Nursing In Ghana

Cimetidine (Tagamet)

Cimetidine (Tagamet) inhibits the action of histamine at the histamine2 (H2) receptors of the stomach, inhibiting gastric acid secretion and reducing total pepsin output.

Brand Names

  • Tagamet
  • Tagamet HB, Tagamet HB Suspension

Drug class

  • Histamine2 (H2) antagonist
  • Pregnancy Category B

Therapeutic actions

Inhibits the action of histamine at the histamine2 (H2) receptors of the stomach, inhibiting gastric acid secretion and reducing total pepsin output.

Indications

  • Short-term treatment of active duodenal ulcer
  • Short-term treatment of benign gastric ulcer
  • Treatment of pathologic hypersecretory conditions (Zollinger-Ellison syndrome)
  • Prophylaxis of stress-induced ulcers and acute upper GI bleeding in critical patients
  • Treatment of erosive GERD
  • OTC use: Relief of symptoms of heartburn, acid indigestion, sour stomach

Contraindications and Cautions

  • Contraindicated with allergy to cimetidine.
  • Use cautiously with impaired renal or hepatic function, lactation.

Available Forms

Tablets—100, 200, 300, 400, 800 mg; liquid—300 mg/5 mL; injection—150 mg/mL, 300 mg/2 mL

Dosages

ADULTS

  • Active duodenal ulcer: 800 mg PO hs or 300 mg PO qid at meals and hs or 400 mg PO bid; continue for 4–6 wk. For intractable ulcers, 300 mg IM or IV q 6–8 hr.
  • Maintenance therapy for duodenal ulcer: 400 mg PO hs.
  • Active gastric ulcer: 300 mg PO qid at meals and hs or 800 mg hs.
  • Pathologic hypersecretory syndrome: 300 mg PO qid at meals and hs, or 300 mg IV or IM q 6 hr. Individualize doses as needed; do not exceed 2,400 mg/day.
  • Erosive GERD: 1,600 mg PO in divided doses bid–qid for 12 wk.
  • Prevention of upper GI bleeding: Continuous IV infusion of 50 mg/hr. Do not treat beyond 7 days (if creatinine clearance < 30 ml/min, give 25 mg/hr).
  • Heartburn, acid indigestion: 200 mg as symptoms occur, up to 4 tablets/24 hr.
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PEDIATRIC PATIENTS

Not recommended for children < 12 yr.

GERIATRIC PATIENTS OR PATIENTS WITH IMPAIRED RENAL FUNCTION

Accumulation may occur. Use lowest dose possible, 300 mg PO or IV q 12 hr; may be increased to q 8 hr if patient tolerates it and levels are monitored; if creatinine clearance < 30 ml/min, give 25 mg/hr IV for prevention of upper GI bleed.

Adverse Effects

  • CNS: Dizziness, somnolence, headache, confusion, hallucinations, peripheral neuropathy; symptoms of brain stem dysfunction (dysarthria, ataxia, diplopia)
  • CV: Cardiac arrhythmias, cardiac arrest, hypotension (IV use)
  • GI: Diarrhea
  • HematologicIncreases in plasma creatinine, serum transaminase
  • Other: Impotence (reversible), gynecomastia (in long-term treatment), rash, vasculitis, pain at IM injection site

Interactions

Drug-drug

  • Increased risk of decreased white blood cell counts with antimetabolites, alkylating agents, other drugs known to cause neutropenia
  • Increased serum levels and risk of toxicity of warfarin-type anticoagulants, phenytoin, beta-adrenergic blocking agents, alcohol, quinidine, lidocaine, theophylline, chloroquine, certain benzodiazepines (alprazolam,chlordiazepoxide, diazepam, flurazepam, triazolam), nifedipine, pentoxifylline, TCAs, procainamide, carbamazepine when taken with cimetidine

Nursing Interventions

  • Give drug with meals and hs.
  • Administer IM dose undiluted deep into large muscle group.
  • Arrange for regular follow-up, including blood tests to evaluate effects.
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Jude Arko

Chief Editor - Nursing In Ghana | Mental Health Nurse | Photog | App Developer

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