CIMETIDINE
Indications benign gastric and duodenal ulceration, stomal ulcer, reflux oesophagitis, Zollinger-Ellison syndrome, other conditions where gastric acid reduction is beneficial
Cautions see notes above; also hepatic impairment; interactions: histamine H2-antagonists and notes above
Side-effects see notes above; also alopecia; very rarely tachycardia, galactorrhoea, interstitial nephritis
Dose
• 400 mg twice daily (with breakfast and at night) or 800 mg at night (benign gastric and duodenal ulceration) for at least 4 weeks (6 weeks in gastric ulceration, 8 weeks in NSAID-associated ulceration); when necessary the dose may be increased to 400 mg 4 times daily; INFANT under 1 year 20 mg/kg daily in divided doses has been used; CHILD 1-12 years, 25-30 mg/kg daily in divided doses; max. 400 mg 4 times daily
Maintenance, 400 mg at night or 400 mg morning and night
• Reflux oesophagitis, 400 mg 4 times daily for 4-8 weeks
• Prophylaxis of stress ulceration, 200-400 mg every 4-6 hours
• Gastric acid reduction (prophylaxis of acid aspiration; do not use syrup), obstetrics 400 mg at start of labour, then up to 400 mg every 4 hours if required (max. 2.4 g daily); surgical procedures 400 mg 90-120 minutes before induction of general anaesthesia
• Short-bowel syndrome, 400 mg twice daily (with breakfast and at bedtime) adjusted according to response
• To reduce degradation of pancreatic enzyme supplements, 0.8-1.6 g daily in 4 divided doses 1-1 ½ hours before meals
Cimetidine * (Non-proprietary)
Tablets, cimetidine 200 mg, net price 60-tab pack = £1.96; 400 mg, 60-tab pack = £2.30; 800 mg, 30-tab pack = £1.99
Oral solution, cimetidine 200 mg/5 mL, net price 300 mL = £14.24
Excipients may include propylene glycol (see Excipients)
* Cimetidine can be sold to the public for adults and children over 16 years (provided packs do not contain more than 2 weeks’ supply) for the short-term symptomatic relief of heartburn, dyspepsia, and hyperacidity (max. single dose 200 mg, max. daily dose 800 mg), and for the prophylactic management of nocturnal heartburn (single night-time dose 100 mg)
Tagamet® (Chemidex)
Tablets, all green, f/c, cimetidine 200 mg, net price 120-tab pack = £19.58; 400 mg, 60-tab pack = £22.62; 800 mg, 30-tab pack = £22.62
Syrup, orange, cimetidine 200 mg/5 mL. Net price 600 mL = £28.49
Excipients include propylene glycol 10%