1. Ameer
Hamza
Submitted To:
Shaheed
Sir Irfan Hamid

2. Cimetidine
Drug name :
Cimetidin
Pharmacological class:
Histamine H2 Antagonists
Enzyme Inhibitors
Therapeutic class:
Anti-Ulcer Agents

3. Chemical name:

4. Chemical structure:

8. Colour: White or off white crystalline powder.
Odour: Unpleasant odour.

11. Mechanism of
action

12. Cimetidine binds to an H2-receptor located on the
basolateral membrane of the gastric parietal cell, blocking
histamine effects. This competitive inhibition results in
reduced gastric acid secretion and a reduction in gastric
volume and acidity.

15. Bioavailability:
PO: 60-70% (undergoes minimal
1st pass metabolism)
Protein Bound: 15-20%
Half life: 2 hours
Absorption : Oral/I.V 60 %

16. Excretion:
 Urine: 48-75%
 Feces: 2-3%

17. Enzymes inhibited:
CYP1A2
CYP2D6
CYP3A4

19. Peptic Ulcer:
Peptic ulcers are sores in the lining of the stomach or
duodenum.
Causes :
H.pylori bacteria .
Regular use of pain relievers. NSAID,s
(aspirin, ibuprofen , naproxen , ketoprofen)
(This information taken from book Medical pharmacology by Padmaja
Udaykumar)(page #317))

20. Gastroesophageal reflux disease
Reflux Oesophagitis :
Acid from the stomach leaks up into the gullet
(oesophagus)
This information taken from
(http://www.patient.co.uk/health/Acid-
Reflux-and-Oesophagitis.htm)

21. Zollinger-Ellison syndrome:
The exact cause of Zollinger-Ellison syndrome
remains unknown.
Zollinger-Ellison syndrome are made up of cells
(gastrinomas) that secrete large amounts of
gastrin, which in turn causes the stomach to
produce far too much acid.
(http://www.mayoclinic.com/health/zollinger-ellison-syndrome/DS00461/DSECTION=causes)

22. Acid related dyspepsia:
Dyspepsia is sometimes called indigestion.
Discomfort that causes persistent pain or fullness in
the upper abdomen, soon after the meal starts.
(http://www.medindia.net/patients/patientinfo/indigestion.htm)

23. Stress ulcer:
Stress can contribute to the development of many
diseases .This includes stomach, or peptic, ulcers.
(http://www.livestrong.com/article/174015-a-stomach-ulcer-from-stress/#ixzz2F8KFZBmc )

25. • 800 mg/D • 400 mg q.i.d
• At bed time upto 12
weeks
Reflux
Peptic
oesoph
Ulcer
agitis
Acid
Zollinger- related
Ellison
syndrome dyspep
sia
• 200 mg t.d.s • 200 mg q.i.d
• With meal at • With meal at
bed time bed time

26.  This information taken from book
Pharmaguid page # 38

27. Drug Interactions

28. Theophylline
CYP1A2
Warfarine Codeine
CYP3A4 Cimetidine
CYP1A2 CYP2D6
Phenytoin
CYP2C9

29. These information taken from,
Pharmaguide page #39.
http://www.merckmanuals.com/professional/clinical_pharmacology/ph
armacokinetics/drug_metabolism.html
http://www.aafp.org/afp/2007/0801/p391.html

31. Rare but
Common side dangerous side
effects: effect:
Decrease libido
Headache. Decrease sperm count
Constipation. Impotence
Confusion. Gynecomastia
Somnolence.
(These side effects associated with
high dose of cimetidine)
Lynn wecker page # 200

32. Brand
names for
Cimetidine

33. B.N: Cimet B.N: Tagamet
M.N: Ferozsons M.N: GSK
Tab.: 400 mg
Inj.: 200 mg
Tab.: 200 , 400 mg
Cimetidine
B.N: Normacid B.N: Bacimet
M.N: Wilson M.N: Davis pharma
Tab.: 400 , 800 mg Tab.: 200 , 400 mg

34. Any
Question ?