Benign gastric and duodenal ulceration, GERD, Zollinger-Ellison syndrome, Prophylaxis of GI haemorrhage from stress ulceration, Prophylaxis of acid aspiration during general anesthesia, Non-ulcer dyspepsia, Prophylaxis of nocturnal heartburn, Short bowel syndrome, Pancreatic insufficiency, Benign gastric and duodenal ulceration, Zollinger-Ellison syndrome Intermittent infusion.
Benign gastric and duodenal ulceration: 800 mg daily at bedtime or 400 mg bid for at least 4 wk (duodenal ulcer), 6 wk (gastric ulcer) and 8 wk (NSAID-associated ulcer). Maintenance: 400 mg daily at bedtime or bid. GERD: 400 mg 4 times/day or 800 mg bid for 4-12 wk. Zollinger-Ellison syndrome: 300 or 400 mg 4 times/day. Prophylaxis of GI haemorrhage from stress ulceration: 200-400 mg 4-6 hrly. Prophylaxis of acid aspiration during general anaesth: 400 mg 90-120 min before induction of anaesth up to 400 mg 4 hrly if needed. Non-ulcer dyspepsia: Max: 800 mg/day in divided doses. Prophylaxis of nocturnal heartburn: 100 mg at bedtime. Short bowel syndrome: Initial: 400 mg bid, adjusted according to response. Pancreatic insufficiency: 800-1600 mg/day in 4 divided doses. IV Benign gastric and duodenal ulceration; Zollinger-Ellison syndrome Intermittent infusion: 300 mg 6-8 hrly infused over 15-20 min. Max: 2400 mg/day. Continuous infusion: 37.5 mg/hr (900 mg/day). A 150 mg IV loading dose may be given in patients requiring rapid elevation of gastric pH.
Cimetidine is contraindicated in any patient hypersensitive to the drug or its components. History of peptic ulcer. Increased risk of developing community-acquired pneumonia in the elderly, patients with chronic lung disease, DM, or the immunocompromised. Increased possibility of a hyperinfection caused by Strongyloides stercoralis in immunocompromised patients. Possibility of malignancy should be excluded prior to therapy as the drug may mask symptoms and delay diagnosis of gastric malignancy. Avoid rapid IV inj. Renal and hepatic impairment. Pregnancy and lactation.
Diarrhoea, other GI disturbances, dizziness, headache, tiredness, myalgia, arthralgia, rashes, altered LFTs, reversible confusional states. Rarely, hypersensitivity reactions and fever, reversible alopecia, blood disorders (e.g. agranulocytosis, leucopenia, and thrombocytopenia), acute pancreatitis, interstitial nephritis, hallucinations and depression, CV disorders (e.g. bradycardia, tachycardia, heart block), transient hypotension, gynaecomastia and impotence.
Pregnancy Category B. Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
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