Cimetidine

Cimetidine is an H2 blocker, a type of pharmaceuticals that decreases the amount of acid produced by the stomach It is sold under the brand name Tagamet.

Why It's Prescribed
"Cimetidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Over-the-counter cimetidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach."

Labeled uses include: Duodenal Ulcer, Dyspepsia, Gastric Ulcer, Gastroesophageal Reflux, Heartburn, Maintenance of Healing Duodenal Ulcer, Multiple Endocrine Neoplasia, Systemic Mastocytosis, Zollinger-Ellison Syndrome

Additionally, unlabeled uses include: NSAID-Induced Gastric Ulcer, Pancreatic Insufficiency, Prevention of Stress Ulcer, Upper GI Bleed, Urticaria

Form, Route, and Dosage
Cimetidine is available as a tablet and a liquid to take orally. Over the counter cimetidine comes only in the strength 200mg, and patients are directed to take one tablet to treat or prevent heartburn and no more than 2 tablets (400mg) per day. However, doctors may prescribe up to 2400mg of cimetidine per day.

Side Effects
Some patients taking this medication might experience side effects, including:
 * headache
 * diarrhea
 * dizziness
 * drowsiness
 * breast enlargement
 * confusion
 * excitement
 * depression
 * nervousness
 * seeing things or hearing voices that do not exist (hallucinating)

As a Pollutant
Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.

In Sewage Sludge
Cimetidine has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found cimetidine in 74 samples (88%) in concentrations ranging from 7.59 to 9,780 parts per billion. There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

Related SourceWatch articles

 * Biosolids
 * Sewage sludge
 * Food Rights Network
 * Pharmaceuticals

External resources

 * PubMed Health - Cimetidine