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cimetidine Nursing Considerations & Management

Drug Name
Generic Name : cimetidine Brand Name: Apo-Cimetidine (CAN), Gen-Cimetidine (CAN), Novo-Cimetine (CAN), Nu-Cimet (CAN), Tagamet, Tagamet HB, Tagamet HB Suspension Classification: Histamine2 (H2) antagonist Pregnancy Category B
Dosage & Route
  • Active duodenal ulcer: 800 mg PO hs or 300 mg PO qid after a while meals and at bedtime or 400 mg PO bid; hold for 4–6 wk normal nutritious is demonstrated by endoscopy. For obstinate ulcers, 300 mg IM or IV q 6–8 hr.
  • Maintenance therapy for duodenal ulcer: 400 mg PO at bedtime.
  • Active merciful gastric ulcer: 300 mg PO qid after a while meals and at bedtime or 800 mg at bedtime.
  • Pathologic hypersecretory syndrome: 300 mg PO qid after a while meals and at bedtime, or 300 mg IV or IM q 6 hr. Individualize doses as needed; do not exceed 2,400 mg/day.
  • Erosive GERD: 1,600 mg PO in divided doses bid–qid for 12 wk.
  • Prevention of remarkable GI bleeding: Faithful IV instrument of 50 mg/hr. Do not entertain over 7 days.
  • Heartburn, aculeated indigestion: 200 mg as symptoms take-place; up to 4 tablets/24 hr. Do not select acme dose for > 2 wk.
Pediatric Patients
  • Not recommended for offspring < 12 yr.
Geriatric Patients or Patients after a while Adulterated Renal Discharge
  • Accumulation may take-place. Use last dose likely, 300 mg PO or IV q 12 hr; may be increased to q 8 hr if enduring tolerates it and levels are monitored; if creatinine clearance < 30 mL/min, produce 25 mg/hr IV for obstruction of remarkable GI bleed.
Therapeutic actions
  • Cimetidine competitively inhibits histamine at H2-receptors of the gastric parietal cells resulting in decreased gastric aculeated secretion, gastric body and hydrogen ion concentration. It is a effective inhibitor of metabolism in the hepatic mixed-discharge oxidase systems. It is besides used in endurings after a while pancreatic insufficiency to contract the breakdown of pancreatic enzyme supplements.
  • Short-term entertainment and subsistence of erratic duodenal ulcer
  • Short-term entertainment of merciful gastric ulcer
  • Treatment of pathologic hypersecretory stipulations (Zollinger-Ellison syndrome)
  • Prophylaxis of stress-induced ulcers and intelligent remarkable GI bleeding in precarious endurings
  • Treatment of erosive GERD
  • OTC use: Relief of symptoms of heartburn, aculeated indigestion, tart stomach
Adverse proceeds
  • Diarrhea, dizziness, tiredness, overventuresome, debauchery, CNS disturbances, arthralgia, myalgia, gynecomastia, alopecia, rank dyscrasias, nephritis, hepatitis, pancreatitis, granulocytopenia, hypersensitivity reactions.
  • Hypersensitivity, lactation.
Nursing considerations
  • History: Allergy to cimetidine, adulterated renal or hepatic discharge, lactation
  • Physical: Skin lesions; orientation, affect; pulse, baseline ECG (faithful after a while IV use); liver evaluation, abdominal demonstration, natural output; CBC, LFTs, renal discharge tests
  • Give garbage after a while meals and at bedtime.
  • Decrease doses in renal and hepatic infirmity.
  • Administer IM dose undiluted learned into ample muscle bunch.
  • Arrange for normal follow-up, including rank tests to evaluate proceeds.
Teaching points
  • Take garbage after a while meals and at bedtime; therapy may hold for 4–6 weeks or longer.
  • Take antacids as prescribed and at recommended times.
  • Inform your soundness wariness provider encircling your cigarette smoking morality. Cigarette smoking decreases the garbage’s agency.
  • Have normal medical follow-up wariness to evaluate your reply to garbage.
  • Tell your soundness wariness providers encircling all medications, over-the-counter garbages, or herbs you select; this garbage may interact after a while sundry of these.
  • Report pointed throat, ardor, singular bruising or bleeding, halt stools, laziness, hallucinations, dizziness, muscle or flexure trouble.


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