CIMETIDINE oral

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    Prescription under medical supervision

     

    Therapeutic action

    • Antiulcer agent (histamine H2-receptor antagonist)

    Indications

    • Prophylaxis of acid pulmonary aspiration syndrome in anaesthesia:
      • in patients with a full stomach (emergency caesarean section, etc.)
      • when a difficult intubation is expected

    Forms and strengths

    • 200 mg effervescent tablet
      Also comes 800 mg effervescent tablet.

    Dosage and duration

    • Adult: 200 to 400 mg single dose, if possible one hour before anaesthetic induction

    Contra-indications, adverse effects, precautions

    • May cause: diarrhoea, headache, dizziness, skin rash, fever.
    • Do not administer with an antacid (aluminium hydroxide, etc.).

    Remarks

    • Effervescent cimetidine can be replaced by effervescent ranitidine, another H2-receptor antagonist, as a single dose of 150 mg.
    • The onset of acid inhibition with cimetidine non-effervescent tablets (200 mg, 400 mg and 800 mg film coated tablets) or ranitidine non-effervescent tablets (150 mg and 300 mg film coated tablets) occurs 30 minutes after administration. The effervescent tablets containing sodium citrate have a more rapid onset of action, and can thus be used for emergency surgery.
    • Omeprazole, another antiulcer agent (proton pump inhibitor), is not compatible with emergency situations as it must be administered at least 4 hours before surgery.
    • Cimetidine in film coated tablets is also used in the treatment of gastro-oesophageal reflux and peptic ulcer. Use by preference ranitidine or omeprazole for these indications.

    Storage

     
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    - Below 25 °C