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H_2受体拮抗药西米替丁,是目前临床最常用的药物之一。虽然其本身的副反应不大,但可抑制其他许多药物的吸收、代谢和排泄,从而产生毒性反应,甚至造成死亡。(一)影响其他药物的吸收西米替丁可干扰酮康唑溶解和吸收时所需的酸性环境,使后者的血药峰浓度降低5倍,全身效应减低65%。西米替丁可使在酸性环境下不稳定的药物吸收增加,例如可使苄青霉素钠的吸收增加8倍。但对其他药物的吸收几无影响。(二)影响其他药物的代谢低清除率药物:(1)口服抗凝药:西米替丁通过竞争性抑制方式使华法林血浓度升高两倍,凝血酶原时间延长20～200%。故两者合用时易发生软组织和泌尿道出
H 2 receptor antagonist cimetidine, is currently one of the most commonly used drugs. Although its own side effects are not, but can inhibit the absorption of many other drugs, metabolism and excretion, resulting in toxic reactions, and even cause death. (A) affect the absorption of other drugs Cimetidine can interfere with ketoconazole dissolution and absorption of the acidic environment required, so that the latter peak plasma concentration decreased by 5 times, a 65% reduction in systemic effects. Cimetidine can increase the absorption of unstable drugs in acidic environment, for example, can increase the absorption of sodium ampicillin 8 times. However, the absorption of other drugs have little effect. (B) affect the low metabolism of other drugs Drugs: (1) oral anticoagulant: cimetidine by competitive inhibition of warfarin blood twice the concentration, prothrombin time by 20 to 200% . So the combination of the two prone to soft tissue and urinary tract