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Cimetidine-associated optic neuropathy
M A Sa'adah1, M Al Salem, A S Ali
1Medical Department, Islamic Hospital, Amman, Jordan. islamic.hospital@index.com.jo
European Neurology
|July 8, 1999
Summary
Cimetidine therapy can cause optic neuropathy, a condition affecting vision. Promptly withdrawing the drug upon visual changes is crucial for recovery, as demonstrated in two patient cases.
Area of Science:
- Neuroscience
- Ophthalmology
- Pharmacology
Background:
- Cimetidine, a widely used medication since 1976, has demonstrated central and peripheral nervous system toxicity.
- While millions have used cimetidine, few adverse events, including optic neuropathy, have been documented.
Observation:
- Two cases of optic neuropathy were observed in patients undergoing cimetidine therapy.
- Both patients experienced visual recovery after discontinuing cimetidine.
- The first patient experienced a recurrence of optic neuropathy upon reintroduction of cimetidine.
Findings:
- Cimetidine is a known zinc chelator, and zinc deficiency is linked to optic neuropathy.
- The study suggests cimetidine-induced optic neuropathy may result from its zinc-chelating properties.
- A causal link between cimetidine and optic neuropathy is proposed, supported by clinical observations and a plausible mechanism.
Implications:
- While routine ophthalmic monitoring may not be necessary, unexplained visual deterioration warrants immediate cimetidine withdrawal.
- This finding highlights a potential neurotoxic effect of cimetidine, emphasizing the importance of monitoring for visual disturbances.
- Understanding the mechanism of cimetidine toxicity can inform clinical practice and patient safety regarding this commonly prescribed medication.