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Drug Interactions with Cimetidine that are Toxic!! (Read 7023 times)
PJP123
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Drug Interactions with Cimetidine that are Toxic!!
11/13/14 at 07:18:23
 
Just came across this info for some of us who get very sick seemingly out of nowhere, when in fact we are having a toxic reaction to combined meds, when taking Cimetidine.  I know it happeded to me on many occasions.  No doctor ever put 2 and 2 together, but here's the proof.  

Drug interactions

Skeletal formula of famotidine. Unlike cimetidine, famotidine has no significant interactions with other drugs.
With regard to pharmacokinetics, cimetidine in particular interferes with some of the body's mechanisms of drug metabolism and elimination through the liver cytochrome P450 (CYP) pathway. To be specific, cimetidine is an inhibitor of the P450 enzymes CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP3A4. By reducing the metabolism of drugs through these enzymes, cimetidine may increase their serum concentrations to toxic levels. Many drugs are affected, including warfarin, theophylline, phenytoin, lidocaine, quinidine, propranolol, labetalol, methadone, metoprolol, tricyclic antidepressants, some benzodiazepines, dihydropyridine calcium channel blockers, sulfonylureas, metronidazole,[8] and some recreational drugs such as ethanol (drinking alcohol) and methylenedioxymethamphetamine (MDMA).

The more recently developed H2-receptor antagonists are less likely to alter CYP metabolism. Ranitidine is not as potent a CYP inhibitor as cimetidine, although it still shares several of the latter's interactions (such as with warfarin, theophylline, phenytoin, metoprolol, and midazolam).[9] Famotidine has negligible effect on the CYP system, and appears to have no significant interactions.
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Britt
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Re: Drug Interactions with Cimetidine that are Toxic!!
Reply #1 - 11/13/14 at 07:47:48
 
Hi Pam! So I take Zantac. As far as th other meds you mentioned as possible interactions, I do take antidepressants. Zoloft, remeron and geodon. Wonder if there is a problem here?
Is Pepcid and h2 or a protein pump inhibitor? Can you use Pepcid instead of Zantac? From what you've read, do you think that if tolerable, this is a better choice?
I did try Tagamet about a year ago, I can't remember the specifics, but I know it didn't go very well.
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PJP123
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Re: Drug Interactions with Cimetidine that are Toxic!!
Reply #2 - 11/13/14 at 14:35:27
 
I read Famitidine (Pepsid) is less toxic, but as I recall I tried them alland I can't take any of them.  I take a Xanax (Benzo) to sleep and calcium channel blocker for dysautonomia so they would interact with these.  I am not under control at all and feel like hell on a regular basis.  Like you Brigitte I don't know really what my diagnosis is other than Autoimmune Chronic Urticaria.  

Now I have complete malabsorption and no doctor to help me.
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Britt
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Re: Drug Interactions with Cimetidine that are Toxic!!
Reply #3 - 11/14/14 at 14:11:01
 
I am so sorry you are feeling so crappy. I've had a bad week, but seem to finally be on the upswing this evening. I have talked to Dr. Afrin via email and he is quite certain that I do have mast cell activation disorder and that the urticaria is just a small part of the big picture. This is the same feeling I get. I can completely relate to MCAS symptoms.
Good news....I'm going to see Dr. Afrin on January 28th!!! I'm so excited! Not sure what to expect from the appointment, and of course there is not a magic pill, but I know he has a list of treatment options. It will also be nice to clear things up and hopfully get a solid diagnosis.
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PJP123
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Re: Drug Interactions with Cimetidine that are Toxic!!
Reply #4 - 11/15/14 at 03:34:38
 
That's all I want too is a solid diagnosis.  I know I feel awful and I'm never going to be who I was before I got sick, but at least I can stop being completely consumed with "I DON'T FEEL GOOD".  That's all I've been saying for so long.
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Re: Drug Interactions with Cimetidine that are Toxic!!
Reply #5 - 11/15/14 at 08:18:48
 
I know how you feel. Like a broken record. I've tried to stop saying it outloud so much. I don't want to be the girl who cried wolf. When I say I really don't feel good, I want my husband to know we've got a problem here. Get the epi ready.

So I spoke too soon last night. I said I was on the upswing. Ya right! At about 9 last night I layed back on the couch and suddenly like an electric current went through my body and I got really dizzy. Even though I was breathing fine, it felt like someone was sitting on my chest and it was hard to breath. Pretty scary. I drank some Benadryl. luckily it passed in about 10 mins. Freaked me out. I think my blood pressure may have dropped. I'm not sure. My husband said my face was white.
I've noticed that my dizzy spells are kind of opposite than one would think. Usually people get dizzy when they stand up too fast from sitting. But most of my dizzy spells happen when I go from standing to sitting. Weird.

Pam~ what meds are you currently taking? Have you noticed that you are more histamine sensitive, or salicylate sensitive, or both? I've taken all vegetable oils out of diet as much as I can and it seems to be helping. I also don't use any personal items like lotions etc. with any plant ingredients, including glycerin, which seems to be a big trigger for me.
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« Last Edit: 11/15/14 at 10:21:38 by Britt »  
 
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Joan
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Re: Drug Interactions with Cimetidine that are Toxic!!
Reply #6 - 11/15/14 at 16:19:25
 
I have never heard of a mast cell disorder doc who recommended  cimetidine to MC patients.  Zantac (ranitidine) and Pepcid (famotidine) are the ones more safely taken as H2 blockers.

Some docs prescribe Claritin as an H1 blocker first, even though it is usually less effective, for the same reason.  It has fewer interactions with other meds.  Be sure to ask your doctor or pharmacist about any new medicine and whether it interacts with other drugs you take.

PJP, It's so frustrating not to have a diagnosis, as well as causing a lot of anxiety.  Unfortunately half the battle with these disorders is to find your own triggers (dietary and environmental) and avoid them.  The other is to get on the right combination of meds for your symptoms.

Once you have both of those things accomplished, you will still have flares of symptoms, but they will be shorter because you know how to medicate properly and milder because you will be keeping your "bucket" of triggers emptier by not exposing yourself to things that cause you symptoms.  The flares will also be less frequent.

If you don't have a mast cell specialist helping you or a doctor who is speaking with a mast cell specialist for advice, it's so important to find one.  It takes some of the burden off you when you have someone to help you get more stable.

Hope you find some relief.

Brigitte,  When you're having an episode, you might want to have your husband take your BP and check your heart rate.  There are inexpensive BP cuffs available.  Of course, take the Benadryl first.  If either is too high or low or irregular, call 911 or go to a hospital.  Also, you might want to take an H2 blocker with the Benadryl and some Singulair if you can tolerate it.
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