Nicardipine Cimetidine

Drugs that may increase sirolimus blood concentrations include the following Nicardipine, verapamil, clotrimazole, fluconazole, itraconazole, clarithromycin, erythromycin, troleandomycin, cisapride, metoclopramide, bromocriptine, cimetidine, danazol, HIV-protease inhibitors, cyclosporine, diltiazem, azole antifungals. 

Clinically important, potentially hazardous interactions with amlodipine, bepridil, cimetidine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine, verapamil... 

Amprenavir, cimetidine, clotrimazole, delavirdine, 6,7-dihydroxybergamottin, ethinylestradiol,fluoxetine, gestodene, indinavir, itraconazole, ketoconazole, miconazole, nelfinavir, nicardipine, ritonavir, saquinavir, troleandomycin, verapamil... 

Cimetidine has been shown to impair metabolism of drugs by the mixed function oxidase system by binding to cytochromes P450 and P448 (B8, D5). In animal models cimetidine reduces halothane metabolism and lessens the severity of hepatic injury (P9, W13). It has not been possible to demonstrate any effect of cimetidine administration on the plasma profile obtained in humans post-halothane anesthesia (R4). However, as with nicardipine the doses of cimetidine used were far lower than the doses used in animal models. 

Concomitant administration of cimetidine results in higher plasma levels of nicardipine. Serum levels of dioxin should be carefully monitored because some calcium-channel antagonists may increase plasma levels of digitalis preparations. 

The plasma levels of diltiazem, isradipine and nifedipine are increased by cimetidine and it may possibly be necessary to reduce the dosages of these calcium-channel blockers. High doses of cimetidine may increase the bioavailability of lercanidipine. Although studies surest no important interactions occur between nicardipine or nisoldipine and cimetidine, the manufacturers advise caution. Plasma felodipine, lacidipine, nimodipine, and... 

No adverse interaction was seen in 22 patients given calcium-channel blockers, including nicardipine, with oral famotidine for 6 to 8 weeks. No changes in the pharmacokinetics or pharmacodynamics of a 12-hour intravenous infusion of nicardipine 24 mg were seen in 12 healthy subjects given intravenous cimetidine 300 mg every 6 hours for 48 hours. ... 

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