Lack of effect of cimetidine on the metabolism of quinidine: effect on renal clearance. 1988

B G Hardy, and J J Schentag
Department of Pharmacy, Sunnybrook Medical Centre, University of Toronto, Canada.

The disposition and urinary recovery of unchanged quinidine, (3S)-3-hydroxyquinidine, 2'-oxoquinidinone and quinidine-N-oxide was studied in 5 normal volunteers following a single oral dose of quinidine sulfate (400 mg) with and without cimetidine pre-treatment (1.2 g/day for 7 days). Total amounts of parent compound or metabolites excreted in the urine following cimetidine pre-treatment were not significantly different from that excreted during quinidine alone. Cimetidine reduced the mean apparent oral clearance of quinidine (+/- s.e.m.) by 33% from 23.7 +/- 2.5 to 15.9 +/- 1.7 l/h (p less than 0.05). This 33% decline in oral clearance paralleled the 33% decline in renal clearance of unchanged quinidine which decreased from 56.7 +/- 13.3 to 38.3 +/- 3.3 ml/min. The reduction in quinidine renal clearance associated with cimetidine pre-treatment, although failing to achieve statistical significance, partially accounted for the observed decrease in mean apparent oral clearance. This suggests that cimetidine may compete for renal tubular secretion of unchanged quinidine and its metabolites rather than alter the oxidative metabolism of quinidine.

UI MeSH Term Description Entries
D008297 Male Males
D011802 Quinidine An optical isomer of quinine, extracted from the bark of the CHINCHONA tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular ACTION POTENTIALS, and decreases automaticity. Quinidine also blocks muscarinic and alpha-adrenergic neurotransmission. Adaquin,Apo-Quinidine,Chinidin,Quincardine,Quinidex,Quinidine Sulfate,Quinora,Apo Quinidine,Sulfate, Quinidine
D002927 Cimetidine A histamine congener, it competitively inhibits HISTAMINE binding to HISTAMINE H2 RECEPTORS. Cimetidine has a range of pharmacological actions. It inhibits GASTRIC ACID secretion, as well as PEPSIN and GASTRIN output. Altramet,Biomet,Biomet400,Cimetidine HCl,Cimetidine Hydrochloride,Eureceptor,Histodil,N-Cyano-N'-methyl-N''-(2-(((5-methyl-1H-imidazol-4-yl)methyl)thio)ethyl)guanidine,SK&F-92334,SKF-92334,Tagamet,HCl, Cimetidine,Hydrochloride, Cimetidine,SK&F 92334,SK&F92334,SKF 92334,SKF92334
D004347 Drug Interactions The action of a drug that may affect the activity, metabolism, or toxicity of another drug. Drug Interaction,Interaction, Drug,Interactions, Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001711 Biotransformation The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alterations may be divided into METABOLIC DETOXICATION, PHASE I and METABOLIC DETOXICATION, PHASE II.

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