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CIMETIDINE

It competitive inhibits histamine induced gastric secretion. All phases (basal, psychic, neurogenic, gastric) of secretion are suppresse whereas it hs no effect on gastric and esophageal motility.

INDICATIONS: Duodenal, gastric, recurrent & stomal ulceration. Oesophageal reflux diseases & other conditions where a reduction of gastric acid is beneficial including persistent dyspeptic symptoms. Zollinger-ellison syndrome. Stress ulcers and gastritis.

DOSAGE: Benign gastric ulcer : 400mg twice at breakfast & bedtime.

Acute duodenal ulcer : 800mg at bed time. Prophylaxis of recurrent duodenal ulcer maint dose of 400mg at bed time.
Peptic oeophagitis: 0.8-1.6gm daily.

Persistent dyspeptic symptoms: 200mg 4 times daily. Max period of treatment should be 4 wks. 800-1600 mg/day depending on severity of symptom. Has to be given in 4 divided doses. Maintenance 400mg at bedtime.

Injection: Children- 20-25 mg/kg body wt. neonates: 10-15mg/kg body wt. all in 4-6 divided doses. Adults : 400mg parenterally.

CONTRA-INDICATIONS: Hypersensitivity.

SPECIAL-PRECAUTIONS: Exclude presence of gastric malignancy. Impaired renal function. i.v. injection by slow infusion.

Pregnancy: Safety not established.
Lactation: Present in breast milk. No known effect on the baby.
Elderly: Dosage may have to be reduced.

SIDE-EFFECTS: Headache, dizziness, bowel upset, rash, diarrhea, confusion, hallucinations, delirium, convulsions, gynaecomastia, sodium & water retention, impotence.

DRUG INTERACTIONS: Absorption reduced by antacids. Protentiate anticoagulants, phenytoin, theophylline benzodiazepines, beta-blockers, lignocaine, procainamide.