Prophylaxis of acid pulmonary aspiration syndrome in anaesthesia:
in patients with a full stomach (emergency caesarean section, etc.)
when a difficult intubation is expected
Forms and strengths
200 mg effervescent tablet
Also comes 800 mg effervescent tablet.
Dosage and duration
Adult: 200 to 400 mg single dose, if possible one hour before anaesthetic induction
Contra-indications, adverse effects, precautions
May cause: diarrhoea, headache, dizziness, skin rash, fever.
Do not administer with an antacid(aluminium hydroxide, etc.).
Remarks
Effervescent cimetidine can be replaced by effervescent ranitidine, another H2-receptor antagonist, as a singledose of 150 mg.
The onset of acid inhibition with cimetidine non-effervescent tablets (200 mg, 400 mg and 800 mg film coated tablets)or ranitidine non-effervescent tablets (150 mg and 300 mg film coated tablets)occurs 30 minutes after administration. The effervescent tablets containing sodium citrate have a more rapid onset of action, and can thus be used for emergency surgery.
Omeprazole, another antiulcer agent (proton pump inhibitor), is not compatible with emergency situations as it must be administered at least 4 hours before surgery.
Cimetidine in film coated tabletsis also used in the treatment of gastro-oesophageal reflux and peptic ulcer. Use by preference ranitidine or omeprazole for these indications.