To the Editor.—
Cimetidine, a potent H2-receptor antagonist, has been recently introduced for the suppression of gastric acid secretion.1,2 This medication has the ability to produce gynecomastia and breast swelling when used for a prolonged period (as in the Zollinger-Ellison syndrome)3 and apparently has a mild sedative effect when given orally.4 Although the usual route of administration is oral, the medication can be given intramuscularly and intravenously (IV). I recently observed a patient in whom profound coma developed while receiving cimetidine, which reversed when the therapy was discontinued. I believe this potential side effect of cimetidine should be brought to the attention of treating physicians.
Report of a Case.—
A 53-year-old bartender, who admits to a 25-year history of excessive alcohol use (which he claims he discontinued three months before hospitalization), was admitted to Franklin General Hospital,Valley Stream, NY, for massive upper gastrointestinal (GI) bleeding.
Levine ML. Cimetidine-Induced Coma in Cirrhosis of the Liver. JAMA. 1978;240(12):1238. doi:10.1001/jama.1978.03290120032011