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Recurrent myalgias associated with cimetidine.

M Labeeuw, J F Cabanne, P Dubot

    International Journal of Clinical Pharmacology, Therapy, and Toxicology
    |July 1, 1986
    PubMed
    Summary
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    A hemodialysis patient developed recurrent myalgia (muscle pain) during cimetidine treatment. This suggests a potential progressive decrease in cimetidine tolerance with repeated exposure in susceptible individuals.

    Area of Science:

    • Pharmacology
    • Nephrology
    • Clinical Medicine

    Background:

    • Cimetidine is a histamine H2 receptor antagonist used to reduce stomach acid.
    • Hemodialysis patients may have altered drug metabolism and excretion.
    • Myalgia is a potential side effect of various medications.

    Observation:

    • A patient undergoing chronic hemodialysis reported recurrent myalgia during cimetidine (400 mg/day) therapy.
    • Myalgia episodes appeared progressively later in the course of repeated cimetidine treatments.
    • Pain resolved upon cimetidine withdrawal and recurred upon re-challenge, with no neurological signs or elevated CPK.

    Findings:

    • The patient experienced severe hip-predominant myalgia linked to cimetidine exposure.
    • Ranitidine treatment, another H2 antagonist, did not cause myalgia over four months.

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  • This case suggests a possible acquired intolerance or decreased tolerance to cimetidine with cumulative exposure.
  • Implications:

    • Clinicians should consider cimetidine-induced myalgia in hemodialysis patients with unexplained muscle pain.
    • The findings highlight the importance of monitoring for adverse effects, especially with repeated drug courses.
    • This case may indicate a need for careful consideration of cimetidine re-administration in susceptible patients.