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Cimetidine Injection and Nifedical XL

Determining the interaction of Cimetidine Injection and Nifedical XL and the possibility of their joint administration.

Check result:

Cimetidine Injection <> Nifedical XL

Relevance: 21.09.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Cimetidine can increase the blood levels and effects of NIFEdipine. This may increase the risk of serious side effects such as irregular heart rhythm, fluid retention, swelling, heart failure, and excessively low blood pressure. You should seek immediate medical attention if you experience sudden, unexplained weight gain; swelling of the hands, ankles, or feet; dizziness, lightheadedness, or fainting; difficulty breathing; chest pain or tightness; or irregular or slow heart beat during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Your doctor or pharmacist may also be able to suggest alternatives to cimetidine that you can use safely with NIFEdipine. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with cimetidine may increase the plasma concentrations of calcium channel blockers that are substrates of the CYP450 3A4 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by cimetidine.

MANAGEMENT: Close monitoring of clinical response and tolerance is recommended if cimetidine is used in combination with calcium channel blockers that are metabolized by CYP450 3A4 such as diltiazem, felodipine, nicardipine, nifedipine, nimodipine, nisoldipine, and verapamil. Dose reductions of 40% to 50% may be considered, if necessary. Patients should be advised to seek medical attention if they experience edema or swelling of the lower extremities; sudden, unexplained weight gain; difficulty breathing; chest pain or tightness; or hypotension as indicated by dizziness, fainting, or orthostasis. Other H2-receptor antagonists may be safer alternatives, since they have not been shown to significantly affect CYP450 3A4 metabolism. However, there have been isolated reports of interaction between ranitidine and calcium channel blockers including nifedipine and nitrendipine.

References

"Product Information. Sular (nisoldipine)." Zeneca Pharmaceuticals, Wilmington, DE.
Smith SR, Kendall MJ, Lobo J, Beerahee A, Jack DB, Wilkins MR "Ranitidine and cimetidine; drug interactions with single dose and steady-state nifedipine administration." Br J Clin Pharmacol 23 (1987): 311-5
Mikus G, Eichelbaum M, Fischer C, et al "Interaction of verapamil and cimetidine: stereochemical aspects of drug metabolism, drug disposition and drug action." J Pharmacol Exp Ther 253 (1990): 1042-8
Muck W, Wingender W, Seiberling M, Woelke E, Ramsch KD, Kuhlmann J "Influence of the H2-receptor antagonists cimetidine and ranitidine on the pharmacokinetics of nimodipine in healthy volunteers." Eur J Clin Pharmacol 42 (1992): 325-8
Smith MS, Benyunes MC, Bjornsson TD, et al "Influence of cimetidine on verapamil kinetics and dynamics." Clin Pharmacol Ther 36 (1984): 551-4
Smith SR, Kendall MJ, Lobo J, et al "Ranitidine and cimetidine; drug interactions with single dose and steady-state nifedipine administration." Br J Clin Pharmacol 23 (1987): 311-5
Winship LC, McKenney JM, Wright JT, Wood JH, Goodman RP "The effect of ranitidine and cimetidine on single-dose diltiazem pharmacokinetics." Pharmacotherapy 5 (1985): 16-9
Schwartz JB, Upton RA, Lin ET, Willias RL, Benet LZ "Effect of cimetidine or ranitidine administration on nifedipine pharmacokinetics and pharmacodynamics." Clin Pharmacol Ther 43 (1988): 673-80
Renwick AG, Le Vie J, Challenor VF, Waller DG, Gruchy B, George CF "Factors affecting the pharmacokinetics of nifedipine." Eur J Clin Pharmacol 32 (1987): 351-5
Janzon K, Edgar B, Lundborg P, Regardh CG "The influence of cimetidine and spironolactone on the pharmacokinetics and haemodynamic effects of felodipine in healthy subjects." Acta Pharmacol Toxicol (Copenh) 59 (1986): 98
Kirch W, Hutt HJ, Heidemann H, et al "Drug interactions with nitrendipine." J Cardiovasc Pharmacol 6 (1984): s982-5
Agencia Española de Medicamentos y Productos Sanitarios Healthcare "Centro de información online de medicamentos de la AEMPS - CIMA. Available from: URL: https://cima.aemps.es/cima/publico/home.html." ([2018]):
Loi CM, Rollins DE, Dukes GE, Peat MA "Effect of cimetidine on verapamil disposition." Clin Pharmacol Ther 37 (1985): 654-7
Wing LM, Miners JO, Lillywhite KJ "Verapamil disposition: effects of sulphinpyrazone and cimetidine." Br J Clin Pharmacol 19 (1985): 385-91
Kirch W, Ramsch K, Janisch HD, Ohnhaus EE "The influence of two histamine H2-receptor antagonists, cimetidine and ranitidine, on the plasma levels and clinical effect of nifedipine and metoprolol." Arch Toxicol Suppl 7 (1984): 256-9
Khan A, Langley SJ, Mullins FG, Dixon JS, Toon S "The pharmacokinetics and pharmacodynamics of nifedipine at steady state during concomitant administration of cimetidine or high dose ranitidine." Br J Clin Pharmacol 32 (1991): 519-22

Cimetidine Injection

Generic Name: cimetidine

Brand name: Tagamet HB, Tagamet

Synonyms: Cimetidine

What is Cimetidine Injection?

Nifedical XL

Generic Name: nifedipine

Brand name: Adalat CC, Afeditab CR, Nifediac CC, Nifedical XL, Procardia, Procardia XL, Adalat

Synonyms: Nifedical XL (Oral)

What is Nifedical XL?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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