Tratul Interactions
Tagamet, apparently through an effect on certain microsomal enzyme systems, has been reported to reduce the hepatic metabolism of warfarin-type anticoagulants, phenytoin, propranolol, nifedipine, chlordiazepoxide, diazepam, certain tricyclic antidepressants, lidocaine, theophylline and metronidazole, thereby delaying elimination and increasing blood levels of these drugs.
Clinically significant effects have been reported with the warfarin anticoagulants; therefore, close monitoring of prothrombin time is recommended, and adjustment of the anticoagulant dose may be necessary when Tagamet is administered concomitantly. Interaction with phenytoin, lidocaine and theophylline has also been reported to produce adverse clinical effects.
However, a crossover study in healthy subjects receiving either Tagamet 300 mg q.i.d. or 800 mg h.s. concomitantly with a 300 mg b.i.d. dosage of theophylline (Theo-Dur®, Key Pharmaceuticals, Inc.) demonstrated less alteration in steady-state theophylline peak serum levels with the 800 mg h.s. regimen, particularly in subjects aged 54 years and older. Data beyond 10 days are not available. (Note: All patients receiving theophylline should be monitored appropriately, regardless of concomitant drug therapy.)
Dosage of the drugs mentioned above and other similarly metabolized drugs, particularly those of low therapeutic ratio or in patients with renal and/or hepatic impairment, may require adjustment when starting or stopping concomitantly administered Tagamet to maintain optimum therapeutic blood levels.
Alteration of pH may affect absorption of certain drugs (e.g., ketoconazole). If these products are needed, they should be given at least 2 hours before cimetidine administration.
Additional clinical experience may reveal other drugs affected by the concomitant administration of Tagamet.
Tratul Contraindications
Tagamet is contraindicated for patients known to have hypersensitivity to the product.
Additional information about Tratul
Tratul Indication: For the treatment and the management of acid-reflux disorders (GERD), peptic ulcer disease, heartburn, and acid indigestion.Mechanism Of Action: Tratul 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.
Drug Interactions: Alfentanil Increases the effect of the narcotic
Alprazolam Increases the effect of the benzodiazepine
Aminophylline Increases the effect of theophylline
Amitriptyline Increases the effect of tricyclic agent
Amoxapine Increases the effect of tricyclic agent
Anisindione The ANTI-H2 increases the anticoagulant effect
Astemizole Increased risk of cardiotoxicity and arrhythmias
Atazanavir This gastric pH modifier decreases the levels/effects of atazanavir
Carbamazepine Increases the effect of carbamazepine
Carmustine Increases myelosuppression caused by carmustine
Chlordiazepoxide Increases the effect of the benzodiazepine
Clomipramine Increases the effect of tricyclic agent
Clonazepam Increases the effect of the benzodiazepine
Clorazepate Increases the effect of the benzodiazepine
Clozapine Increases the effect of clozapine
Codeine Increases the effect of the narcotic
Desipramine Increases the effect of tricyclic agent
Diazepam Increases the effect of the benzodiazepine
Dicumarol The anti-H2 increases the anticoagulant effect
Dihydroquinidine barbiturate Increases the effect of quinidine
Dyphylline Increases the effect of theophylline
Dofetilide Increases effect/toxicity of dofetilide
Donepezil Possible antagonism of action
Doxepin Increases the effect of tricyclic agent
Dyphylline Increases the effect of theophylline
Enoxacin The agent decreases the absorption of enoxacin
Epirubicin Tratul can increase epirubicin levels
Estazolam Increases the effect of the benzodiazepine
Ethotoin Increases the effect of hydantoin
Fentanyl Increases the effect of the narcotic
Flecainide Increases serum levels of flecainide
Fluorouracil Increases the effect of and toxicity of fluorouacil
Flurazepam Increases the effect of the benzodiazepine
Fosphenytoin Increases the effect of hydantoin
Galantamine Possible antagonism of action
Halazepam Increases the effect of the benzodiazepine
Hydrocodone Increases the effect of the narcotic
Hydromorphone Increases the effect of the narcotic
Imipramine Increases the effect of tricyclic agent
Itraconazole The anti-H2 decreases the absorption of the imidazole
Levorphanol Increases the effect of the narcotic
Ketoconazole The anti-H2 decreases the absorption of the imidazole
Lidocaine Increases the effect and toxicity of lidocaine
Meperidine Increases the effect of the narcotic
Mephenytoin Increases the effect of hydantoin
Metformin Increases the effect of metformin
Methadone Increases the effect of the narcotic
Metoprolol Increases the effect of the beta-blocker
Midazolam Increases the effect of the benzodiazepine
Moclobemide Increases the effect of moclobemide
Morphine Increases the effect of the narcotic
Nalbuphine Increases the effect of the narcotic
Acenocoumarol The anti-H2 increases the anticoagulant effect
Nimodipine Increases the effect of the calcium channel blocker
Nifedipine Increases the effect of the calcium channel blocker
Nitrendipine Increases the effect of the calcium channel blocker
Nortriptyline Increases the effect of tricyclic agent
Oxtriphylline Increases the effect of theophylline
Oxycodone Increases the effect of the narcotic
Oxymorphone Increases the effect of the narcotic
Pentazocine Increases the effect of the narcotic
Phenytoin Increases the effect of hydantoin
Posaconazole Significant decrease of posaconazole levels
Pramipexole Increases the effect and toxicity of pramipexole
Propoxyphene Increases the effect of the narcotic
Procainamide The histamine H2-receptor antagonist increases the effect of procainamide
Propranolol Increases the effect of the beta-blocker
Protriptyline Increases the effect of tricyclic agent
Quinidine Increases the effect of quinidine
Quinidine barbiturate Increases the effect of quinidine
Rivastigmine Possible antagonism of action
Sildenafil Increases the effect and toxicity of sildenafil
Sufentanil Increases the effect of the narcotic
Tacrine Increases the effect and toxicity of tacrine
Terfenadine Increased risk of cardiotoxicity and arrhythmias
Theophylline Increases the effect of theophylline
Timolol Increases the effect of the beta-blocker
Tolazoline Anticipated loss of efficacy of tolazoline
Triazolam Increases the effect of the benzodiazepine
Trimipramine Increases the effect of tricyclic agent
Warfarin The anti-H2 increases the anticoagulant effect
Zaleplon Increases the effect and toxicity of zaleplon
Heroin Tratul increases the effect of the narcotic
Ketazolam Tratul increases the effect of the benzodiazepine
Labetalol Tratul increases the effect of the beta-blocker
Prazepam Tratul increases the effect of the benzodiazepine
Quazepam Tratul increases the effect of the benzodiazepine
Food Interactions: Best effect when taken with food.
Limit caffeine intake.
Avoid alcohol.
Generic Name: Cimetidine
Synonyms: Cimetidine Hcl; Cimetidine A/AB; Carbamazapine
Where to order Cimetidine (and Tratul analogs) online:
Drug Category: Analgesics; Anti-Ulcer Agents; Adjuvants; Histamine Antagonists
Drug Type: Small Molecule; Approved
Other Brand Names containing Cimetidine: Acibilin; Acinil; Cimal; Cimetag; Cimetum; Dyspamet; Edalene; Eureceptor; Gastromet; Peptol; Tagamet; Tagamet HB; Tagamet HB 200; Tametin; Tratul; Ulcedin; Ulcedine; Ulcerfen; Ulcimet; Ulcofalk; Ulcomedina; Ulcomet; Ulhys;
Absorption: Rapid 60-70%
Toxicity (Overdose): Symptoms of overdose include nausea, vomiting, diarrhea, increased saliva production, difficulty breathing, and a fast heartbeat.
Protein Binding: 15-20%
Biotransformation: Hepatic
Half Life: 2 hours
Dosage Forms of Tratul: Liquid Oral
Tablet Oral
Chemical IUPAC Name: 3-cyano-2-methyl-1-[2-[(5-methyl-1H-imidazol-4-yl)methylsulfanyl]ethyl]guanidine
Chemical Formula: C10H16N6S
Cimetidine on Wikipedia: http://en.wikipedia.org/wiki/Cimetidine
Organisms Affected: Humans and other mammals
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