Description of the medicine: Cimetidine (Cimetidinum)
CIMETIDIN (Cimetidinum) *.
Synonyms: Belomet, Histak, Histodil, Primamet, Simetidine, Tagamet, Cimitiget, Cinamet, Aciloc, Altramet, Belomet, Benomet, Besidin, Cimedal, Cimetar, Cimetiget, Cinamet, Gastromet, Histac, Histodil, Hystac, Neutronorm, Primut, Sutamet Surpamet, Tagamet, Tametin, Tamper, Ulcedon, Ulceratil, Ulcimet, Ulcomet, Zagastrol, Zontac, etc.
The main pharmacological effect of cimetidine is inhibition of gastric acid secretion associated with blockade of the H 2 receptors of the gastric wall. It inhibits spontaneous secretion and secretion stimulated by histamine, pentagastrin, caffeine, as well as gastric distension, but has little effect on carbacholine hypersecretion, since it does not have anticholinergic activity. It does not affect adrenergic receptors, does not have a local anesthetic effect.
The drug reduces the release of pepsin.
Cimetidine is rapidly absorbed from the gastrointestinal tract. Due to its low lipophilicity, it does not penetrate into the central nervous system and does not have a sedative effect.
Cimetidine is used to treat peptic ulcer of the stomach and duodenal ulcer and in other conditions requiring a decrease in hyperacidity of gastric juice, including reflux esophagitis, Zinger Linger-Ellison syndrome, etc.
Cimetidine is usually prescribed orally (after meals) for adults in a daily dose of 0.8-1 g, which is divided into 4 doses: 3 times 0.2 g and 0.2 or 0.4 g at bedtime. If necessary, increase the daily dose to 1, 6 g. The course of treatment usually lasts 4 to 6 weeks (if necessary, up to 8 weeks). At the end of the intensive treatment course, maintenance therapy is carried out for several months (0.4 g at night or in the morning 0.2 g and in the evening 0.2 g).
Stop taking the drug, gradually reducing the dose. A sudden cessation of admission can lead to a sharp increase in secretion and exacerbation of the disease.
Cimetidine can be used together with antacids, however, the antacid should be taken one hour after taking cimetidine, since the absorption of cimetidine decreases with a simultaneous administration.
Cimetidine is administered intravenously at a dose of 0.2 g (200 mg) at intervals of 4 to 6 hours. The maximum daily dose is 2 g. When administered dropwise, the dose is 0.1 g (100 mg) per hour for 2 hours; administration is repeated every 4 to 6 hours. The maximum infusion rate is 150 mg per hour (or 2 mg / kg per hour). Intravenous administration is carried out only in a hospital; with rapid intravenous administration, heart rhythm disturbances and a strong decrease in blood pressure are possible.
When using cimetidine, various side effects can be observed: diarrhea, muscle pain, allergic reactions (skin rashes), headache, dizziness, depression. Changes in biochemical parameters (the significance of transaminases, etc.) may be observed. With prolonged use of high doses of the drug, gynecomastia may develop, which is associated with the ability of the drug to stimulate prolactin secretion. There is also evidence that cimetidine inhibits the production of intrinsic factor and the absorption of vitamin B 12, and also that it can have an antiandrogenic effect.