Cimetidine/Procainamide
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Cimetidine decreases the amount of procainamide that your body removes.
What might happen:
When these two drugs are taken together, the cimetidine causes the procainamide to build up in your body. This increased amount of procainamide will have a greater effect for both desired and undesired effects. This may cause you to have dizziness, weakness, fatigue, or an irregular heartbeat.
What you should do about this interaction:
Call your doctor if you feel dizzy, weak, or sense an irregular heartbeat. You may be more likely to notice the effects of this interaction if you have kidney problems or are elderly.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Drayer DE, Lowenthal DT, Woosley RL, Nies AS, Schwartz A, Reidenberg MM. Cumulation of N-acetylprocainamide, an active metabolite of procainamide, in patients with impaired renal function. Clin Pharmacol Ther 1977 Jul; 22(1):63-9.
2.Somogyi A, Heinzow B. Cimetidine reduces procainamide elimination. N Engl J Med 1982 Oct 21;307(17):1080.
3.Somogyi A, McLean A, Heinzow B. Cimetidine-procainamide pharmacokinetic interaction in man: evidence of competition for tubular secretion of basic drugs. Eur J Clin Pharmacol 1983;25(3):339-45.
4.Higbee MD, Wood JS, Mead RA. Procainamide-cimetidine interaction: a potential toxic interaction in the elderly. J Am Geriatr Soc 1984 Feb; 32(2):162-4.
5.Christian CD Jr, Meredith CG, Speeg KV Jr. Cimetidine inhibits renal procainamide clearance. Clin Pharmacol Ther 1984 Aug;36(2):221-7.
6.Somogyi A, Bochner F. Dose and concentration dependent effect of ranitidine on procainamide disposition and renal clearance in man. Br J Clin Pharmacol 1984 Aug;18(2):175-81.
7.Klotz U, Arvela P, Rosenkranz B. Interaction study of diazepam (D) and procainamide (PA) with the new H2-receptor antagonist famotidine (F). Clin Pharmacol Ther 1985;37(2):205.
8.Somogyi A, Bochner F. Ranitidine and procainamide absorption. Br J Clin Pharmacol 1985 Aug;20(2):182-3.
9.Rodvold KA, Paloucek FP, Jung D, Gallastegui J. Interaction of steady-state procainamide with H2-receptor antagonists cimetidine and ranitidine. Ther Drug Monit 1987 Dec;9(4):378-83.
10.Lai MY, Jiang FM, Chung CH, Chen HC, Chao PD. Dose dependent effect of cimetidine on procainamide disposition in man. Int J Clin Pharmacol Ther Toxicol 1988 Mar;26(3):118-21.
11.Rocci ML Jr, Kosoglou T, Ferguson RK, Vlasses PH. Ranitidine-induced changes in the renal and hepatic clearances of procainamide are correlated. J Pharmacol Exp Ther 1989 Mar;248(3):923-8.
12.Bauer LA, Black D, Gensler A. Procainamide-cimetidine drug interaction in elderly male patients. J Am Geriatr Soc 1990 Apr;38(4):467-9.
