ACIMET
CIMETIDINE · by BLOOM PHARMA
Composition
Inj 200 mg: Per 2 ml: Cimetidine 200 mg; solution; amp. Susp 100 mg/200 mg: Per 5 ml: Cimetidine (as hydrochloride) 100 mg/200 mg. Tab 200 mg/400 mg/800 mg: Cimetidine 200 mg/400 mg/800 mg.
Indications & Dosage
Benign Duodenal Ulceration, benign Gastric Ulceration and NSAID associated Ulceration: ORAL OR BY IM OR IV INJ: Adult: 400 mg twice daily in the morning and at night for at least 4 wks (at least 6 wks in case of Gastric Ulceration 8 weeks in case of NSAID associated Ulceration), alternatively 800 mg once daily at night for at least 4 weeks, increased if necessary up to 400 mg 4 times a day. Maintenance: 400 mg once daily, at night, alternatively, 400 mg twice daily, in the morning and at night. Children above 1 yr: 20-40 mg/kg daily in divided doses Reflux oesophagitis: ORAL OR BY IM OR IV INJ: Adult: 400 mg 4 times a day for 4-8 weeks Children above 1 yr: 25-30 mg/kg daily in divided doses Prophylaxis of stress ulceration: ORAL OR BY IM OR IV INJ: Adult: 200-400 mg every 4-6 hours Gastric acid reduction in obstetrics: ORAL OR BY IM OR IV INJ: Adult: 400 mg, at start of labour, then increased if necessary up to 400 mg every 4 hours, do not use syrup in prophylaxis of acid aspiration; max. 2.4 g per day. Zollinger-Ellison syndrome and other cases of high gastric secretion, and haemorrhage from ulceration or erosion of upper GI tract: ORAL OR BY IM OR IV INJ: Adult: 200 mg 3 times a day with meals and 400 mg at bedtime. Children above 1 yr: 20-40 mg/kg daily in divided doses Gastric acid reduction during surgical procedures: ORAL OR BY IM OR IV INJ: Adult: 400 mg, 90-120 minutes before induction of general anaesthesia. Short-bowel syndrome: ORAL OR BY IM OR IV INJ: Adult: 400 mg twice daily, adjusted according to response, with breakfast and at bedtime To reduce degradation of pancreatic enzyme supplements: ORAL OR BY IM OR IV INJ: Adult: 0.8-1.6 g daily in 4 divided doses, 1 hours before meals.Acid related dyspepsia and non-ulcer acidic ORAL OR BY IM OR IV INJ: Adult: 400 mg twice daily in the morning and at night for at least 4 wks (at least 6 wks in case of Gastric Ulceration 8 weeks in case of NSAID associated Ulceration), alternatively 800 mg once daily at night for at least 4 weeks, increased if necessary up to 400 mg 4 times a day. Maintenance: 400 mg once daily, at night, alternatively, 400 mg twice daily, in the morning and at night. Children above 1 yr: 20-40 mg/kg daily in divided doses.
Administration
Diluted 200 mg in 0.9% NaCI total volume of 20 ml to be given slow IV over a period of 2 min, to be repeated 4-6 hourly. For intermittent infusion diluted400 mg in 100 ml dextrose 5% injection, infusion time not less than 30 min. Total dosage in 24 hr should not exceed 6 infusions or 2400 mg.
Compatibility
Stable in D5LRL,D5 Y. NS, D5 th NS, D5W, LR,sodium bicarbonate 5%
Stability
Intact vials staystable in parenteral nutrition solutions for up to 7 days when protected from light.
Precautions
Exclude malignant disease before and during treatment. Monitor patients on long term therapy. Renal impairment; reduce dose to 200mg 4 times daily if eGFR 30-50 ml/minute/1.73m2, reduce dose to 200mg 3 times daily if eGFR 15-30 ml/minute/1.73m2, reduce dose to 200mg twice daily if eGFR less than 15 ml/minute/1.73m2. Occasional risk of confusion
Interactions
Oral anticoagulants, phenytoin, theophylline, IV lignocaine.
Pregnancy
Caution advised
Lactation
: Not recommended.
Side Effects
Diarrhoea, dizziness, rash, tiredness, gynaecomastia, occasional reversible liver damage, confusion, fever, headache, myalgia, arthralgia, sinus bradycardia, tachycardia, heart block, anaphylaxis, hallucinations, depression. Rare: interstitial nephritis, acute pancreatitis, thrombocytopenia, leucopenia, pancytopenia, aplastic anaemia, alopecia, galactorrhoea, pancreatitis, vasculitis.