Apo-Cimetidine

Apo-Cimetidine (Cimetidine) is used in prevention of the recurrence of duodenal or stress ulcer in patients at risk of haemorrhage, the management of pathological hypersecretion. It is also used to reduce the gastric acidity and secretory volume thus reducing the risk of pulmonary damage from aspiration of gastric contents in patients undergoing general anaesthesia.

The usual adult dose is 800mg at night. Reduction of nocturnal gastric acid secretion appears to be the most important factor in healing duodenal ulcers. Alternatively, 400mg may be given twice daily, in the morning and at bedtime.

• skin rashes
• headache
• drowsiness
• diarrhoea
• dizziness
• hepatotoxicity
• pancreatitis
• interstitial nephritis
• pancytopenia
• allergic reactions
• arthralgia
• constipation
• alopecia
• agitation
• psychosis
• leucopenia
• neutropenia
• myalgia
• interstitial nephritis
• tachycardia
• sinus bradycardia
• anaphylaxis

Caution is required in patients with impaired kidney and liver function. Apo-Cimetidine (Cimetidine) levels are reduced by haemodialysis, but are unchanged by peritoneal dialysis. Therefore Apo-Cimetidine (Cimetidine) should be administered after a patient has undergone haemodialysis.

Treatment of gastric ulcers with cimetidine can mask the symptoms associated with carcinoma of the stomach and diagnosis of the condition may be delayed. The delay in diagnosis should by borne in mind in middle aged or older patients with new or recently changed dyspeptic symptoms. If a gastric ulcer is suspected the possibility of malignancy should be eliminated before treatment with Apo-Cimetidine (Cimetidine) begins.