Abstract
The H2-receptor antagonist cimetidine has been reported to decrease the hepatic clearance of numerous drugs by inhibiting cytochrome P-450 metabolism, decreasing liver blood flow or both. In this open-label, randomized crossover study we determined whether therapeutic doses of famotidine, a newer H2-receptor antagonist, has similar effects. Ten healthy subjects received single doses of both phenytoin 100 mg orally and indocyanine green intravenously without other treatment, and then again during treatment with famotidine or cimetidine. After a drug-free period, this sequence was repeated with the alternate H2-receptor antagonist. Cimetidine decreased the plasma clearance of phenytoin by 16% +/- 14% (mean +/- s.d.), but was not found to have a significant influence on phenytoin volume of distribution or terminal elimination rate constant nor on blood clearance of indocyanine green. Famotidine was not found to alter either phenytoin or indocyanine green kinetics.
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Selected References
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- Bianchi Porro G. Famotidine in the treatment of gastric and duodenal ulceration: overview of clinical experience. Digestion. 1985;32 (Suppl 1):62–69. doi: 10.1159/000199264. [DOI] [PubMed] [Google Scholar]
- Desmond P. V., Mashford M. L., Harman P. J., Morphett B. J., Breen K. J., Wang Y. M. Decreased oral warfarin clearance after ranitidine and cimetidine. Clin Pharmacol Ther. 1984 Mar;35(3):338–341. doi: 10.1038/clpt.1984.40. [DOI] [PubMed] [Google Scholar]
- Dunk A. A., Jenkins W. J., Burroughs A. K., Walt R. P., Osuafor T. O., Sherlock S., Mackie S., Dick R. The effect of ranitidine on the plasma clearance and hepatic extraction of indocyanine green in patients with chronic liver disease. Br J Clin Pharmacol. 1983 Aug;16(2):117–120. doi: 10.1111/j.1365-2125.1983.tb04973.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Feely J., Guy E. Lack of effect of ranitidine on the disposition of lignocaine. Br J Clin Pharmacol. 1983 Mar;15(3):378–379. doi: 10.1111/j.1365-2125.1983.tb01514.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Feely J., Wilkinson G. R., Wood A. J. Reduction of liver blood flow and propranolol metabolism by cimetidine. N Engl J Med. 1981 Mar 19;304(12):692–695. doi: 10.1056/NEJM198103193041202. [DOI] [PubMed] [Google Scholar]
- Fernandes E., Melewicz F. M. Ranitidine and theophylline. Ann Intern Med. 1984 Mar;100(3):459–459. doi: 10.7326/0003-4819-100-3-459_1. [DOI] [PubMed] [Google Scholar]
- Frigo G. M., Lecchini S., Caravaggi M., Gatti G., Tonini M., D'Angelo L., Perucca E., Crema A. Reduction of phenytoin clearance caused by cimetidine. Eur J Clin Pharmacol. 1983;25(1):135–137. doi: 10.1007/BF00544030. [DOI] [PubMed] [Google Scholar]
- Griffin J. W., Jr, May J. R., DiPiro J. T. Drug interactions: theory versus practice. Am J Med. 1984 Nov 19;77(5B):85–89. [PubMed] [Google Scholar]
- Henry D. A., Macdonald I. A., Kitchingman G., Bell G. D., Langman M. J. Cimetidine and ranitidine: comparison of effects on hepatic drug metabolism. Br Med J. 1980 Sep 20;281(6243):775–777. doi: 10.1136/bmj.281.6243.775. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hetzel D. J., Bochner F., Hallpike J. F., Shearman D. J., Hann C. S. Cimetidine interaction with phenytoin. Br Med J (Clin Res Ed) 1981 May 9;282(6275):1512–1512. doi: 10.1136/bmj.282.6275.1512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hoensch H. P., Hutzel H., Kirch W., Ohnhaus E. E. Isolation of human hepatic microsomes and their inhibition by cimetidine and ranitidine. Eur J Clin Pharmacol. 1985;29(2):199–206. doi: 10.1007/BF00547422. [DOI] [PubMed] [Google Scholar]
- Imai Y., Inada M., Tamura S., Kawata S., Minami Y., Tarui S. Comparative effects of famotidine and cimetidine on 7-ethoxycoumarin O-deethylase activity in human livers. Br J Clin Pharmacol. 1986 Oct;22(4):495–496. doi: 10.1111/j.1365-2125.1986.tb02925.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jusko W. J., Koup J. R., Alván G. Nonlinear assessment of phenytoin bioavailability. J Pharmacokinet Biopharm. 1976 Aug;4(4):327–336. doi: 10.1007/BF01063122. [DOI] [PubMed] [Google Scholar]
- Klotz U., Arvela P., Rosenkranz B. Famotidine, a new H2-receptor antagonist, does not affect hepatic elimination of diazepam or tubular secretion of procainamide. Eur J Clin Pharmacol. 1985;28(6):671–675. doi: 10.1007/BF00607913. [DOI] [PubMed] [Google Scholar]
- Locniskar A., Greenblatt D. J., Harmatz J. S., Zinny M. A., Shader R. I. Interaction of diazepam with famotidine and cimetidine, two H2-receptor antagonists. J Clin Pharmacol. 1986 Apr;26(4):299–303. doi: 10.1002/j.1552-4604.1986.tb03527.x. [DOI] [PubMed] [Google Scholar]
- Moustafa M. A., Claesen M., Adline J., Vandervorst D., Poupaert J. H. Evidence for an arene-3,4-oxide as a metabolic intermediate in the meta- and para-hydroxylation of phenytoin in the dog. Drug Metab Dispos. 1983 Nov-Dec;11(6):574–580. [PubMed] [Google Scholar]
- Neuvonen P. J., Tokola R. A., Kaste M. Cimetidine-phenytoin interaction: effect on serum phenytoin concentration and antipyrine test. Eur J Clin Pharmacol. 1981;21(3):215–220. doi: 10.1007/BF00627923. [DOI] [PubMed] [Google Scholar]
- Powell J. R., Donn K. H. Histamine H2-antagonist drug interactions in perspective: mechanistic concepts and clinical implications. Am J Med. 1984 Nov 19;77(5B):57–84. [PubMed] [Google Scholar]
- Puurunen J., Sotaniemi E., Pelkonen O. Effect of cimetidine on microsomal drug metabolism in man. Eur J Clin Pharmacol. 1980 Aug;18(2):185–187. doi: 10.1007/BF00561588. [DOI] [PubMed] [Google Scholar]
- Rendić S., Sunjić V., Toso R., Kajfez F., Ruf H. H. Interaction of cimetidine with liver microsomes. Xenobiotica. 1979 Sep;9(9):555–564. doi: 10.3109/00498257909042321. [DOI] [PubMed] [Google Scholar]
- Staiger C., Korodnay B., Devries J. X., Weber E., Müller P., Simon B., Dammann H. G. Comparative effects of famotidine and cimetidine on antipyrine kinetics in healthy volunteers. Br J Clin Pharmacol. 1984 Jul;18(1):105–106. doi: 10.1111/j.1365-2125.1984.tb05031.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Testa R., Grasso A., Dagnino F., Ibba R., Varagona G., Celle G. Famotidine does not affect indocyanine green disposition and serum bile acid levels in healthy subjects. Br J Clin Pharmacol. 1987 Jun;23(6):779–780. [PMC free article] [PubMed] [Google Scholar]
- Watts R. W., Hetzel D. J., Bochner F., Hallpike J. F., Hann C. S., Shearman D. J. Lack of interaction between ranitidine and phenytoin. Br J Clin Pharmacol. 1983 Apr;15(4):499–500. doi: 10.1111/j.1365-2125.1983.tb01538.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
