Physiological basis and clinical relevance of drug interactions with cimetidine

It is now well recognized that coadministration of cimetidine can alter the pharmacokinetic disposition of many drugs, and that this can result in either an altered therapeutic response, or induce a toxic response to the drug. Inhibition of oxidative metabolism is the most widely recognized mechanism for such a drug: drug interaction. However, cimetidine can alter drug absorption, distribution, metabolism and renal elimination of other drugs. This review discusses the mechanisms by which cimetidine can influence normal drug disposition and describes available information about specific drug whose disposition has been shown to be altered by cimetidine, and indicates the potential clinical relevance of such interaction