Cimetidine: Difference between revisions
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==General== | ==General== | ||
*Type: H2 | *Type: [[H2 blocker]] | ||
*Dosage Forms: 200, 300, 400, | *Dosage Forms: 200, 300, 400, 800mg | ||
*Common Trade Names: Tagamet HB 200 | *Common Trade Names: Tagamet HB 200 | ||
==Adult Dosing== | ==Adult Dosing== | ||
===Duodenal Ulcer, Active=== | |||
*800mg PO QHS x 4-8 weeks | |||
===Duodenal Ulcer, Maintenance=== | |||
*400mg PO QHS | |||
===Gastric Ulcer, active benign=== | |||
*800mg PO QHS x 6 weeks | |||
===H. Pylori Infection=== | |||
*400mg PO BID x 10-28 days | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===GERD/PUD=== | |||
*Neonates: 5- 10mg/kg/day PO divided q8-12h | |||
*Infants: 10-20mg/kg/day PO divided q8-12h | |||
*Children: 20-40mg/kg/day PO divided q6H | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B (animal studies show no risk for adverse fetal effects, human fetal harm possible but unlikely) | ||
*Lactation: | *Lactation: Probably Safe | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: CrCL 10-50: decrease dose 50%, CrCl <10, decrease dose 75% | ||
**Pediatric | **Pediatric: CrCl 20-40, decrease dose 25% or give q8h, CrCL <20: decrease dose 50% | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: Not Defined | ||
**Pediatric | **Pediatric not defined | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*caution if renal impairment | |||
*caution if hepatic impairment | |||
*caution in elderly patients | |||
*caution if chronic pulmonary disease | |||
*caution if [[DM]] | |||
*caution if immunocompromised | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*[[Anticholinergic toxicity]] | |||
*[[neutropenia]] | |||
*[[thrombocytopenia]] | |||
*agranulocytosis | |||
*aplastic anemia | |||
*[[pneumonia]] | |||
*[[depression]] | |||
*[[psychosis]] | |||
*[[hallucinations]] | |||
*[[pancreatitis]] | |||
*interstital nephritis | |||
*[[bradycardia]] | |||
*[[tachycardia]] | |||
*[[AV block]] | |||
*skin reaction | |||
===Common=== | ===Common=== | ||
*[[headche]] | |||
*[[diarrhea]] | |||
*[[dizziness]] | |||
*gynecomastia | |||
*[[nausea]] | |||
*[[vomiting]] | |||
*confusion | |||
*agitation | |||
*drowsiness | |||
*[[rash]] | |||
*ALT,AST elevation | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 2H | ||
*Metabolism: | *Metabolism: Liver; CYP450, 1A2, 2C19, 2D6 Inhibitor | ||
*Excretion: | *Excretion: urine | ||
*Mechanism of Action: | *Mechanism of Action: Histamine H2 Receptor blocker | ||
==See Also== | ==See Also== | ||
*[[Anticholinergic toxicity]] | |||
== | ==References== | ||
*2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi: 10.1111/jgs.15767. [PubMed 30693946] | |||
*American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106(4):843-863. [PubMed 17413923] | |||
*Andreev E, Koopman M, Arisz L. A rise in plasma creatinine that is not a sign of renal failure: which drugs can be responsible? J Intern Med. 1999;246(3):247-252. [PubMed 10475992] | |||
*ASHP Therapeutic Guidelines on Stress Ulcer Prophylaxis. ASHP Commission on Therapeutics and approved by the ASHP Board of Directors on November 14, 1998. Am J Health Syst Pharm. 1999;56(4):347-379. [PubMed 10690219] | |||
*Aronoff GR, Bennett WM, Berns JS, et al, eds. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children. 5th ed. Philadelphia, PA: American College of Physicians; 2007. | |||
<references/> | <references/> | ||
[[Category: | |||
[[Category:Pharmacology]] | |||
Revision as of 18:55, 8 June 2019
General
- Type: H2 blocker
- Dosage Forms: 200, 300, 400, 800mg
- Common Trade Names: Tagamet HB 200
Adult Dosing
Duodenal Ulcer, Active
- 800mg PO QHS x 4-8 weeks
Duodenal Ulcer, Maintenance
- 400mg PO QHS
Gastric Ulcer, active benign
- 800mg PO QHS x 6 weeks
H. Pylori Infection
- 400mg PO BID x 10-28 days
Pediatric Dosing
GERD/PUD
- Neonates: 5- 10mg/kg/day PO divided q8-12h
- Infants: 10-20mg/kg/day PO divided q8-12h
- Children: 20-40mg/kg/day PO divided q6H
Special Populations
- Pregnancy Rating: B (animal studies show no risk for adverse fetal effects, human fetal harm possible but unlikely)
- Lactation: Probably Safe
- Renal Dosing
- Adult: CrCL 10-50: decrease dose 50%, CrCl <10, decrease dose 75%
- Pediatric: CrCl 20-40, decrease dose 25% or give q8h, CrCL <20: decrease dose 50%
- Hepatic Dosing
- Adult: Not Defined
- Pediatric not defined
Contraindications
- Allergy to class/drug
- caution if renal impairment
- caution if hepatic impairment
- caution in elderly patients
- caution if chronic pulmonary disease
- caution if DM
- caution if immunocompromised
Adverse Reactions
Serious
- Anticholinergic toxicity
- neutropenia
- thrombocytopenia
- agranulocytosis
- aplastic anemia
- pneumonia
- depression
- psychosis
- hallucinations
- pancreatitis
- interstital nephritis
- bradycardia
- tachycardia
- AV block
- skin reaction
Common
- headche
- diarrhea
- dizziness
- gynecomastia
- nausea
- vomiting
- confusion
- agitation
- drowsiness
- rash
- ALT,AST elevation
Pharmacology
- Half-life: 2H
- Metabolism: Liver; CYP450, 1A2, 2C19, 2D6 Inhibitor
- Excretion: urine
- Mechanism of Action: Histamine H2 Receptor blocker
See Also
References
- 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi: 10.1111/jgs.15767. [PubMed 30693946]
- American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106(4):843-863. [PubMed 17413923]
- Andreev E, Koopman M, Arisz L. A rise in plasma creatinine that is not a sign of renal failure: which drugs can be responsible? J Intern Med. 1999;246(3):247-252. [PubMed 10475992]
- ASHP Therapeutic Guidelines on Stress Ulcer Prophylaxis. ASHP Commission on Therapeutics and approved by the ASHP Board of Directors on November 14, 1998. Am J Health Syst Pharm. 1999;56(4):347-379. [PubMed 10690219]
- Aronoff GR, Bennett WM, Berns JS, et al, eds. Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children. 5th ed. Philadelphia, PA: American College of Physicians; 2007.