Serum-Prolactin in Patients Receiving Chronic Oral Cimetidine

Spiegel, Allen M.; Lopatin, Richard N.; Peikin, Steven R.; Mccarthy, D.

doi:10.1016/s0140-6736(78)90229-5

Cited by 21 publications

(9 citation statements)

References 11 publications

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“…On the contrary, we were unable to de¬ monstrate any significant change in serum prolac¬ tin levels in the 20 patients given oral cimetidine for 3 months to treat their duodenal ulcers. The finding of normal prolactin levels in patients re¬ ceiving oral cimetidine is consistent with previously reported data (Majumdar et al 1978;Spiegel et al 1978). However, elevated prolactin levels have been found by other investigators under the same experimental conditions (Delle Fave et al 1977;Bateson et al 1977).…”

Section: Discussionsupporting

confidence: 92%

Prolactin secretion in man following acute and long-term cimetidine administration

Masala

Faedda

Satta

et al. 1980

Acta Endocrinologica

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In 20 patients with duodenal ulcer we measured serum prolactin levels following acute and long-term cimetidine administration. In addition, in 20 healthy volunteers we studied the effect of pre-treatment with bromocriptine, metergoline, nomifensine and cyproheptadine on cimetidine-induced prolactin release. Intravenous cimetidine stimulated prolactin secretion in patients and in normal subjects. In the latter, bromocriptine and metergoline pre-administration blunted the release of prolactin in response to iv cimetidine whereas nomifensine and cyproheptadine were ineffective. Long-term treatment with cimetidine (1.2 g daily for 3 months) had no effect on prolactin secretion in the 20 patients studied. No incidence of gynaecomastia, galactorrhoea or disorders of the menstual cycle was observed.It has been shown that cimetidine, an H2 receptor blocking agent, releases prolactin in man (Carlson & Ippoliti 1977; Bohnet et al. 1978). Moreover, side effects such as gynaecomastia and galactorrhoea have been reported in patients treated with the drug (Hall 1976; Delle Faveetal. 1977; Bateson etal. 1977).We studied the effects of both acute and chronic cimetidine treatment on serum prolactin levels in 20 patients with duodenal ulcers. Additional stu¬ dies were carried out on 20 normal subjects in order to elucidate the mechanism(s) responsible for cimetidine-induced prolactin secretion. Materials and MethodsStudies were performed on 20 healthy volunteers, medi¬ cal students and technicians, aged 19 to 36 years and 20 patients with duodenal ulcer, aged 23 to 38 years. In each group 50 per cent were male. All the patients had an endoscopie diagnosis of duodenal ulcer requiring treat¬ ment with cimetidine. An informed consent was obtained prior to the study. The experiments started at 08.00 h after an overnight fast with the subjects in a recumbent position. A venous cannula was inserted in a forearm vein at least 45 min prior to beginning the study; patency was maintained by a slow infusion of normal saline. After collection of three baseline samples (-30, -15 and 0 min) all subjects received an iv bolus of 200 mg cimetidine (Tagamet®; Smith Kline 8c French, Milan, Italy). Blood was collected 15, 30, 60 and 120 min later. In the volunteers, cimetidine administration was repeated 60 min after giving the following drugs: bromocriptine (2.5 mg p.o.), metergoline (2 mg p.o.), nomifensine (200 mg p.o.) and cyproheptadine (8 mg p.o.). A 3 day interval elapsed between each test which was performed exactly as described above. The patients were treated with cimetidine, 400 mg p.o., t.i.d. for 3 months. Blood samples were obtained weekly from each patient, at 08.00 h, prior to the administration of the first daily dose.Blood samples for hormone assay were centrifuged and serum specimens stored at -20°C until assayed. All samples from each subject were processed in duplicate in the same assay. Serum prolactin was measured by a specific double-antibody radioimmunoassay (McNeilly 1973). Standard, antiserum and 125I-labelled human pro¬...

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Section: Discussionsupporting

confidence: 92%

Prolactin secretion in man following acute and long-term cimetidine administration

Masala

Faedda

Satta

et al. 1980

Acta Endocrinologica

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“…The maximal PRL values in response to TRH i.v. are seen after 10-20 min, the maximal TSH values after 20 min (Jacobs et al, 1971) (Rowley-Jones, 1978;Spiegel et al, 1978;Valcavi et al, 1978). The rise in PRL after oral cimetidine reported by Delle Fave et al (1977) remains unconfirmed and is not explained by the higher dose or prolonged administration, for the present authors did not find any rise in PRL on the 1600 mg regimen during 8 weeks in patients with oesophagitis.…”

Section: Discussionsupporting

confidence: 49%

“…At the time that the present investigations were started, the only definite study on cimetidine and prolactin reported a significant increase in plasma prolactin concentration after acute intravenous administration of cimetidine (Carlson and Ippoliti, 1977). Since then, several reports have been published in which no increase after single dose or maintenance dosage of oral cimetidine was found (Rowley-Jones, 1978: Spiegel et al. 1978: Valcavi et al, 1978, while the significant rise after i.v.…”

Section: Introductionmentioning

confidence: 81%

The effect of oral cimetidine on the basal and stimulated values of prolactin, thyroid stimulating hormone, follicle stimulating hormone and luteinizing hormone

Nelis

Meene

1980

Postgraduate Medical Journal

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“…However, hyperprolactinemia has not been found in larger series of patients treated with these drugs [96][97][98][99][100] except for one case of a woman treated with famotidine [101].…”

Section: Gastrointestinal Medicationsmentioning

confidence: 99%

Drugs and prolactin

Molitch

2008

Pituitary

142

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Medications commonly cause hyperprolactinemia and their use must be differentiated from pathologic causes. The most common medications to cause hyperprolactinemia are the antipsychotic agents, although some of the newer atypical antipsychotics do not do so. Other medications causing hyperprolactinemia include antidepressants, antihypertensive agents, and drugs which increase bowel motility. Often, the medication-induced hyperprolactinemia is symptomatic, causing galactorrhea, menstrual disturbance, and erectile dysfunction. In the individual patient, it is important differentiate hyperprolactinemia due to a medication from a structural lesion in the hypothalamic-pituitary area. This can be done by stopping the medication temporarily to determine if the prolactin (PRL) levels return to normal, switching to another medication in the same class which does not cause hyperprolactinemia (in consultation with the patient's physician and/or psychiatrist), or by performing an MRI or CT scan. If the hyperprolactinemia is symptomatic, management strategies include switching to an alternative medication which does not cause hyperprolactinemia, using estrogen/testosterone replacement, or cautiously adding a dopamine agonist.

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Serum-Prolactin in Patients Receiving Chronic Oral Cimetidine

Cited by 21 publications

References 11 publications

Prolactin secretion in man following acute and long-term cimetidine administration

Prolactin secretion in man following acute and long-term cimetidine administration

The effect of oral cimetidine on the basal and stimulated values of prolactin, thyroid stimulating hormone, follicle stimulating hormone and luteinizing hormone

Drugs and prolactin

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