30 min–1 hr of cimetidine and take sucralfate 2 hr after cimetidine.
PO: Administer with meals or immediately afterward and at bedtime to prolong effect.
- Doses administered once daily should be administered at bedtime to prolong effect.
- Cimetidine tablets have a characteristic odor.

Explain purpose and side effects of cimetidine. Instruct patient to take as directed for the full course of therapy, even if feeling better. Take missed doses as soon as remembered but not if almost time for next dose. Do not double doses. Advise patient to read Patient Information before starting and with each Rx refill in case of changes.
- Advise patients taking OTC cimetidine not to take the maximum dose for >2 wk without consulting health care provider. Notify health care provider if difficulty swallowing occurs or abdominal pain persists.
- Inform patient that smoking interferes with the action of histamine antagonists. Encourage patient to quit smoking or not to smoke after last dose of the day.
- May cause drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertness until response to the drug is known.
- Advise patient to avoid alcohol, products containing aspirin or NSAIDs, and foods that may cause an ↑ in GI irritation.
- Inform patient that ↑ fluid and fiber intake and exercise may minimize constipation.
- Advise patient to report onset of black, tarry stools; fever; sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health care professional promptly.
- Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Decrease in abdominal pain, heartburn, acid indigestion, and sour stomach.
Prevention of gastric irritation and bleeding. Healing of duodenal ulcers can be seen by endoscopy. Therapy for ulcers is usually 6–8 wk.
Decreased symptoms of esophageal reflux.

~~Tagamet~~

NDC Code

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8192- Cimetidine
  - 0093-8192-01- 100 TABLET, FILM COATED in 1 BOTTLE (0093-8192-01)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8192- Cimetidine
  - 0093-8192-05- 500 TABLET, FILM COATED in 1 BOTTLE (0093-8192-05)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8192-
  - 0093-8192-99- 39063 TABLET, FILM COATED in 1 PAIL (0093-8192-99)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8204- Cimetidine
  - 0093-8204-01- 100 TABLET, FILM COATED in 1 BOTTLE (0093-8204-01)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8204- Cimetidine
  - 0093-8204-05- 500 TABLET, FILM COATED in 1 BOTTLE (0093-8204-05)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8204-
  - 0093-8204-99- 29297 TABLET, FILM COATED in 1 PAIL (0093-8204-99)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8305- Cimetidine
  - 0093-8305-01- 100 TABLET, FILM COATED in 1 BOTTLE (0093-8305-01)

0093- Teva Pharmaceuticals USA, Inc.
- 0093-8305-
  - 0093-8305-99- 16484 TABLET, FILM COATED in 1 PAIL (0093-8305-99)

0121- PAI Holdings, LLC dba PAI Pharma
- 0121-1025- Cimetidine Hydrochloride
  0121-1025-08- 237 mL in 1 BOTTLE (0121-1025-08)

0363- Walgreen Company
- 0363-0022- cimetidine 200 acid reducer
  - 0363-0022-72- 1 BOTTLE in 1 CARTON (0363-0022-72) / 60 TABLET, FILM COATED in 1 BOTTLE

0378- Mylan Pharmaceuticals Inc.
- 0378-0053- Cimetidine
  - 0378-0053-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0053-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-0317- Cimetidine
  - 0378-0317-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0317-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-0372- Cimetidine
  - 0378-0372-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0372-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-0541- Cimetidine
  - 0378-0541-01- 100 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (0378-0541-01)

38779- Medisca Inc.
- 38779-0325-
  - 38779-0325-3- 5000 g in 1 PAIL (38779-0325-3)

38779- Medisca Inc.
- 38779-0325-
  38779-0325-4- 25 g in 1 JAR (38779-0325-4)

38779- Medisca Inc.
- 38779-0325-
  38779-0325-5- 100 g in 1 JAR (38779-0325-5)

38779- Medisca Inc.
- 38779-0325-
  38779-0325-7- 25000 g in 1 DRUM (38779-0325-7)

38779- Medisca Inc.
- 38779-0325-
  38779-0325-8- 500 g in 1 JAR (38779-0325-8)

38779- Medisca Inc.
- 38779-0325-
  38779-0325-9- 1000 g in 1 JAR (38779-0325-9)

49035- Wal-Mart Stores Inc
- 49035-820- Equate Cimetidine
  49035-820-72- 1 BOTTLE in 1 CARTON (49035-820-72) / 60 TABLET, FILM COATED in 1 BOTTLE

49035- Wal-Mart Stores Inc
- 49035-820- Equate Cimetidine
  - 49035-820-76- 1 BOTTLE in 1 CARTON (49035-820-76) / 120 TABLET, FILM COATED in 1 BOTTLE

49452- Spectrum Laboratory Products, Inc.
- 49452-2063-
  - 49452-2063-4- 25000 g in 1 DRUM (49452-2063-4)

49711- Union Quimico Farmaceutica SA
- 49711-0095-
  49711-0095-0- 25 kg in 1 DRUM (49711-0095-0)

49964- Corden Pharma Bergamo SpA
- 49964-0006-
  49964-0006-0- 50 kg in 1 DRUM (49964-0006-0)

50090- A-S Medication Solutions
- 50090-0500- Cimetidine
  50090-0500-0- 30 TABLET, FILM COATED in 1 BOTTLE (50090-0500-0)

50090- A-S Medication Solutions
- 50090-0500- Cimetidine
  - 50090-0500-1- 60 TABLET, FILM COATED in 1 BOTTLE (50090-0500-1)

50090- A-S Medication Solutions
- 50090-3574- Cimetidine
  - 50090-3574-0- 30 TABLET, FILM COATED in 1 BOTTLE (50090-3574-0)

50090- A-S Medication Solutions
- 50090-3574- Cimetidine
  - 50090-3574-1- 60 TABLET, FILM COATED in 1 BOTTLE (50090-3574-1)

51552- Fagron Inc
- 51552-0531-
  - 51552-0531-5- 100 g in 1 CONTAINER (51552-0531-5)

51552- Fagron Inc
- 51552-0531-
  51552-0531-8- 1000 g in 1 CONTAINER (51552-0531-8)

51655- Northwind Pharmaceuticals, LLC
- 51655-697- Cimetidine
  51655-697-51- 40 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (51655-697-51)

51927- Professional Compounding Centers of America
- 51927-0190-
  - 51927-0190-0- 1 kg in 1 BOTTLE (51927-0190-0)

52183- Prestige Brands Holdings, Inc.
- 52183-223- TAGAMET
  52183-223-30- 3 BLISTER PACK in 1 BOX (52183-223-30) / 10 TABLET in 1 BLISTER PACK

55289- PD-Rx Pharmaceuticals, Inc.
- 55289-581- Cimetidine
  - 55289-581-10- 10 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (55289-581-10)

55289- PD-Rx Pharmaceuticals, Inc.
- 55289-581- Cimetidine
  - 55289-581-20- 20 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (55289-581-20)

55289- PD-Rx Pharmaceuticals, Inc.
- 55289-581- Cimetidine
  - 55289-581-30- 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (55289-581-30)

55289- PD-Rx Pharmaceuticals, Inc.
- 55289-581- Cimetidine
  - 55289-581-60- 60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (55289-581-60)

55289- PD-Rx Pharmaceuticals, Inc.
- 55289-581- Cimetidine
  - 55289-581-90- 90 TABLET, FILM COATED in 1 BOTTLE, PLASTIC (55289-581-90)

59640- H E B
- 59640-022- heartburn prevention
  - 59640-022-72- 1 BOTTLE in 1 CARTON (59640-022-72) / 60 TABLET, FILM COATED in 1 BOTTLE

59651- Aurobindo Pharma Limited
- 59651-823- CIMETIDINE
  - 59651-823-01- 100 TABLET, FILM COATED in 1 BOTTLE (59651-823-01)

59651- Aurobindo Pharma Limited
- 59651-823-
  - 59651-823-60- 60000 TABLET, FILM COATED in 1 BAG (59651-823-60)

59651- Aurobindo Pharma Limited
- 59651-824- CIMETIDINE
  59651-824-01- 100 TABLET, FILM COATED in 1 BOTTLE (59651-824-01)

59651- Aurobindo Pharma Limited
- 59651-824-
  - 59651-824-41- 40000 TABLET, FILM COATED in 1 BAG (59651-824-41)

59651- Aurobindo Pharma Limited
- 59651-825- CIMETIDINE
  59651-825-01- 100 TABLET, FILM COATED in 1 BOTTLE (59651-825-01)

59651- Aurobindo Pharma Limited
- 59651-825- CIMETIDINE
  - 59651-825-05- 500 TABLET, FILM COATED in 1 BOTTLE (59651-825-05)

59651- Aurobindo Pharma Limited
- 59651-825-
  - 59651-825-62- 30000 TABLET, FILM COATED in 1 BAG (59651-825-62)

59651- Aurobindo Pharma Limited
- 59651-826- CIMETIDINE
  59651-826-01- 100 TABLET, FILM COATED in 1 BOTTLE (59651-826-01)

59651- Aurobindo Pharma Limited
- 59651-826-
  - 59651-826-55- 15000 TABLET, FILM COATED in 1 BAG (59651-826-55)

59779- CVS Pharmacy
- 59779-022- heartburn relief
  59779-022-72- 1 BOTTLE in 1 CARTON (59779-022-72) / 60 TABLET, FILM COATED in 1 BOTTLE

59779- CVS Pharmacy
- 59779-022- heartburn relief
  - 59779-022-76- 1 BOTTLE in 1 CARTON (59779-022-76) / 120 TABLET, FILM COATED in 1 BOTTLE

60592- KALCHEM INTERNATIONAL INC
- 60592-074-
  - 60592-074-10- 1000 g in 1 BOTTLE (60592-074-10)

62135- Chartwell RX, LLC
- 62135-630- CIMETIDINE
  62135-630-30- 30 TABLET, FILM COATED in 1 BOTTLE (62135-630-30)

62135- Chartwell RX, LLC
- 62135-631- CIMETIDINE
  - 62135-631-90- 90 TABLET, FILM COATED in 1 BOTTLE (62135-631-90)

62135- Chartwell RX, LLC
- 62135-632- CIMETIDINE
  - 62135-632-90- 90 TABLET, FILM COATED in 1 BOTTLE (62135-632-90)

62135- Chartwell RX, LLC
- 62135-633- CIMETIDINE
  - 62135-633-90- 90 TABLET, FILM COATED in 1 BOTTLE (62135-633-90)

62135- Chartwell RX, LLC
- 62135-809- CIMETIDINE HYDROCHLORIDE
  - 62135-809-24- 2 TRAY in 1 BOX (62135-809-24) / 10 CUP in 1 TRAY / 5 mL in 1 CUP (62135-809-05)

62135- Chartwell RX, LLC
- 62135-809- CIMETIDINE HYDROCHLORIDE
  - 62135-809-37- 237 mL in 1 BOTTLE (62135-809-37)

62991- LETCO MEDICAL, LLC
- 62991-1456-
  - 62991-1456-1- 25 g in 1 JAR (62991-1456-1)

62991- LETCO MEDICAL, LLC
- 62991-1456-
  62991-1456-2- 100 g in 1 JAR (62991-1456-2)

62991- LETCO MEDICAL, LLC
- 62991-1456-
  62991-1456-3- 500 g in 1 JAR (62991-1456-3)

62991- LETCO MEDICAL, LLC
- 62991-1456-
  62991-1456-4- 1000 g in 1 JAR (62991-1456-4)

62991- LETCO MEDICAL, LLC
- 62991-1456-
  62991-1456-5- 25000 g in 1 DRUM (62991-1456-5)

63029- Medtech Products Inc.
- 63029-222- Tagamet
  63029-222-01- 1 BLISTER PACK in 1 BOX (63029-222-01) / 30 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-02- 1 BLISTER PACK in 1 BOX (63029-222-02) / 6 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-03- 1 BLISTER PACK in 1 BOX (63029-222-03) / 50 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-04- 4 BLISTER PACK in 1 BOX (63029-222-04) / 10 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-05- 4 BLISTER PACK in 1 BOX (63029-222-05) / 9 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-06- 7 BLISTER PACK in 1 BOX (63029-222-06) / 10 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-09- 1 BOTTLE in 1 CARTON (63029-222-09) / 90 TABLET in 1 BOTTLE

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-11- 1 BOTTLE in 1 CARTON (63029-222-11) / 100 TABLET in 1 BOTTLE

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-12- 2 BLISTER PACK in 1 BOX (63029-222-12) / 6 TABLET in 1 BLISTER PACK

63029- Medtech Products Inc.
- 63029-222- Tagamet
  - 63029-222-70- 1 BOTTLE in 1 CARTON (63029-222-70) / 70 TABLET in 1 BOTTLE

63029- Medtech Products Inc.
- 63029-223- Tagamet
  - 63029-223-30- 3 BLISTER PACK in 1 BOX (63029-223-30) / 10 TABLET in 1 BLISTER PACK

63187- Proficient Rx LP
- 63187-333- Cimetidine
  - 63187-333-30- 30 TABLET, FILM COATED in 1 BOTTLE (63187-333-30)

69452- Bionpharma Inc.
- 69452-323- Cimetidine
  - 69452-323-20- 100 TABLET, FILM COATED in 1 BOTTLE (69452-323-20)

69452- Bionpharma Inc.
- 69452-323- Cimetidine
  - 69452-323-30- 500 TABLET, FILM COATED in 1 BOTTLE (69452-323-30)

69452- Bionpharma Inc.
- 69452-324- Cimetidine
  - 69452-324-20- 100 TABLET, FILM COATED in 1 BOTTLE (69452-324-20)

69452- Bionpharma Inc.
- 69452-324- Cimetidine
  - 69452-324-30- 500 TABLET, FILM COATED in 1 BOTTLE (69452-324-30)

69452- Bionpharma Inc.
- 69452-325- Cimetidine
  - 69452-325-20- 100 TABLET, FILM COATED in 1 BOTTLE (69452-325-20)

69452- Bionpharma Inc.
- 69452-325- Cimetidine
  - 69452-325-30- 500 TABLET, FILM COATED in 1 BOTTLE (69452-325-30)

69452- Bionpharma Inc.
- 69452-326- Cimetidine
  - 69452-326-20- 100 TABLET, FILM COATED in 1 BOTTLE (69452-326-20)

69452- Bionpharma Inc.
- 69452-326- Cimetidine
  - 69452-326-30- 500 TABLET, FILM COATED in 1 BOTTLE (69452-326-30)

71052- DARMERICA, LLC
- 71052-456-
  - 71052-456-01- 1000 g in 1 CONTAINER (71052-456-01)

71052- DARMERICA, LLC
- 71052-456-
  71052-456-05- 5000 g in 1 CONTAINER (71052-456-05)

71052- DARMERICA, LLC
- 71052-456-
  71052-456-25- 25000 g in 1 CONTAINER (71052-456-25)

72288- Amazon.com Services LLC
- 72288-022- basic care acid reducer
  72288-022-76- 1 BOTTLE in 1 CARTON (72288-022-76) / 120 TABLET, FILM COATED in 1 BOTTLE

72375- SMS Lifesciences India Limited
- 72375-0010-
  - 72375-0010-1- 1 BAG in 1 DRUM (72375-0010-1) / 25 kg in 1 BAG

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Route/Dosage ⬆ ⬇

Availability ⬆ ⬇

Assessment ⬆ ⬇

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Code ⬆