PubMed · 6908801
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D D Mar. 1981. Cimetidine update.. https://pubmed.ncbi.nlm.nih.gov/6908801/
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BACKGROUND: Current estimates of renal function in kidney transplant patients are frequently inaccurate compared to radionuclide GFR (rGFR) measurement. Cimetidine inhibits tubular secretion of creatinine and improves the accuracy of formulas to estimate GFR. METHODS: We studied the effect of a cimetidine-aided (800 mg tid for 24 hr) serum creatinine on the correlation of creatinine clearance and three prediction formulas (Cockroft-Gault, Levey, and Nankivell) compared to rGFR in 15 kidney-pancreas transplant patients. Results were adjusted for body surface area. RESULTS: Correlations with rGFR using cimetidine-aided creatinine were: Cockroft-Gault, r=0.710; Levey, r=0.752; Nankivell, r=0.676; creatinine clearance, r=0.643. By Bland and Altman analysis, agreement with rGFR was best with the Nankivell and Cockroft-Gault equations and worst with creatinine clearance. Cimetidine ($0.48 Canadian) costs substantially less than the rGFR test ($66.00 Canadian). CONCLUSION: Using cimetidine, prediction equations give a stronger correlation with GFR than creatinine clearance.
Metformin is a guanidine derivative used for the treatment of NIDDM. As it is used for a long-term therapy, it may be coadministered with other drugs. Present paper deals with the in vitro availability studies of metformin in presence of commonly used H(2) receptor antagonists. The later drugs compete with histamine for H(2) receptors and block gastric acid secretion and some cardiovascular effects of histamine. These studies were carried out in simulated gastric juices, simulating empty and full stomach, simulated intestinal juice and buffers of pH 7.4 simulating blood pH at 37 degrees C on a B.P. 2003 dissolution test apparatus. Commonly prescribed H(2) receptor antagonists like cimetidine, ranitidine and famotidine were used in these studies. The present study clearly indicated that availability of metformin can be altered in presence of most of the H(2) receptor antagonists studied except in presence of famotidine at pH 4 where the drug concentration remains unaltered. The availability of metformin was increased in simulated gastric juice, pH 7.4 and pH 9 (except ranitidine at pH 9) whereas the decrease in availability was observed in presence of cimetidine and ranitidine at pH 4 and ranitidine at pH 9. On the basis of these results, it is can be suggested that metformin should be coadministered with care along with H(2) receptor antagonists especially in case of ranitidine; although chances of adverse reactions are rare but decrease availability of metformin may result in delayed effect. On the other hand, increase in metformin concentration may result in hypoglycemic effects.
Administration of cimetidine after curative surgery can improve prognosis of patients with colorectal cancer. In this study, we analyzed whether cimetidine can influence the survival of patients with a recurrent disease after colorectal surgery. The subjects were 29 patients with recurrent disease: 14 patients were administered with cimetidine and 15 patients were not. In the cimetidine administered group, seven cases were recurrent in the liver, 5 cases in a local site and 1 case in the lymph node, whereas 7 cases were recurrent in the liver, 4 cases in a local site and 3 cases in the lung for the non-cimetidine administered group. There were no significant differences for both groups in terms of patient's survival after recurrence. Although it was not significant, the patient's survival after curative resection of recurrent disease for the cimetidine administered group was better than the non cimetidine administered group. Although the results did not show cimetidine could influence the overall survival of the patients after recurrence, it might be possible to improve the survival of the patients after resection of the recurrent disease.