Nocid
Generic Name
Cimetidine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nocid 250 mg chewable tablet | ৳ 1.40 | N/A |
Description
Overview of the medicine
Nocid 250 mg Chewable Tablet contains Cimetidine, a histamine H2-receptor antagonist that reduces stomach acid production. It is used to treat and prevent various acid-related conditions like peptic ulcers and GERD.
Uses & Indications
Dosage
Adults
For active duodenal ulcer: 800 mg once daily at bedtime or 400 mg twice daily. For GERD: 400 mg twice daily. Chew thoroughly before swallowing.
Elderly
No specific dose reduction is usually required unless renal function is impaired. Monitor for CNS effects.
Renal_impairment
Dosage adjustment is necessary. For CrCl < 30 mL/min, the recommended dose is 200 mg every 12 hours. Further reduction may be needed in severe impairment.
How to Take
Nocid 250 mg Chewable Tablet should be chewed thoroughly before swallowing. It can be taken with or without food, but taking it with meals may help reduce gastrointestinal upset. Follow your doctor's instructions regarding the exact timing and frequency.
Mechanism of Action
Cimetidine selectively blocks histamine H2-receptors located on the gastric parietal cells, leading to a reduction in both basal and stimulated gastric acid secretion. This action decreases the acidity in the stomach and promotes healing of ulcers.
Pharmacokinetics
Onset
Within 30 minutes to 1 hour.
Excretion
Primarily renal; 50-80% of an oral dose is excreted unchanged in the urine within 24 hours. Small amounts are excreted in feces.
Half life
Approximately 2 hours (range 1.5-3 hours).
Absorption
Rapidly absorbed from the gastrointestinal tract; bioavailability is approximately 60-70%. Peak plasma concentrations are reached within 1-2 hours after oral administration.
Metabolism
Partially metabolized in the liver to sulfoxide and hydroxymethyl derivatives; approximately 30% undergoes first-pass metabolism.
Side Effects
Contraindications
- Known hypersensitivity to cimetidine or any other component of the formulation.
- Use with extreme caution in patients with a history of severe kidney disease.
Drug Interactions
Warfarin
Cimetidine can inhibit the metabolism of warfarin, leading to increased anticoagulant effect and risk of bleeding. Close INR monitoring is advised.
Phenytoin
Cimetidine may increase plasma concentrations of phenytoin, requiring dose adjustment and monitoring for toxicity.
Propranolol
Cimetidine can increase the bioavailability of propranolol.
Theophylline
Cimetidine can decrease the clearance of theophylline, leading to increased levels and potential toxicity. Monitor theophylline levels.
Ketoconazole/Itraconazole
Absorption of these antifungals is pH-dependent; cimetidine increases gastric pH, reducing their absorption. Administer at least 2 hours apart.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include respiratory depression, tachycardia, vomiting, and confusion. Management is primarily symptomatic and supportive. Gastric lavage and activated charcoal may be considered if ingestion is recent. Hemodialysis can effectively remove cimetidine from the blood.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but adequate and well-controlled studies in pregnant women are lacking. Use only if clearly needed. Cimetidine is excreted in breast milk; therefore, use with caution in breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
DGDA Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Cimetidine was one of the first H2-receptor antagonists and has been extensively studied in numerous clinical trials since its introduction, establishing its efficacy and safety profile for various acid-related disorders. Post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Renal function tests (e.g., creatinine, BUN) periodically, especially in elderly or patients with pre-existing renal impairment.
- Liver function tests (e.g., AST, ALT) if abnormalities are suspected or with prolonged use.
- Complete Blood Count (CBC) with differential, particularly during prolonged high-dose therapy.
Doctor Notes
- Be mindful of potential drug interactions, especially with medications metabolized by cytochrome P450 enzymes (e.g., warfarin, phenytoin, theophylline).
- Dose adjustment is crucial in patients with impaired renal function to avoid accumulation and toxicity.
- Monitor elderly patients closely for CNS-related side effects such as confusion and dizziness.
- Advise patients to chew the tablet thoroughly to ensure proper absorption and efficacy.
Patient Guidelines
- Chew the tablet thoroughly before swallowing.
- Do not exceed the recommended dose.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements.
- Report any unusual or severe side effects to your doctor immediately.
- Do not stop taking this medicine suddenly without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nocid may cause dizziness, confusion, or drowsiness in some individuals. Patients should exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Avoid trigger foods such as spicy, fatty, or acidic foods that can worsen acid reflux.
- Limit alcohol intake and stop smoking, as these can exacerbate stomach acid production.
- Manage stress through relaxation techniques as stress can affect digestive health.
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