Cimetidine pancreatitis with

Zalcitabine NRTI1 0.75 mg tid3 Administer 1 h before or 2 h after an antacid Peripheral neuropathy oral ulcerations, pancreatitis, headache, nausea, rash, arthralgias Avoid concurrent cimetidine avoid concurrent neuropathic drugs (eg, ddl, zalcitabine, isoniazid). Do not administer with lamivudine... 

Arnold F, Doyle PJ, Bell G. Acute pancreatitis in a patient treated with cimetidine. Lancet 1978 l(8060) 382-3. 

Some cases of life threatening GI bleeding have been successfully treated by I.V. administration of somatostatin. A comparative clinical trial of somatostatin with cimetidine in the control of bleeding is in progress. Another important possible application is in the treatment of pancreatitis since somatostatin inhibits... 

V. Hubbard, G. Dunn, and L. Lester. Effectiveness of cimetidine as an adjunct to supplemental pancreatic enzymes in patients with cystic fibrosis. Am. J. Clin. Nutr. 33 2281 (1980). 

Lamivudine inhibits the intracellular phosphorylation of zalcitabine and antagonizes zalcitabine s antiretroviral activity in vitro, although the clinical significance of this interaction is unknown. Probenecid increases the zalcitabine AUC by about 50%, probably through inhibition of tubular secretion cimetidine increases the AUC by 36% via an unknown mechanism. Zalcitabine should be avoided in patients with a history of pancreatitis or neuropathy because the risk and severity of both complications increase. Coadministration of other drugs that cause pancreatitis or neuropathy also will increase the risk and severity of these symptoms. Ethambutol, isoniazid, vincristine, cisplatin, and pentamidine, as well as the antiretroviral drugs didanosine and stavudine, therefore, should be avoided. 

Reynolds TB, Peters RL, Yamade S (1971) Chronic active and lupoid hepatitis caused by a laxative, oxyphenisation. N Engl J Med 285 813-820 Sakula A (1977) Bronchial asthma due to allergy to pancreatic extract. Lancet 2 193 Sharpe PC, Hawkins BW (1977) Efficacy and safety of cimetidine. Long-term treatment with cimetidine. In Burland WL, Simkins MA (eds) Cimetidine. Proc Second Int Symp on Histamine H2-receptor Antagonists. Excerpta Medica, Amsterdam London New York, pp 358-366... 

Endoluminal pH is lower than normal in CF, as a result of low pancreatic bicarbonate secretion. At an acid pH, there may be an alteration of the physical state of BA, with precipitation, particularly of free and glycoconjugated BA, which have a pK of approximately 4. It has been recently demonstrated that cimetidine improves lipid digestion and solubilization in CF patients, just by reducing BA precipitation and hence increasing the solubilization of lipids. 

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