Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: DrugBank:APRD00568 (Cimetidine)
 1,659 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cyclosporine is metabolized by the hepatic microsomal cytochrome P-450 mixed function oxidases. To determine the effects of inducers and inhibitors of this enzyme on nephrotoxicity, male Fischer 344 rats were treated with cyclosporine in doses of 25 mg/kg and 40 mg/kg by daily gavage for 14 days. Groups of animals were given phenobarbital 75 mg/kg i.p., cimetidine 75 mg/kg i.p., or .9% saline i.p. for 3 days prior to starting cyclosporine and throughout therapy. Animals treated with the oil vehicle for cyclosporine served as controls. Animals receiving cyclosporine together with phenobarbital hat better preservation of glomerular filtration rate than did other cyclosporine-treated animals. Cimetidine did not enhance cyclosporine nephrotoxicity. Direct tubular toxicity was not evident using cortical slice transport of tetraethylammonium, fractional excretion of sodium and light microscopy as markers. If phenobarbital protects from cyclosporine nephrotoxicity because of its enzyme inducing action, it would follow that the parent drug and not a toxic metabolite mediates renal dysfunction. Based on the decreased glomerular filtration rate in the absence of overt tubular damage the major mechanism of cyclosporine nephrotoxicity is probably related to vascular or glomerular effects of the drug.
 ...
PMID:Effect of phenobarbital and cimetidine on experimental cyclosporine nephrotoxicity: preliminary observations. 370 21

The effect of cimetidine and ranitidine on the demethylation of imipramine (IMI) and on the hydroxylation of desmethylimipramine (DMI) was studied in microsomes from four human livers. Cimetidine inhibited both demethylation of IMI and 2-hydroxylation of DMI, whilst the effect of ranitidine was not statistically significant. 2-hydroxylation of DMI is probably mediated by debrisoquine hydroxylase, a cytochrome P-450 isozyme that is monogenically controlled. The results suggest that cimetidine inhibits this enzyme.
 ...
PMID:Differential effects of cimetidine and ranitidine on imipramine demethylation and desmethylimipramine hydroxylation by human liver microsomes. 370 53

A chronic-dosing pharmacokinetic study was carried out in six healthy subjects to examine the potential for cimetidine to reduce the CLR and CLH of triamterene. Blood and urine samples were collected frequently for 24 hours after dosing with triamterene alone (100 mg/day) for 4 days and concomitant cimetidine (400 mg twice daily) for an additional 4 days. Cimetidine significantly reduced the clearance of triamterene by hydroxylation by 32% (P less than 0.016) and the CLR of triamterene by 28% (P less than 0.063), with no change in its protein binding. The CLR of the active sulfate conjugate of triamterene was not altered by cimetidine. There was a reduced recovery of triamterene and its metabolites in urine after cimetidine, suggesting a decreased absorption. These results are consistent with cimetidine inhibiting cytochrome P-450 enzymes in the liver and also competing with triamterene for renal tubular secretion. Despite the pharmacokinetic interaction, cimetidine caused minimal alteration to the natriuretic and antikaliuretic effects of triamterene.
 ...
PMID:Effect of cimetidine on renal and hepatic drug elimination: studies with triamterene. 375 3

Cimetidine is an H2 antagonist which inhibits cytochrome P-450 and reduces hepatic blood flow. To determine whether cimetidine interferes with the plasma pharmacokinetics of doxorubicin, we gave six female New Zealand rabbits doxorubicin 3 mg/kg, followed a month later by cimetidine 120 mg/kg every 12 h over 72 h and doxorubicin 3 mg/kg. Serial plasma specimens were obtained over 72 h and assayed for doxorubicin and its metabolites by high-performance liquid chromatography and fluorescence detection. Doxorubicin plasma pharmacokinetics were prolonged after cimetidine pretreatment [AUC 0.76 +/- 0.22 vs. 2.85 +/- 1.22 microM X h, no pretreatment vs pretreatment (p = 0.005), half-life = 11.7 +/- 6.55 vs 28.0 +/- 8.16 h (P = 0.0002), and clearance = 0.129 +/- 0.036 vs 0.036 +/- 0.011 l/min-1 kg-1 (P = 0.0007)]. No significant differences were found between the AUCs for doxorubicinol, 7-deoxy doxorubicinol aglycone, or two unidentified nonpolar metabolites in nonpretreatment and pretreatment studies. Cimetidine increases and prolongs the plasma exposure to doxorubicin in rabbits. Doxorubicin metabolism does not appear to be affected by cimetidine.
 ...
PMID:The effects of cimetidine upon the plasma pharmacokinetics of doxorubicin in rabbits. 380 77

Changes in high-density lipoprotein (HDL) cholesterol levels were monitored in five patients treated with cimetidine for gastrointestinal disturbances. A progressive rise of HDL cholesterolemia, statistically significant after four weeks of treatment and highly so after eight weeks (+ 25.4%) was noted. The composition of HDL2 varied insignificantly, whereas a marked rise of HDL3 cholesterol (+ 23.4%) and protein (+ 13.9%) was observed at the end of eight weeks. Cimetidine seems to act in a similar way as microsomal enzyme inducers, in spite of the described inhibition of specific pathways in drug metabolism; recent evidence shows that cytochrome P-450 turnover is delayed after cimetidine. Whatever the mechanism(s), H2 receptors may play a role in the cholesterol removal from tissues.
 ...
PMID:Cimetidine increases HDL-cholesterol, particularly in the HDL3 subfraction. 401 May 21

Controversy exists as to whether H2-receptor antagonists decrease hepatic blood flow. This study examined the effect of single doses of cimetidine 300 and 600 mg po on apparent hepatic blood flow as estimated by indocyanine green (ICG) clearance. A double-blind, repeated-measure study was performed in nine supine healthy men. Following an overnight fast, placebo or cimetidine was administered one hour prior to ICG 0.5 mg/kg iv. Plasma samples were obtained serially for a period of 20 minutes following dye administration and stored at -70 degrees until high performance liquid chromatographic analysis. Cimetidine had no apparent effect on mean +/- SD ICG clearance following placebo, cimetidine 300 mg, and cimetidine 600 mg (366 +/- 66 vs. 336 +/- 55 vs. 350 +/- 58 ml/min/m2, respectively; NS). Corresponding values for estimated hepatic blood flow were 632 +/- 109, 580 +/- 103, and 617 +/- 112 ml/min, respectively; NS. No statistically significant changes in ICG half-life or volume of distribution at steady state occurred as a function of treatment. Contrary to previous reports, single-dose cimetidine administration appeared to have no appreciable effect on hepatic blood flow. These results implicate cimetidine binding to the cytochrome P-450 system as the sole mechanism responsible for inhibition of the systemic clearance of co-administered drugs metabolized by the liver.
 ...
PMID:The effect of single doses of cimetidine on estimated hepatic blood flow. 406 17

At present, there are two H2-receptor antagonists available for the treatment of peptic ulcer disease - cimetidine and ranitidine. Cimetidine is well known to interact with a number of concurrently administered drugs. Like cimetidine, ranitidine binds to cytochrome P-450 in the liver where it appears to exert an inhibitory effect, but to a lesser extent than cimetidine. Both H2-receptor antagonists may also reduce hepatic blood flow. Several drugs which are known to interact with cimetidine have been found not to interact significantly with ranitidine, including propranolol, lignocaine, phenytoin and diazepam. However, significant pharmacokinetic interactions between ranitidine and several other drugs have been established. These interactions may be attributed variously to an effect of ranitidine on hepatic metabolism or to an effect on the absorption of concomitantly administered drugs. For example, the bioavailability of midazolam is significantly increased due to the influence of ranitidine on gastric pH and thus on absorption of midazolam, leading to an increased soporific effect of this benzodiazepine; an effect of ranitidine on oxidative liver metabolism also appears to be a contributory factor in this interaction. Conversely, ranitidine distinctly reduced protein-bound cobalamin absorption from a mean of 7.66% prior to ranitidine administration to 0.84% during treatment with ranitidine 300 mg daily. A significant pharmacokinetic interaction has also been demonstrated between ranitidine and procainamide: the AUC of procainamide increased and the renal clearance fell significantly from a mean of 378 to 309 ml/min with ranitidine co-administration. However, this interaction is due to a different mechanism. In this case, ranitidine appears to compete with procainamide for the common renal proximal tubular secretion site. The reported interactions of ranitidine with warfarin, metoprolol, nifedipine, theophylline and fentanyl appear to be due to inhibition of cytochrome P-450. In a clinical study, warfarin clearance was significantly reduced from 66.7 to 48.7 ml/min by ranitidine, and by cimetidine to 42.9 ml/min. Similarly, the elimination half-lives of metoprolol and nifedipine were distinctly prolonged and the AUCs significantly increased by ranitidine. However, the latter pharmacokinetic interactions appear unlikely to be of clinical significance since the clinical effects of metoprolol and nifedipine were unaffected by ranitidine treatment. In therapeutic concentrations, ranitidine inhibited the disappearance of fentanyl from an in vitro microsomal preparation, indicating that it inhibits microsomal drug metabolism.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Interactions and non-interactions with ranitidine. 609 71

Cimetidine and ranitidine interact with microsomes from human and pig liver and with purified cytochrome P-450 in the ligand-type manner. The affinity for cimetidine is about 10 times as high as that for ranitidine. Accordingly amplitudes of the specta are much higher for cimetidine. These results are in accordance with those obtained earlier with rat liver microsomes. The inhibitory potency of either compound with regard to dealkylation of 7-ethoxycoumarin appears to be less in the human preparation.
 ...
PMID:Cimetidine and ranitidine: their interaction with human and pig liver microsomes and with purified cytochrome P-450. 609 54

The literature on cimetidine drug interactions has been thoroughly reviewed. Several different mechanisms have been proposed for cimetidine-related drug interactions. These mechanisms include: (1) impaired hepatic drug metabolism due to inhibition of hepatic microsomal enzymes, (2) reduced hepatic blood flow, resulting in decreased clearance of drugs that are highly extracted by the liver, (3) increased potential for myelosuppression when administered concurrently with other drugs capable of causing myelosuppression, and (4) altered bioavailability of acid-labile drugs. Cimetidine binds reversibly to the hepatic cytochrome P-450 and P-448 systems, resulting in decreased metabolism of drugs that undergo Phase I reactions (e.g., dealkylation and hydroxylation). In contrast, glucuronidation pathways are unaffected. The rapid onset and reversal of cimetidine's inhibition of hepatic metabolism indicates an effect on hepatic enzyme systems. Cimetidine also has been reported to decrease hepatic blood flow. Drugs that are highly extracted by the liver, such as propranolol, lidocaine, and morphine, may be postulated to have a decreased hepatic clearance. Cimetidine, through its effect on gastric pH, may increase the absorption of acid-labile drugs or may decrease the absorption of drugs. There have been reports of increased potential for myelosuppression when cimetidine is administered concurrently with drugs capable of causing bone marrow suppression. An understanding of the mechanisms involved in cimetidine drug interactions allows the clinician to prevent and predict these interactions.
 ...
PMID:Review of cimetidine drug interactions. 613 Sep 30

Cimetidine (I) interacts with the hemin iron of cytochrome P-450 from rat liver microsomes, with its imidazole and cyano coordinating groups. Ranitidine (II) interacts through its nitronic acid oxygen and its amine nitrogen, as shown by optical difference and ESR-spectra. I, N-cyano-N'[2-[[[5-(dimethylamino)-methyl-2-furanyl]methyl] thio]-ethyl]-N"-methyl guanidine (IV), 4(5)-hydroxymethyl-5(4)-methyl imidazole (VII), 4(5)-methyl-5(4)-[(2-aminoethyl)-thiomethyl]-imidazole hydrochloride (IX), 2-[[[(5-dimethylamino)-methyl-2-furanyl]-methyl]-thio]ethene amine dihydrochloride (X) and imidazole (XI) inhibit 7-ethoxycoumarin dealkylation competitively. In I both imidazole and cyano groups contribute to the inhibitory activity, the latter group being more effective according to electron spin resonance. Mixed type inhibition was observed with II, desmethylranitidine (VIII) and N-[[2-(5-methylimidazol-4-yl)methylthio]-ethyl]-N'-methyl-2-nitro-1, 1-ethenediamine (III). These compounds inhibited the reaction to a small extent; ranitidine S-oxide (VI) did not interact at all with microsomes from phenobarbital-pretreated rats. Using microsomes from 3-methylcholanthrene-pretreated rats, the affinities of interaction and the amplitudes of optical difference spectra were higher with VIII than with its parent, compound II.
 ...
PMID:Characterization of cimetidine, ranitidine, and related structures' interaction with cytochrome P-450. 613 18


<< Previous 1 2 3 4 5 6 7 Next >>