Cimetidine

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Cimetidine is an H2 blocker, a type of pharmaceuticals that decreases the amount of acid produced by the stomach [1] It is sold under the brand name Tagamet.

Why It's Prescribed

"Cimetidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Over-the-counter cimetidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach."[2]

Labeled uses include:[3] Duodenal Ulcer, Dyspepsia, Gastric Ulcer, Gastroesophageal Reflux, Heartburn, Maintenance of Healing Duodenal Ulcer, Multiple Endocrine Neoplasia, Systemic Mastocytosis, Zollinger-Ellison Syndrome

Additionally, unlabeled uses include:[4] NSAID-Induced Gastric Ulcer, Pancreatic Insufficiency, Prevention of Stress Ulcer, Upper GI Bleed, Urticaria

Form, Route, and Dosage

Cimetidine is available as a tablet and a liquid to take orally.[5] Over the counter cimetidine comes only in the strength 200mg, and patients are directed to take one tablet to treat or prevent heartburn and no more than 2 tablets (400mg) per day.[6] However, doctors may prescribe up to 2400mg of cimetidine per day.[7]

Risks

Side Effects

Some patients taking this medication might experience side effects, including:[8]

  • headache
  • diarrhea
  • dizziness
  • drowsiness
  • breast enlargement
  • confusion
  • excitement
  • depression
  • nervousness
  • seeing things or hearing voices that do not exist (hallucinating)

As a Pollutant

Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.[9]

In Sewage Sludge

Cimetidine has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found cimetidine in 74 samples (88%) in concentrations ranging from 7.59 to 9,780 parts per billion.[10] There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

Articles and resources

Related SourceWatch articles

References

  1. Cimetidine: MedlinePlus Drug Information, Accessed August 31, 2010.
  2. Cimetidine: MedlinePlus Drug Information, Accessed August 31, 2010.
  3. Cimetidine Oral: Dosage, Uses, and Warnings, Accessed September 3, 2010.
  4. Cimetidine Oral: Dosage, Uses, and Warnings, Accessed September 3, 2010.
  5. Cimetidine: MedlinePlus Drug Information, Accessed August 31, 2010.
  6. Drugstore.com, Accessed September 2, 2010.
  7. Cimetidine Oral: Dosage, Uses, and Warnings, Accessed September 3, 2010.
  8. Cimetidine: MedlinePlus Drug Information, Accessed August 31, 2010.
  9. O.A.H. Jones, N. Voulvoulis, and J.N. Lester, Human Pharmaceuticals in Wastewater Treatment Processes, Environmental Science and Technology, 2005.
  10. Targeted National Sewage Sludge Survey Report, US EPA website, Accessed August 28, 2010.

External resources

External articles