Tagamet HB 200: Adult Dosing

Dosage forms: 200

duodenal ulcer, active

800 mg PO qhs x4-8wk

Alt: 400 mg PO bid; 300 mg PO qid; Max: 1600 mg/day

duodenal ulcer, maintenance

400 mg PO qhs

gastric ulcer, active benign

800 mg PO qhs x6wk

Alt: 300 mg PO qid x6wk; Max: 2400 mg/day; Info: give qac and hs

GERD

1600 mg/day PO div bid-qid x12wk

Zollinger-Ellison syndrome

300-600 mg PO qid

Max: 2400 mg/day

renal dosing

adjust dose amount

CrCl 10-50: decr. dose 50%; CrCl <10: decr. dose 75%; HD: give dose after dialysis, no supplement; CAPD: no supplement

hepatic dosing

not defined

Tagamet HB 200: Peds Dosing

Dosage forms: 200

*GERD

children

Dose: 20-40 mg/kg/day PO div q6h

renal dosing

adjust dose amount, frequency

CrCl 10-50: decr, dose 25% or give q8h; CrCl <10: decr. dose 50% or give q12h

hepatic dosing

not defined

Tagamet HB 200: Contraindications/Cautions

• hypersens. to drug/class/compon.
• caution if impaired renal fxn
• caution if impaired liver fxn
• caution in elderly or debilitated pts
• caution if chronic pulmonary dz
• caution if diabetes mellitus
• caution if immunocompromised

Tagamet HB 200: Drug Interactions

Contraindicated

• cisapride

• dofetilide

• pimozide

• thioridazine

Avoid/Use Alternative

• beta blocker/thiazide combos

• beta blockers, systemic

• BZDs, partial 3A4 substrates

• CCBs, others

• cefditoren

• cefpodoxime

• cefuroxime

• dasatinib

• delavirdine

• ezetimibe/simvastatin

• galantamine

• iron salts, oral

• itraconazole

• ketoconazole

• metformin/sulfonylurea combos

• metformins

• moricizine

• nevirapine

• posaconazole

• quinidine

• sirolimus

• sitagliptin/metformin

• tacrine

• terbinafine

• tizanidine

• tricyclic antidepressants

• zolmitriptan

Monitor/Modify Tx

• acetaminophen/caffeine/CNS depressant combos

• acyclovir

• alfentanil

• aripiprazole

• aspirin/caffeine/CNS depressant combos

• aspirin/caffeine/orphenadrine

• atazanavir

• atomoxetine

• caffeine

• carbamazepine

• cyclosporine

• enalapril/felodipine

• felodipine

• fentanyl

• isradipine

• nicardipine

• nifedipine

• nimodipine

• nisoldipine

• pemetrexed

• phenytoins

• procainamide

• sufentanil

• tacrolimus

• theophyllines

• valacyclovir

• valproic acid derivatives

• warfarin

• zaleplon

Therapeutic Advantage

• digestive enzymes

Caution Advised

• albendazole

• alendronate/cholecalciferol

• alfuzosin

• ambrisentan

• amiodarone

• azelastine nasal

• bupivacaine

• bupropion

• buspirone

• chloroquine phosphate

• citalopram

• clozapine

• dolasetron

• duloxetine

• efavirenz/emtricitabine/tenofovir

• emtricitabine/tenofovir

• entecavir

• ergotamine/caffeine

• escitalopram

• ethanol

• flecainide

• fluvastatin

• gefitinib

• lidocaine

• memantine

• meperidine

• meperidine/promethazine

• mepivacaine

• methylphenidate

• midodrine

• mycophenolate mofetil

• olanzapine

• olanzapine/fluoxetine

• paroxetine

• pramipexole

• propafenone

• quetiapine

• ramelteon

• riluzole

• sertraline

• sildenafil

• sitagliptin

• tamsulosin

• tenofovir

• venlafaxine

Tagamet HB 200: Adverse Reactions

Serious Reactions

• neutropenia
• thrombocytopenia
• agranulocytosis
• anemia, aplastic
• pneumonia
• depression
• psychosis
• hallucinations
• anaphylactic/anaphylactoid rxns (rare)
• pancreatitis (rare)
• interstitial nephritis (rare)
• bradycardia (rare)
• tachycardia (rare)
• AV block (rare)
• skin rxns, severe (rare)

Common Reactions

• headache
• diarrhea
• dizziness
• gynecomastia
• nausea
• vomiting
• confusion
• agitation
• drowsiness
• rash
• elevated liver transaminases

Tagamet HB 200: Safety Monitoring

Pregnancy: B

Lactation: Probably Safe

Monitoring Parameters: Cr at baseline

Tagamet HB 200: Pharmacology

Metabolism: liver; CYP450: 1A2 (weak), 2C19, 2D6 (weak) inhibitor

Excretion: urine primarily (48% unchanged), feces; Half-life: 2h

Class: H2 Blockers

Mechanism Of Action
selectively antagonizes histamine H2 receptors (H2 blocker)

Tagamet HB 200: Manufacturer/Pricing

Manufacturer: GlaxoSmithKline Consumer Healthcare DEA/FDA: OTC

Tagamet HB 200: Patient Education

• Generic Name: cimetidine

• Pronounced: sy MET ih deen

• Brand Names: Tagamet, Tagamet HB

What is the most important information I should know about cimetidine?

Use this medication exactly as directed on the label, or as your doctor has prescribed it for you. Do not use more of the medication than recommended. Do not use the medication for longer than recommended.

Avoid taking antacids unless your doctor recommends them for heartburn pain. Follow your doctor's advice about the type of antacid to use and when to use it. You may not be able to take the antacid at the same time you take your dose of cimetidine.

Taking cimetidine may make you more susceptible to virus that can cause pneumonia. This has occurred most often in elderly people and in those with diabetes, a weak immune system, or chronic lung disease. Before using cimetidine, tell your doctor if you have any of these conditions.

There may be other drugs that can affect cimetidine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What is cimetidine?

Cimetidine is in a group of drugs called histamine receptor antagonists. Cimetidine works by decreasing the amount of acid your stomach produces.

Cimetidine is used to treat and prevent certain types of ulcer, and to treat conditions that cause the stomach to produce too much acid. Cimetidine is also used to treat gastroesophageal reflux disease (GERD), when stomach acid backs up into the esophagus and causes heartburn.

Cimetidine may also be used for conditions other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking cimetidine?

Taking cimetidine may make you more susceptible to virus that causes pneumonia. You may be more likely to develop pneumonia if you have certain health problems.

Before using this medication, tell your doctor if you have:

• diabetes;
• asthma or a chronic lung disorder;
• a weak immune system;
• bone marrow suppression;
• kidney disease; or
• liver disease.

If you have any of the conditions listed above, you may not be able to use cimetidine or you may need a dosage adjustment or special tests during treatment.

Cimetidine is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not use this medication without telling your doctor if you are pregnant or plan to become pregnant during treatment.

Cimetidine passes into breast milk, and may be harmful to a nursing baby. Do not take cimetidine without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to a child younger than 16 years old unless your doctor has told you to.

How should I take cimetidine?

Use this medication exactly as directed on the label, or as your doctor has prescribed it for you. Do not use more of the medication than recommended. Do not use the medication for longer than recommended.

Cimetidine is usually taken with meals or at bedtime.

Take each dose with a full glass of water.

To be sure you get the correct dose of the oral solution (liquid), measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not stop taking cimetidine without first talking to your doctor. It may take up to 8 weeks for an ulcer to heal.

Your ulcer may take longer to heal if you smoke cigarettes.

Store cimetidine at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a cimetidine overdose may include nausea, vomiting, diarrhea, confusion, extreme weakness, or fainting.

What should I avoid while taking cimetidine?

Avoid taking antacids unless your doctor recommends them for heartburn pain. Follow your doctor's advice about the type of antacid to use and when to use it. You may not be able to take the antacid at the same time you take your dose of cimetidine.

What are the possible side effects of cimetidine?

Stop using cimetidine and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• cough, fever, chest congestion, trouble breathing;
• red or blistering skin rash;
• jaundice (yellowing of the skin or eyes);
• easy bruising or bleeding, unusual weakness;
• feeling faint, light-headed, disoriented, or confused;
• urinating less than usual;
• irregular heartbeat; or
• a rash.

Other less serious side effects are more likely to occur. Talk with your doctor if you have any of these side effects:

• feeling dizzy, depressed, or agitated;
• breast swelling or tenderness (in men);
• joint or muscle pain;
• mild skin rash;
• headache; or
• diarrhea, nausea, or constipation.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect cimetidine?

If you also take ketoconazole (Nizoral), take it at least 2 hours before you take cimetidine.

Before taking this medication, tell your doctor if you are using any of the following medicines:

• a blood thinner (warfarin or Coumadin);
• phenytoin (Dilantin);
• nifedipine (Adalat);
• metronidazole (Flagyl);
• propranolol (Inderal);
• chlordiazepoxide (Librium);
• lidocaine (Xylocaine);
• diazepam (Valium);
• theophylline (Theo-Dur, Slo-Bid, Bronkodyl); or
• depression or anxiety medication such as amitriptyline (Elavil), imipramine (Tofranil), clomipramine (Anafranil), desipramine (Norpramin), nortripytyline (Aventyl).

You may not be able to take cimetidine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

There may be other drugs not listed that can affect cimetidine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist has additional information about cimetidine written for health professionals that you may read.

What does my medication look like?

Cimetidine is available with a prescription under the brand name Tagamet. It is also available over the counter under the brand name Tagamet HB. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Tagamet 200 mg--round, light-green, film-coated tablets
• Tagamet 300 mg--round, light-green, film-coated tablets
• Tagamet 400 mg--oval, light-green, film-coated tablets
• Tagamet 800 mg--oval, light-green, film-coated tablets

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.

Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.

The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Tagamet HB 200: Pill Pictures

This information is currently unavailable or not applicable for this drug.