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May 1989

Cimetidine and ß-Blockers

Author Affiliations

Pittsburgh, Pa

Arch Intern Med. 1989;149(5):1222-1223. doi:10.1001/archinte.1989.00390050166042

To the Editor.—We read with interest the article in the May 1988 issue of the Archives concerning the 1988 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure.1 However, in Table 5 there is an error. It states: "Cimetidine may reduce bioavailability of β-blockers metabolized primarily by the liver by inducing hepatic oxidative enzymes." This, in fact, is false. Cimetidine therapy may actually increase the bioavailability of hepatically metabolized β-blockers by competitive inhibition of hepatic microsomal enzymes, as shown by Asgharnejad et al.2 Additionally, cimetidine therapy has been shown to decrease liver blood flow by 25%, as