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Cimetidine: Drug information

Cimetidine: Drug information
2024© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Cimetidine: Patient drug information" and "Cimetidine: Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Cimetidine Acid Reducer [OTC]
Brand Names: Canada
  • APO-Cimetidine [DSC]
Pharmacologic Category
  • Histamine H2 Antagonist
Dosing: Adult
Erosive esophagitis due to gastroesophageal reflux disease

Erosive esophagitis due to gastroesophageal reflux disease (alternative agent):

Note: Although a labeled indication, H2-receptor antagonists (eg, cimetidine) for the treatment of erosive esophagitis due to gastroesophageal reflux disease are not preferred due to the availability of proton pump inhibitors (Ref).

Oral: 400 mg 4 times daily or 800 mg twice daily for 12 weeks.

Heartburn

Heartburn (OTC labeling):

Prevention: Oral: 200 mg daily up to 30 minutes prior to eating foods or beverages that cause heartburn (maximum: 400 mg per 24 hours).

Relief of symptoms: Oral: 200 mg daily; maximum: 400 mg per 24 hours.

Interstitial cystitis

Interstitial cystitis (bladder pain syndrome) (off-label use): Oral: 200 mg 3 times daily or 300 to 400 mg twice daily (Ref).

Pathological hypersecretory conditions

Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome [gastrinoma]) (alternative agent):

Note: Although a labeled indication, clinical experience suggests that H2-receptor antagonists (eg, cimetidine) are not preferred for controlling acid hypersecretion in pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome) due to the availability of proton pump inhibitors (Ref).

Oral: 300 mg 4 times daily; adjust dose to patient response; maximum 2.4 g/day.

Peptic ulcer disease

Peptic ulcer disease (duodenal or benign gastric ulcers) (alternative agent):

Note: Although a labeled indication, current guidelines recommend proton pump inhibitors as standard of care for treatment of peptic ulcer disease rather than H2-receptor antagonists (eg, cimetidine) (Ref).

Duodenal ulcer, active: Oral: 300 mg 4 times daily, or 400 mg twice daily, or 800 mg once daily at bedtime for up to 8 weeks.

Note: Higher doses of 1.6 g once daily at bedtime for 4 weeks may be beneficial for patients with duodenal ulcers >1 cm (defined endoscopically) who smoke ≥1 pack/day.

Duodenal ulcer, prophylaxis: Oral: 400 mg once daily at bedtime.

Gastric ulcer, active: Oral: 300 mg 4 times daily or 800 mg once daily at bedtime for up to 8 weeks.

Stress ulcer prophylaxis in critically ill patients

Stress ulcer prophylaxis in critically ill patients (alternative agent) (off-label use): Note: Used as an alternative for proton pump inhibitors in critically ill patients with risk factors for GI bleeding (eg, coagulopathy, mechanical ventilation for >48 hours, traumatic brain injury, history of GI ulceration or bleeding within past year, extensive burns) (Ref).

Oral or NG tube: 300 mg 4 times daily (Ref). Discontinue prophylaxis once risk factors have resolved (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

Manufacturer's labeling:

Mild to moderate kidney impairment: There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.

Severe kidney impairment: 300 mg every 12 hours; may increase frequency with caution. When hepatic impairment is also present, further reductions in dosage may be necessary.

Alternate recommendations (Ref):

GFR >50 mL/minute: No dosage adjustment necessary.

GFR 10 to 50 mL/minute: Administer 50% of normal dose.

GFR <10 mL/minute: 300 mg every 8 to 12 hours.

Hemodialysis: Dose after dialysis.

CRRT: Administer 50% of normal dose.

Peritoneal dialysis: 300 mg every 8 to 12 hours.

Geriatric patients ≥65 years: CrCl <50 mL/minute: Reduce the dose because of risk of mental status changes (specific dosage adjustment is not provided (Ref).

Stress ulcer prophylaxis in critically ill patients (off-label use): CrCl <30 mL/minute: 300 mg twice daily (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling; use with caution. Dosage adjustments may be needed in patients with both kidney and hepatic impairment.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Cimetidine: Pediatric drug information")

Duodenal ulcer, treatment and maintenance

Duodenal ulcer, treatment and maintenance:

Children ≥5 years and Adolescents <16 years: Limited data available, efficacy results variable: Oral: 20 to 40 mg/kg/day in 3 to 4 divided doses for 4 to 8 weeks (maximum dose: 300 mg/dose), followed by 5 to 8 mg/kg/dose once daily at bedtime (maximum dose: 400 mg/dose) (Ref).

Adolescents ≥16 years: Oral: 800 mg at bedtime or 400 mg twice daily or 300 mg 4 times daily for up to 8 weeks, followed by maintenance therapy of 400 mg once daily at bedtime (Ref). Note: Although treatment of active duodenal ulcers and maintenance therapy are included in the FDA manufacturer's labeling, use has fallen out of favor and in adults, experts suggest that cimetidine not be routinely used due to several cimetidine drug interactions and the preference for other options (eg, other histamine H2 antagonists, proton pump inhibitors [PPIs]).

Gastric ulcer, active

Gastric ulcer, active: Adolescents ≥16 years: Oral: 800 mg at bedtime or 300 mg 4 times daily for up to 8 weeks (Ref). Note: Although treatment of active gastric ulcers is included in the FDA manufacturer's labeling, use has fallen out of favor and in adults, experts suggest that cimetidine not be routinely used due to several cimetidine drug interactions and the preference for other options (eg, other histamine H2 antagonists, PPIs).

Gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD):

Infants, Children, and Adolescents <16 years: Limited data available: Oral: 30 to 40 mg/kg/day in 4 divided doses; maximum dose: 400 mg/dose (Ref). A pharmacokinetic modeling study suggests that the optimal dose for acid suppression is 10 mg/kg/dose every 6 hours and that some patients may need doses as high as 15 mg/kg/dose (Ref).

Adolescents ≥16 years: Oral: 400 mg 4 times daily or 800 mg twice daily for 12 weeks (Ref).

Pathological hypersecretory conditions

Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas):

Adolescents ≥16 years: Oral: 300 mg 4 times daily; adjust dose to patient response; maximum daily dose: 2,400 mg/day (Ref). Note: Although treatment of pathological hypersecretory conditions is included in the FDA manufacturer's labeling, use has fallen out of favor and in adults, experts suggest that cimetidine not be routinely used due to several cimetidine drug interactions and the preference for other options (eg, other histamine H2 antagonists, PPIs).

Sour stomach/Heartburn

Sour stomach/Heartburn (OTC labeling):

Prevention: Children ≥12 years and Adolescents: Oral: 200 mg daily up to 30 minutes prior to eating foods or beverages that cause heartburn (maximum daily dose: 400 mg/24 hours).

Relief of symptoms: Children ≥12 years and Adolescents: Oral: 200 mg daily; maximum daily dose: 400 mg/24 hours.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Adolescents ≥16 years: Oral (Ref):

Mild to moderate renal impairment: There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.

Severe renal impairment: 300 mg every 12 hours; may increase frequency with caution. When hepatic impairment is also present, further reductions in dosage may be necessary.

Dosing: Hepatic Impairment: Pediatric

Adolescents ≥16 years: There are no dosage adjustments provided in the manufacturer’s labeling; use with caution. Dosage adjustments may be needed in patients with both renal and hepatic impairment.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Central nervous system: Headache (2% to 4%), dizziness (1%), drowsiness (1%)

Endocrine & metabolic: Gynecomastia (≤4%)

Gastrointestinal: Diarrhea (1%)

Frequency not defined: Renal: Increased serum creatinine

Postmarketing: Agitation, agranulocytosis, alopecia, anaphylaxis, anxiety, aplastic anemia, arthralgia, confusion, decreased white blood cell count, depression, disorientation, fever (Potter 1986), hallucination, hemolytic anemia (immune-based), hepatic fibrosis, hypersensitivity angiitis, hypersensitivity reaction, hypotension, impotence (Jensen 1983), increased serum transaminases, interstitial nephritis, myalgia, pancreatitis, pancytopenia, polymyositis (Watson 1983), psychosis, urinary retention, thrombocytopenia

Contraindications

Hypersensitivity to cimetidine or any component of the formulation

OTC labeling: When used for self-medication (OTC), do not use if trouble or pain when swallowing food, vomiting with blood, or bloody or black stools, allergic to cimetidine or other acid reducers. Do not use with other acid reducers.

Warnings/Precautions

Concerns related to adverse effects:

• Confusion: Rare cases of reversible confusion have been associated with cimetidine; usually in older or severely ill patients, or in patients with kidney or hepatic impairment.

• Vitamin B12 deficiency: Prolonged treatment (≥2 years) may lead to vitamin B12 malabsorption and subsequent vitamin B12 deficiency. The magnitude of the deficiency is dose-related and the association is stronger in females and those younger in age (<30 years); prevalence is decreased after discontinuation of therapy (Lam 2013).

Disease-related concerns:

• Gastric malignancy: Relief of symptoms does not preclude the presence of a gastric malignancy.

• Hepatic impairment: Use with caution in patients with hepatic impairment.

• Kidney impairment: Use with caution in patients with kidney impairment; dosage adjustment recommended.

Special populations:

• Immunocompromised patients: May have increased risk of hyperinfection of strongyloidiasis.

• Older adults: Use caution in this age group due to risk of confusion and other CNS effects. Cimetidine should be avoided in those older adults with, or at risk of, delirium.

Other warnings/precautions:

• Serum creatinine/creatinine clearance estimates: Cimetidine can cause a transient and reversible rise in serum creatinine and/or decrease in CrCl (when using routine CrCl estimation formulas). This interference is likely due to competitive inhibition of cimetidine with creatinine for active tubular secretion and independent of an actual change in GFR. In patients with normal kidney function, the rise in serum creatinine may not be clinically apparent, but in patients with varying degrees of kidney impairment, this rise in serum creatinine may be more significant. Thus, treatment with cimetidine in patients with kidney failure may invalidate measurements of serum creatinine and estimates of CrCl (Andreev 1999; Larsson 1980). However, CrCl estimation formulas, such as Cockcroft-Gault, are known to overestimate actual GFR, particularly in patients with kidney impairment, and use of cimetidine has been explored clinically to improve the accuracy of CrCl estimates in these patients (Choi 1993; Van Acker 1992).

• OTC labeling: When used for self-medication (OTC), notify health care provider before use if any of the following are present: frequent chest pain; frequent wheezing particularly with heartburn; nausea/vomiting; unexplained weight loss; stomach pain; heartburn >3 months; heartburn with light-headedness, sweating, or dizziness; chest pain or shoulder pain with shortness of breath; sweating or pain that spreads to arms, neck, or shoulders; light-headedness. Stop use and notify health care provider if heartburn continues or worsens, stomach pain continues, or if use is required >14 days.

Warnings: Additional Pediatric Considerations

Use of gastric acid inhibitors, including proton pump inhibitors and H2 blockers, has been associated with an increased risk for development of acute gastroenteritis and community-acquired pneumonia in pediatric patients (Canani 2006). A large epidemiological study has suggested an increased risk for developing pneumonia in patients receiving H2 receptor antagonists; however, a causal relationship with cimetidine has not been demonstrated. A cohort analysis including more than 11,000 neonates reported an association between H2 blocker use and an increased incidence of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) neonates (Guillet 2006). An approximate sixfold increase in mortality, NEC, and infection (ie, sepsis, pneumonia, urinary tract infection) was reported in patients receiving another H2 blocker, ranitidine, in a cohort analysis of 274 VLBW neonates (Terrin 2012).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Oral, as hydrochloride [strength expressed as base]:

Generic: 400 mg/6.67 mL (6.67 mL [DSC]); 300 mg/5 mL (5 mL [DSC], 237 mL)

Tablet, Oral:

Cimetidine Acid Reducer: 200 mg

Generic: 200 mg, 300 mg, 400 mg, 800 mg

Generic Equivalent Available: US

Yes

Pricing: US

Solution (Cimetidine HCl Oral)

300 mg/5 mL (per mL): $2.53

Tablets (Cimetidine Oral)

200 mg (per each): $3.00

300 mg (per each): $1.61 - $2.05

400 mg (per each): $2.61 - $3.34

800 mg (per each): $5.02 - $6.20

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet, Oral:

Generic: 200 mg, 300 mg, 400 mg [DSC], 600 mg [DSC], 800 mg

Administration: Adult

Oral: Administer with meals. For stress ulcer prophylaxis in critically-ill patients (off-label use), may administer via NG tube (Ref).

Administration: Pediatric

Oral: Administer with food; do not administer simultaneously with antacids.

Use: Labeled Indications

Erosive esophagitis due to gastroesophageal reflux disease: Treatment of erosive gastroesophageal reflux disease (GERD).

Note: Although a labeled indication, H2-receptor antagonists (eg, cimetidine) for the treatment of erosive esophagitis due to GERD are not preferred due to the availability of proton pump inhibitors (PPIs) (ACG [Katz 2022]).

Heartburn (OTC only): Relief and prevention of heartburn associated with acid indigestion and sour stomach.

Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome [gastrinoma]): Treatment of pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas).

Note: Although a labeled indication, clinical experience suggests that H2-receptor antagonists (eg, cimetidine) are not preferred for controlling acid hypersecretion in pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome) due to the availability of PPIs (Guarnotta 2018; Ito 2023; Tomassetti 2005).

Peptic ulcer disease (duodenal or benign gastric ulcers): Short-term treatment of active duodenal or active benign gastric ulcers and maintenance therapy after the healing of active duodenal ulcer.

Note: Although a labeled indication, current guidelines recommend PPIs as standard of care for treatment of peptic ulcer disease rather than H2-receptor antagonists (eg, cimetidine) (ACG [Laine 2021]).

Use: Off-Label: Adult

Interstitial cystitis/bladder pain syndrome; Stress ulcer prophylaxis in critically-ill patients

Medication Safety Issues
Sound-alike/look-alike issues:

Cimetidine may be confused with simethicone

Metabolism/Transport Effects

Substrate of OAT1/3, P-glycoprotein/ABCB1 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential; Inhibits CYP1A2 (weak), CYP2C19 (weak), CYP2D6 (weak), CYP3A4 (weak), OCT1, OCT2

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Acalabrutinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Acalabrutinib. Management: Give acalabrutinib capsules 2 hours before a histamine H2 receptor antagonist (H2RA). No action is required if acalabrutinib tablets are coadministered with H2RAs. Risk D: Consider therapy modification

ALfentanil: Cimetidine may increase the serum concentration of ALfentanil. Risk C: Monitor therapy

ALPRAZolam: CYP3A4 Inhibitors (Weak) may increase the serum concentration of ALPRAZolam. Risk C: Monitor therapy

Amiodarone: Cimetidine may increase the serum concentration of Amiodarone. Risk X: Avoid combination

Atazanavir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Atazanavir. Management: Specific dose limitations and administration guidelines exist; consult full interaction monograph or atazanavir prescribing information. Risk D: Consider therapy modification

Atorvastatin: Cimetidine may enhance the adverse/toxic effect of Atorvastatin. Specifically, there is a theoretical potential for enhanced effects on reducing endogenous steroid activity. Risk C: Monitor therapy

Azelastine (Systemic): Cimetidine may increase the serum concentration of Azelastine (Systemic). Risk C: Monitor therapy

Belumosudil: Histamine H2 Receptor Antagonists may decrease the serum concentration of Belumosudil. Risk C: Monitor therapy

Bosutinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Bosutinib. Management: Administer histamine H2 receptor antagonists (H2RAs) more than 2 hours before or after bosutinib. Risk D: Consider therapy modification

Bromazepam: Cimetidine may increase the serum concentration of Bromazepam. Risk C: Monitor therapy

Calcium Channel Blockers: Cimetidine may increase the serum concentration of Calcium Channel Blockers. Risk C: Monitor therapy

CarBAMazepine: CYP3A4 Inhibitors (Weak) may increase the serum concentration of CarBAMazepine. Risk C: Monitor therapy

Carmustine: Cimetidine may enhance the myelosuppressive effect of Carmustine. Management: Consider alternatives to cimetidine in patients receiving carmustine. If the combination cannot be avoided, monitor for enhanced carmustine myelotoxicity. Risk D: Consider therapy modification

Cefditoren: Histamine H2 Receptor Antagonists may decrease the serum concentration of Cefditoren. Risk X: Avoid combination

Cefpodoxime: Histamine H2 Receptor Antagonists may decrease the serum concentration of Cefpodoxime. Risk C: Monitor therapy

Cefuroxime: Histamine H2 Receptor Antagonists may decrease the absorption of Cefuroxime. Management: Avoid concomitant use of oral cefuroxime axetil and H2 receptor antagonists if possible. If combined, ensure oral cefuroxime axetil is taken with food to minimize the magnitude of this interaction. Risk D: Consider therapy modification

ChlordiazePOXIDE: Cimetidine may increase the serum concentration of ChlordiazePOXIDE. Risk C: Monitor therapy

Chlormethiazole: Cimetidine may increase the serum concentration of Chlormethiazole. Risk C: Monitor therapy

Chloroquine: Cimetidine may increase the serum concentration of Chloroquine. Risk X: Avoid combination

Cisapride: Cimetidine may increase the serum concentration of Cisapride. Management: Consider alternatives to cimetidine. If this combination cannot be avoided, monitor for toxic effects of cisapride, particularly QTc interval prolongation. Risk D: Consider therapy modification

Citalopram: Cimetidine may increase the serum concentration of Citalopram. Management: Limit citalopram dose to a maximum of 20 mg/day if used with cimetidine. Patients using this combination should be monitored closely for evidence of citalopram toxicity (eg, serotonin syndrome, QT prolongation). Risk D: Consider therapy modification

CloBAZam: CYP2C19 Inhibitors (Weak) may increase serum concentrations of the active metabolite(s) of CloBAZam. CYP2C19 Inhibitors (Weak) may increase the serum concentration of CloBAZam. Risk C: Monitor therapy

Clofarabine: OCT2 Inhibitors may increase the serum concentration of Clofarabine. Risk C: Monitor therapy

CloZAPine: Cimetidine may increase the serum concentration of CloZAPine. Risk C: Monitor therapy

CycloSPORINE (Systemic): CYP3A4 Inhibitors (Weak) may increase the serum concentration of CycloSPORINE (Systemic). Risk C: Monitor therapy

Cysteamine (Systemic): Histamine H2 Receptor Antagonists may diminish the therapeutic effect of Cysteamine (Systemic). Risk C: Monitor therapy

Dacomitinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Dacomitinib. Management: Administer dacomitinib at least 6 hours before or 10 hours after an histamine H2-receptor antagonist (H2RA). Risk D: Consider therapy modification

Dalfampridine: OCT2 Inhibitors may increase the serum concentration of Dalfampridine. Management: Consider alternatives to this combination. Carefully weigh the risk of seizures against the benefit of combining OCT2 inhibitors with dalfampridine. Risk D: Consider therapy modification

Dasatinib: Histamine H2 Receptor Antagonists may decrease the absorption of Dasatinib. Management: Antacids (taken 2 hours before or after dasatinib administration) can be used in place of H2-antagonists if some acid-reducing therapy is needed. Risk X: Avoid combination

Delavirdine: Histamine H2 Receptor Antagonists may decrease the serum concentration of Delavirdine. Risk X: Avoid combination

Dofetilide: Cimetidine may increase the serum concentration of Dofetilide. This is likely via inhibition of dofetilide renal tubular secretion (primarily) and inhibition of dofetilide metabolism. Risk X: Avoid combination

Doxofylline: Cimetidine may increase the serum concentration of Doxofylline. Risk C: Monitor therapy

Enoxacin: Cimetidine may increase the serum concentration of Enoxacin. Cimetidine may decrease the serum concentration of Enoxacin. Risk C: Monitor therapy

EpiRUBicin: Cimetidine may increase the serum concentration of EpiRUBicin. Risk X: Avoid combination

Erlotinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Erlotinib. Management: Avoid H2-antagonists in patients receiving erlotinib when possible. If concomitant treatment cannot be avoided, erlotinib should be dosed once daily, 10 hours after and at least 2 hours before H2-antagonist dosing. Risk D: Consider therapy modification

Erythromycin (Systemic): Cimetidine may increase the serum concentration of Erythromycin (Systemic). Risk C: Monitor therapy

Escitalopram: Cimetidine may increase the serum concentration of Escitalopram. Risk C: Monitor therapy

Fezolinetant: CYP1A2 Inhibitors (Weak) may increase the serum concentration of Fezolinetant. Risk X: Avoid combination

Finerenone: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Finerenone. Risk C: Monitor therapy

Flibanserin: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Flibanserin. Risk C: Monitor therapy

Flunitrazepam: Cimetidine may increase the serum concentration of Flunitrazepam. Risk C: Monitor therapy

Fluorouracil Products: Cimetidine may increase the serum concentration of Fluorouracil Products. Risk C: Monitor therapy

FLUoxetine: Cimetidine may increase the serum concentration of FLUoxetine. Risk C: Monitor therapy

Fosamprenavir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Fosamprenavir. Cimetidine may also inhibit the metabolism of the active metabolite amprenavir, making its effects on fosamprenavir/amprenavir concentrations difficult to predict. Risk C: Monitor therapy

Fosphenytoin-Phenytoin: Cimetidine may enhance the adverse/toxic effect of Fosphenytoin-Phenytoin. Cimetidine may increase the serum concentration of Fosphenytoin-Phenytoin. Management: Consider using an alternative H2-antagonist to avoid this interaction. Monitor for toxic effects of hydantoin antiseizure drugs if cimetidine is initiated/dose increased. Risk D: Consider therapy modification

Gefitinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Gefitinib. Management: Administer gefitinib at least 6 hours before or 6 hours after administration of a histamine H2 receptor antagonist (H2RA), and closely monitor clinical response to gefitinib. Risk D: Consider therapy modification

GlipiZIDE: Cimetidine may increase the serum concentration of GlipiZIDE. Risk C: Monitor therapy

Hydroxychloroquine: Cimetidine may increase the serum concentration of Hydroxychloroquine. Risk X: Avoid combination

Indinavir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Indinavir. Risk C: Monitor therapy

Infigratinib: Histamine H2 Receptor Antagonists may decrease serum concentrations of the active metabolite(s) of Infigratinib. Histamine H2 Receptor Antagonists may decrease the serum concentration of Infigratinib. Management: Avoid coadministration of infigratinib with histamine receptor antagonists (H2RAs) or other gastric acid-lowering agents. If H2RAs cannot be avoided, administer infigratinib 2 hours before or 10 hours after administration of H2RAs. Risk D: Consider therapy modification

Itraconazole: Histamine H2 Receptor Antagonists may increase the serum concentration of Itraconazole. Histamine H2 Receptor Antagonists may decrease the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any histamine H2 receptor antagonists (H2RAs). Exposure to Tolsura brand itraconazole may be increased by H2RAs; consider itraconazole dose reduction. Risk D: Consider therapy modification

Ixabepilone: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Ixabepilone. Risk C: Monitor therapy

Ketoconazole (Systemic): Histamine H2 Receptor Antagonists may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer ketoconazole with an acidic beverage (eg, non-diet cola) and monitor for reduced efficacy if concomitant use with a H2RA is required. Increases in ketoconazole dose may be required. Risk D: Consider therapy modification

Ledipasvir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Ledipasvir. Management: Administer H2 receptor antagonist doses less than or comparable to famotidine 40 mg twice daily simultaneously or 12 hours prior to ledipasvir. The effect of administering H2 receptor antagonists at other time intervals is unknown and not recommended. Risk D: Consider therapy modification

Lemborexant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lemborexant. Management: The maximum recommended dosage of lemborexant is 5 mg, no more than once per night, when coadministered with weak CYP3A4 inhibitors. Risk D: Consider therapy modification

Levoketoconazole: Histamine H2 Receptor Antagonists may decrease the absorption of Levoketoconazole. Risk X: Avoid combination

Lidocaine (Systemic): Cimetidine may increase the serum concentration of Lidocaine (Systemic). Risk C: Monitor therapy

Lidocaine (Topical): Cimetidine may increase the serum concentration of Lidocaine (Topical). Risk C: Monitor therapy

Lomitapide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Lomitapide. Management: Patients on lomitapide 5 mg/day may continue that dose. Patients taking lomitapide 10 mg/day or more should decrease the lomitapide dose by half. The lomitapide dose may then be titrated up to a max adult dose of 30 mg/day. Risk D: Consider therapy modification

Mavacamten: CYP2C19 Inhibitors (Weak) may increase the serum concentration of Mavacamten. Management: Start mavacamten at 5 mg/day if stable on a weak CYP2C19 inhibitor. For those stable on mavacamten who are initiating a weak CYP2C19 inhibitor, reduce mavacamten dose by one dose level. Risk D: Consider therapy modification

Melatonin: Cimetidine may increase the serum concentration of Melatonin. Risk C: Monitor therapy

Meperidine: Cimetidine may increase the serum concentration of Meperidine. Risk C: Monitor therapy

MetFORMIN: Cimetidine may increase the serum concentration of MetFORMIN. Management: Consider alternatives to cimetidine in patients receiving metformin due to a potential for increased metformin concentrations and toxicity (including lactic acidosis). Risk D: Consider therapy modification

Midazolam: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Midazolam. Risk C: Monitor therapy

Mirtazapine: Cimetidine may increase the serum concentration of Mirtazapine. Risk C: Monitor therapy

Moclobemide: Cimetidine may increase the serum concentration of Moclobemide. Management: Consider using alternative agents to increase gastric pH in order to avoid this interaction. If combined, a moclobemide dose reduction of 50% may be necessary, and patients should be monitored for increased moclobemide effects/toxicities. Risk D: Consider therapy modification

Nelfinavir: Histamine H2 Receptor Antagonists may decrease serum concentrations of the active metabolite(s) of Nelfinavir. Histamine H2 Receptor Antagonists may decrease the serum concentration of Nelfinavir. Concentrations of the active M8 metabolite may also be reduced. Risk C: Monitor therapy

Neratinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Neratinib. Specifically, histamine H2 receptor antagonists may reduce neratinib absorption. Management: Administer neratinib at least 2 hours before or 10 hours after administration of a histamine H2 receptor antagonist to minimize the impact of this interaction. Risk D: Consider therapy modification

Nilotinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Nilotinib. Management: The nilotinib dose should be given 10 hours after or 2 hours before the H2 receptor antagonist in order to minimize the risk of a significant interaction. Risk D: Consider therapy modification

NiMODipine: CYP3A4 Inhibitors (Weak) may increase the serum concentration of NiMODipine. Risk C: Monitor therapy

Nirogacestat: Histamine H2 Receptor Antagonists may decrease the serum concentration of Nirogacestat. Risk X: Avoid combination

Octreotide: Histamine H2 Receptor Antagonists may decrease the serum concentration of Octreotide. Risk C: Monitor therapy

Ornidazole: Cimetidine may increase the serum concentration of Ornidazole. Risk C: Monitor therapy

PARoxetine: Cimetidine may increase the serum concentration of PARoxetine. Risk C: Monitor therapy

PAZOPanib: Histamine H2 Receptor Antagonists may decrease the serum concentration of PAZOPanib. Risk X: Avoid combination

Pentoxifylline: Cimetidine may increase the serum concentration of Pentoxifylline. Risk C: Monitor therapy

Pexidartinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Pexidartinib. Management: Administer pexidartinib 2 hours before or 10 hours after histamine H2 receptor antagonists. Risk D: Consider therapy modification

Pilsicainide: Cimetidine may increase the serum concentration of Pilsicainide. Risk C: Monitor therapy

Pimozide: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Pimozide. Risk X: Avoid combination

Posaconazole: Cimetidine may decrease the serum concentration of Posaconazole. Management: Avoid concurrent cimetidine unless potential benefits outweigh the risks of possible inadequate response. If concomitant use cannot be avoided, monitor steady state posaconazole trough levels and monitor for evidence of decreased antifungal effects. Risk D: Consider therapy modification

Pramipexole: Cimetidine may increase the serum concentration of Pramipexole. Risk C: Monitor therapy

Praziquantel: Cimetidine may increase the serum concentration of Praziquantel. Risk C: Monitor therapy

Procainamide: Cimetidine may increase the serum concentration of Procainamide. Management: Consider an alternative H2-receptor antagonist in patients taking procainamide. If combined, monitor for increased therapeutic effects/toxicity of procainamide. Risk D: Consider therapy modification

Propranolol: Cimetidine may increase the serum concentration of Propranolol. Risk C: Monitor therapy

QuiNIDine: Cimetidine may increase the serum concentration of QuiNIDine. Risk C: Monitor therapy

QuiNINE: Cimetidine may increase the serum concentration of QuiNINE. Management: Consider using an alternative H2-receptor antagonist (eg, ranitidine) instead of cimetidine due to a lower interaction risk. If combined, monitor patients closely for signs and symptoms of quinine toxicity. Risk D: Consider therapy modification

Rilpivirine: Histamine H2 Receptor Antagonists may decrease the serum concentration of Rilpivirine. Management: Administer histamine H2 receptor antagonists (H2RAs) at least 12 hours before or 4 hours after oral rilpivirine. Risk D: Consider therapy modification

Risedronate: Histamine H2 Receptor Antagonists may increase the serum concentration of Risedronate. This applies specifically to delayed-release risedronate. Risk X: Avoid combination

Roflumilast-Containing Products: Cimetidine may increase serum concentrations of the active metabolite(s) of Roflumilast-Containing Products. Cimetidine may increase the serum concentration of Roflumilast-Containing Products. Risk C: Monitor therapy

Saquinavir: Histamine H2 Receptor Antagonists may increase the serum concentration of Saquinavir. Management: Consider alternatives to this combination for patients taking the Invirase formulation of saquinavir. No action beyond standard clinical care measures is required for patients taking the Fortovase formulation of saquinavir. Risk D: Consider therapy modification

Secretin: Histamine H2 Receptor Antagonists may diminish the diagnostic effect of Secretin. Specifically, use of H2-Antagonists may cause a hyperresponse in gastrin secretion in response to secretin stimulation testing, falsely suggesting gastrinoma. Management: Avoid concomitant use of histamine H2-antagonists (H2RAs) and secretin. Discontinue H2RAs at least 2 days prior to secretin administration. Risk D: Consider therapy modification

Selpercatinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Selpercatinib. Management: Coadministration of selpercatinib and H2 receptor antagonists should be avoided. If coadministration cannot be avoided, selpercatinib should be administered 2 hours before or 10 hours after H2 receptor antagonists. Risk D: Consider therapy modification

Sertindole: Cimetidine may increase the serum concentration of Sertindole. Risk X: Avoid combination

Simvastatin: CYP3A4 Inhibitors (Weak) may increase serum concentrations of the active metabolite(s) of Simvastatin. CYP3A4 Inhibitors (Weak) may increase the serum concentration of Simvastatin. Risk C: Monitor therapy

Sirolimus (Conventional): CYP3A4 Inhibitors (Weak) may increase the serum concentration of Sirolimus (Conventional). Risk C: Monitor therapy

Sirolimus (Protein Bound): CYP3A4 Inhibitors (Weak) may increase the serum concentration of Sirolimus (Protein Bound). Management: Reduce the dose of protein bound sirolimus to 56 mg/m2 when used concomitantly with a weak CYP3A4 inhibitor. Risk D: Consider therapy modification

Sotorasib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Sotorasib. Risk X: Avoid combination

Sparsentan: Histamine H2 Receptor Antagonists may decrease the serum concentration of Sparsentan. Risk X: Avoid combination

Sulpiride: Histamine H2 Receptor Antagonists may decrease the serum concentration of Sulpiride. Management: Consider alternatives to this combination, such as antacids given 2 hours after sulpiride, if possible. This does not apply when sulpiride and H2RAs are intentionally coadministered for the treatment of duodenal ulcers. Risk D: Consider therapy modification

Tacrolimus (Systemic): CYP3A4 Inhibitors (Weak) may increase the serum concentration of Tacrolimus (Systemic). Risk C: Monitor therapy

Tamsulosin: Cimetidine may increase the serum concentration of Tamsulosin. Risk C: Monitor therapy

Theophylline Derivatives: CYP1A2 Inhibitors (Weak) may increase the serum concentration of Theophylline Derivatives. Risk C: Monitor therapy

Thioridazine: CYP2D6 Inhibitors (Weak) may increase the serum concentration of Thioridazine. Management: Consider avoiding concomitant use of thioridazine and weak CYP2D6 inhibitors. If combined, monitor closely for QTc interval prolongation and arrhythmias. Some weak CYP2D6 inhibitors list use with thioridazine as a contraindication. Risk D: Consider therapy modification

TiZANidine: CYP1A2 Inhibitors (Weak) may increase the serum concentration of TiZANidine. Management: Avoid these combinations when possible. If combined use is necessary, initiate tizanidine at an adult dose of 2 mg and increase in 2 to 4 mg increments based on patient response. Monitor for increased effects of tizanidine, including adverse reactions. Risk D: Consider therapy modification

TOLBUTamide: Cimetidine may increase the serum concentration of TOLBUTamide. Risk C: Monitor therapy

Triazolam: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Triazolam. Risk C: Monitor therapy

Tricyclic Antidepressants: Cimetidine may increase the serum concentration of Tricyclic Antidepressants. Risk C: Monitor therapy

Ubrogepant: CYP3A4 Inhibitors (Weak) may increase the serum concentration of Ubrogepant. Management: In patients taking weak CYP3A4 inhibitors, the initial and second dose (given at least 2 hours later if needed) of ubrogepant should be limited to 50 mg. Risk D: Consider therapy modification

Urapidil: Cimetidine may enhance the hypotensive effect of Urapidil. Risk C: Monitor therapy

Velpatasvir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Velpatasvir. Risk C: Monitor therapy

Vitamin K Antagonists (eg, warfarin): Cimetidine may enhance the anticoagulant effect of Vitamin K Antagonists. Management: Avoid coadministration of cimetidine and vitamin K antagonists. If unavoidable, monitor for increased effects of vitamin K antagonists when cimetidine is initiated/dose increased, or decreased effects if cimetidine is discontinued/dose decreased. Risk D: Consider therapy modification

Zaleplon: Cimetidine may increase the serum concentration of Zaleplon. Management: The initial dose of zaleplon should be limited to 5 mg in patients taking cimetidine. Monitor patients for increased zaleplon effects/toxicities (ie, sedation, CNS depression) when these agents are combined. Risk D: Consider therapy modification

ZOLMitriptan: Cimetidine may increase the serum concentration of ZOLMitriptan. Management: Limit the maximum single dose of zolmitriptan to 2.5 mg, not to exceed 5 mg in 24 hours, when coadministered with cimetidine. Risk D: Consider therapy modification

Food Interactions

Prolonged treatment (≥2 years) may lead to malabsorption of dietary vitamin B12 and subsequent vitamin B12 deficiency (Lam 2013).

Pregnancy Considerations

Cimetidine crosses the placenta (Howe 1981). Histamine H2 antagonists have been evaluated for the treatment of gastroesophageal reflux disease (GERD), as well as gastric and duodenal ulcers during pregnancy (Cappell 2003; Richter 2003). Histamine H2 antagonists may be used for aspiration prophylaxis prior to cesarean delivery (ASA 2007).

Breastfeeding Considerations

Cimetidine is excreted in breast milk. Breastfeeding is not recommended by the manufacturer.

Monitoring Parameters

CBC, gastric pH; monitor kidney function to correct dose; occult blood with GI bleeding; signs of confusion.

Mechanism of Action

Competitive inhibition of histamine at H2 receptors of the gastric parietal cells resulting in reduced gastric acid secretion, gastric volume and hydrogen ion concentration reduced

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: 1 hour

Duration: 80% reduction in gastric acid secretion for 4 to 5 hours after 300 mg dose

Absorption: Rapid

Distribution: Children and Adolescents: 1.23 ± 0.45 L/kg (Lloyd 1985b); Adults: 1 to 1.5 L/kg (Somogyi 1983)

Protein binding: 20% (Somogyi 1983)

Metabolism: Partially hepatic, forms metabolites (Somogyi 1983)

Bioavailability: ~60% to 70% (Somogyi 1983)

Half-life elimination: Neonates: 3.6 hours (Lloyd 1985a); Children and Adolescents: 1.39 ± 0.25 hours (Lloyd 1985b); Adults: ~2 hours

Time to peak, serum: Oral: 0.75 to 1.5 hours

Excretion: Primarily urine (48% as unchanged drug); feces (2%) (Somogyi 1983)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Drug accumulation may occur in patients with severe kidney failure.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Adiatin | Apo cimetidine | Cimedine | Cimetag | Citius | Tagamet;
  • (AR) Argentina: Tagamet | Ulcerfen;
  • (AT) Austria: Cimetag | Cimetidin genericon pharma | Neutromed | Neutronorm | Sodexx cimetidin | Ulcometin | Ulcostad;
  • (AU) Australia: Cimehexal | Cimetidine-bc | Cimetimax | Magicul | Sbpa cimetidine | Sigmetadine | Tagamet;
  • (BD) Bangladesh: Acinil | Altramet | Apomed | Dimet | Histodil | Ulmet;
  • (BE) Belgium: Cimetidine Eurogenerics | Cimetidine ratiopharm | Cimetidine teva generics belgium | Cimetimed | Tagamet | Topcimet;
  • (BG) Bulgaria: Cimetidin | Tagamet;
  • (BR) Brazil: Cimedax | Cimetidan | Cimetidina | Cimetilab | Cimetinax | Cimetival | Cimeton | Cintidina | Climatidine | Duomet | Furp cimetidina | Gastidin | Gastrocine | Genodine | Novacimet | Pristonal | Prometidine | Stomakon | Stomet | Tagaliv | Tagamet | Tagamil | Tranimet | Ulcedine | Ulcenax | Ulcenon | Ulceracid | Ulcimet | Ulcinax | Ulcitag | Ulcitrat;
  • (CH) Switzerland: Cimetidin-mepha | Tagamet;
  • (CI) Côte d'Ivoire: Apo cimetidine;
  • (CN) China: Cimetidine and Sodium Chloride | Fu xin | Ghangfu you shu | Tagamet | Tai wei mei;
  • (CO) Colombia: Cimetidina | Cimetidina mk | Convenal | Tagamet | Ulset;
  • (CZ) Czech Republic: Apo cimetidine | Belomet | Cimetidin | Cimetin | Lock | Primamet;
  • (DE) Germany: Azucimet | Cim lich | Cime | Cime abz | Cime puren | Cime sanorania | Cimebeta | Cimehexal | Cimemerck | Cimetidin | Cimetidin al | Cimetidin vp | Cimsigma | Ciuk | Dura h2 | H2 blocker | Sigacimet | Tagamet | Ulcolind h | Ulcubloc;
  • (DO) Dominican Republic: Tagamet;
  • (EC) Ecuador: Cimetidina | Cimetin | Gastromet | Ulcemet;
  • (EE) Estonia: Acinil | Cimesan | Cimetidin | Histodil | Primamet | Tsimetidiin | Ulcomet;
  • (EG) Egypt: Acidnor | Histadil | Tagamet;
  • (ES) Spain: Fremet | Gastro h2 lesvi | Tagamet;
  • (ET) Ethiopia: Cimet;
  • (FI) Finland: Acinil | Asiloc | Tagamet | Ulcur;
  • (FR) France: Cimetidine g gam | Cimetidine gnr | Cimetidine merck | Cimetidine ratiopharm | Cimetidine rpg | Cimetidine teva | Tagamet;
  • (GB) United Kingdom: Acitak | Cimetidine almus | Cimetidine arrow | Cimetidine berk | Cimetidine cox | Cimetidine dc | Cimetidine kent | Cimetidine sandoz | Galenamet | Peptimax | Phimetin | Tagadine | Tagamet | Ultec | Zita;
  • (GR) Greece: Alkastom | Besidin | Grinolon | Tagamet | Tamper;
  • (HK) Hong Kong: Altramet | Apo cimetidine | Axcel Cimetidine | Bigacon | Cementin | Cimedin | Cimedine | Cimeldine | Cimeta | Cimetidine Sunward | Cimulcer | Citidine | Clinimet | Defense | Gastab | Gastidine | Ginomin | Lotidine | Maritidine | Neo ulcergen | Neutronorm | Nulcer | Sanwell | Shintamet | Simaglen | Stomcap 1 | Syncomet | Tagamet | Taladine | Timet | Ulcergen | Ulcerin | Ulcermet | Ulcime | Ulcomet | Ulsikur | Ultec | Ultipus | Wetidine;
  • (HU) Hungary: Cimehexal | Histodil;
  • (ID) Indonesia: Benomet-300 | Cimet | Cimexol | Corsamet | Decamet | Licomet | Magicul | Nulcer | Omekur | Ramet | Sanmetidin | Simetidin | Tagamet | Tobymet | Ulcumet | Ulsikur | Xepamet;
  • (IE) Ireland: Cedine | Cimagen | Cimeldine | Galenamet | Geramet | Pinamet | Tagamet;
  • (IL) Israel: Cemidin | Cimetag | Cimi | Tagamet;
  • (IN) India: Alucim | Tagamed;
  • (IT) Italy: Biomag | Brumetidina | Cimetidina | Dina | Eureceptor | Notul | Tagamet | Temic | Ulcedin | Ulcodina | Ulcomedina | Ulis;
  • (JO) Jordan: Cimedine | Tagamet;
  • (JP) Japan: Alukamet | Amuisan | Asmedin | Astrofen taiyo | Cilcar z | Cimeron | Cimetidine | Cimetidine hexal | Cimetidine tsuruhara | Cimetiparl | Cimetiran | Cmetiparl | Cylock | Cystamet | Dancart | Dancart chemiphar | Dansul | Esmeralda | Gasfellan | Gasfellon | Gastirine | Gastromet | Icrol | Ishimet | Lafcedin | Masuberan | Phardine mita | Roian c | Starcel | Stomatidin | Tagamet | Tagamet glaxosmithkline | Tagamet sumitomo | Taigastron | Takamigin c takata | Tiekapto | Togast | Ulcermec | Ulchyone;
  • (KE) Kenya: Cemet | Cimet | Labcimet | Micro cimetidine | Ulmet;
  • (KR) Korea, Republic of: Alvogen cimetidine | Aprogen cimetidine | Arlico cimetidine | Austidine | Bc cimetidine | Celmedine | Cigamet | Cignatin | Cimeridine | Cimeron | Cimet | Cimetadine | Cimeten | Cimetid | Cimetidine daewoo | Cimetidine myungmoon | Cimetidine woori | Cimetin | Cimetine | Cimtin | Ciradine | Cismetin | Citidine | Citin | Citine | Citron | Cl pharm cimetidine | Cmg cimetidine | Cmt | Cytin | Dongkoo cimetidine | Drimedine | Dualmet | Emetin | Etex cimetidine | Fanimet | Gl cimetidine | H 2b | H-2 | Hanlim cimetidine | Hastin | Himetine | Hlb cimetidine | Humetin | Huons cimetidine | Js cimetidine | Jungwoo cimetadine | Kms cimetidine | Kukje cimetidine | Magacidine | Meticon | Metidin | Metirin | Nelson cimetidine | Neutronorm | Newcime | Newmetidine | Newsime | Pharma cimetidine | Pharmgen cimetidine | Sama cimetidin | Signatin | Sinil cimetidine | Soctin | Somatin | Sulumetin | Tagamet | Tagatin | Tagetidin | Tagma | Tagmatin | Tagmetin | Taiguk cimetidine | Tgp cimetidine | Thrumetin | Trimetin | Ulcimet | Ulcomet | Ultamet | Union cimetidine | Wilpidin | Youngil cimetidine;
  • (KW) Kuwait: Apo cimetidine | Tagamet;
  • (LB) Lebanon: Apo cimetidine | Cimetril | Neutronorm | Tagamet;
  • (LT) Lithuania: Acinil | Apo cimetidine | Belomet | Cimehexal | Cimesan | Cimetidin | Histodyl | Novo cime | Primamet | Tagamet;
  • (LU) Luxembourg: Cimehexal | Cimetidine Eurogenerics | Tagamet;
  • (LV) Latvia: Acinil | Apo cimetidine | Belomet | Cimbene | Cimehexal | Cimesan | Cimetidin | Cimetidin acis | Cimetidin Stada | Histodyl | Novo cime | Primamet | Tagamet;
  • (MA) Morocco: Adiatin | Antagon h2 | Apo-cimetine | Tagamet | Ulcemat | Ulcestop;
  • (MX) Mexico: Beamat | Cimetase | Colimet | Columina | Gastrodina | Sinegastrin | Tagamet | Ulcedine | Ulcerim c | Ulogen h-2 | Ulpax-cimetidina;
  • (MY) Malaysia: Apo cimetidine | Axcel Cimetidine | Cimidine | Cimulcer | Duotric | Dynamet | Hamitag | Histodil | Shintamet | Tagamet | Tymidin | Ulcidine | Xepamet;
  • (NG) Nigeria: Chimexbon cimetidine | Cimec | Cinamodine | Citimed | Galen's cimetidine | Gasrol | Jopan cimetidine | Kadine | Mayadine | Me cure's cimetidine | New divine cimetidine | Nkoyo cimetidine | Octidime | Ordine | Rajcimeti | Stomprozol | Surelife cimetidine | Tacmed | Tardine;
  • (NL) Netherlands: Tagamet;
  • (NO) Norway: Acinil | Cimal | Cimetid | Cimetidin | Cimetidin accord | Cimetidin acis | Cimetidin al | Cimetidine aa pharma | Cimetidine cf | Cimetidine mylan | Gastrobitan | Tagamet;
  • (NZ) New Zealand: Apo cimetidine | Cytine | Tagamet;
  • (PE) Peru: Tagamet | Ulcimet;
  • (PH) Philippines: Antag | Ciclem | Cimedin | Cimetidine Am-Europharma | Duogastril | Getidin | Montidin | Sermet | Shintamet | Tagamet | Ulcenon | Zymet;
  • (PK) Pakistan: Acidil | Acimet | Agamid | Altramet | Arimet | Bacimet | Cid | Cidin | Cimepha | Cimet | Cimetamat | Cimirax | Cimizan | Cinil | Citadine | Citam | Contracid | Dozamet | Drape | Endonil | Eromet | Fovomet | Imetide | Neutronorm | Normacid | Phardine | Rakamet | Semag | Semidine | Tagamet | Ul-get | Ulcedine | Ulceloc | Ulcemet | Ulcerex | Ulcerine | Ulcet | Ulcetag | Ulsacure | Vasimet | Venopax | Wilcimet | Zemet;
  • (PL) Poland: Altramet | Belomet | Cimetidin | Cimetidine | Histodil | Tagamet;
  • (PR) Puerto Rico: Cimetidine | Cimetidine in sodium chloride | Heartburn Relief | Tagamet | Tagamet hb;
  • (PT) Portugal: Cim | Cimetidina Sanofi | Evicer | Tagamet;
  • (QA) Qatar: Cimedine | Cimetag;
  • (RO) Romania: Cimedine | Cimetidin | Cimetidina arena;
  • (RU) Russian Federation: Cimetidin | Histodyl | Primamet;
  • (SA) Saudi Arabia: Cimedine | Tagamet;
  • (SG) Singapore: Apo cimetidine | Axcel Cimetidine | Cementin | Cimetidine Sunward | Citidine | Erlmetin | Himetin | Shintamet | Tagamet | Ulsikur | Xepamet;
  • (SI) Slovenia: Altramet | Belomet;
  • (SK) Slovakia: Apo cimetidine | Belomet | Primamet;
  • (TH) Thailand: Aidar | Alserine | Apo cimetidine | Bismet | Brumetidina | Cencamat | Chintamet | Ciamet | Cidimet | Cidine | Cimag | Cimax | Cimeca | Cimedin | Cimedine | Cimet | Cimet-p | Cimetin | Cimetine | Cimetstar | Cimulcer | Citadine | Citamet | Citidine | Citimet | Citius | Clinimet | Cmd | Cocidine | Cymet | Cytomet | Duodin | Duotric | G.i | Gastacil | Gastridine | Gastrodin | Homet | Iwamet | K.b.cymedin | Lagamet | Manomet | Medine | Mergamet | Metadine | Metamet | Metidine F | Milamet | Mogamet | Neutronorm | Norcidin | Pantidine | Pat Cimet | Peptica | Peptidine | Peptil | Peptimet | Pipcimet | Pondarmett | Promet | Pybumet | Rinadine | Rudine | Seatidine | Sertidine | Servicimet | Siamidine | Sigamet | Silmet | Simaglen | Simex | Sincimet | Sinomet | Stomedine | Tacamac | Tacidine | Tadine | Tagadine | Tagamet | Tagapro | Tamed | Tametab | Temet | Tisomet | Tymet | U-cimet | Ulcacin | Ulcemet | Ulcerine | Ulcimet | Ulcine | Ulsamet | Umamett | Vescidine | Zolintab;
  • (TN) Tunisia: Cimedine | Metracine | Tagamet;
  • (TR) Turkey: Simetin | Tagamet;
  • (TW) Taiwan: Acinil | Agastrin | Anulcus | Apo cimetidine | Brumetidina | C.m.t. | Ciketin | Cimedin | Cimedine | Cimefine | Cimenice | Cimeron | Cimet | Cimetin | Cimetine | Cimewei | Cimewell | Cimewet | Cimidin | Cinulcus | Citamet | Citidine | Citius | Civigen | Ciwei | Ciweitin | Ciwetim | Ciwetin | Ciwidine | Ciyanlin | Comgamet | Cowemin | Cystamet | Da con Wei | Defense | Derziqu | Duocer | Fanimet | Fastop | Gastomet | Gastrodin | Gawei | Himetin | Hou We Ming | Iscan | Koweishu | Ku-We-Rin | Megato | N-Way | Nurodin | P.U.N | Paiewell | Paoweian | Pawegon | Potence | Pouwepin | Powegon | Royamet | Safeway | Sanwell | Shuful | Sigamet | Stogamet | Suweilin | Suwelin | Swega | Tacreton | Tagamet | Tagamin | Tagasone | Tagawei | Tailiwell | Tamedin | Tamedine | Taweimin | Tawemet | Tigawet | Ulcestop | Weibau | Weicolin | Weisdin | Weisu | Wellcome | Wergen | Wetidine | Wijeton | Wintidine | Zukei;
  • (UA) Ukraine: Cimehexal | Cimetidin | Histodyl | Primamet;
  • (UG) Uganda: Agocim | Astidin | Recim;
  • (UY) Uruguay: Amipylo | Biogastrol | Cimetidina | Fisiol | Ulcimet;
  • (VE) Venezuela, Bolivarian Republic of: Cavimet | Cimetidina | Cimetin | Cimetix | Gadol | Iscaten | Tagamet;
  • (VN) Viet Nam: Agintidin | Tagimex;
  • (ZA) South Africa: Aci-med | Acidown | Adco-cimetidine | Apo cimetidine | Berk cimetidine | Bio cimetidine | Cimlok | Cinadine | Cymi | Hexamet | Lenamet | Micro-cimetidine | Norton-cimetidine | Rolab-cimetidine | Secadine | Tagamet;
  • (ZM) Zambia: Cimedin | Cimet | Ulcidin;
  • (ZW) Zimbabwe: Adco-cimetidine | Bio cimetidine
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