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Ulcer medications - histamine H2 antagonists

Index > Depletions > Ulcer medications - histamine H2 antagonists     Print

Medications
Depletions
Editorial Note
Supporting Research

Medications

  • Cimetidine
    • Tagamet
    • Tagamet HB [OTC]
  • Famotidine
    • Mylanta AR(Discontinued by Manufacturer)
    • Pepcid RPD
    • Pepcid
    • Pepcid AC [OTC]
    • Pepcid AC gelcaps [OTC]
  • Nizatidine
    • Axid
    • Axid AR [OTC]

Depletions

Calcium

Osteoporosis (bone loss) is the primary disease associated with chronic calcium deficiency; it may be associated with bone pain and spinal deformity. Depleted levels can also cause muscle cramps, irregular heartbeat, and depression.

Iron

Depleted levels of iron may lead to anemia and weakened immune function. Symptoms include dizziness, fatigue, shortness of breath, pale skin color, and possibly irregular heartbeat.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, and birth defects. Symptoms may include fatigue, mouth sores, swollen tongue, and poor growth.

Vitamin B12 (Cobalamin)

Obvious symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Vitamin D

Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, leading to deficiency of that nutrient, as well as the associated symptoms such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness. More recently, vitamin D deficiency has been linked to compromised immunity, cancer, and other chronic conditions. Because this nutrient is fat soluble, prolonged periods of deficiency are required to produce these symptoms.

Zinc

Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, skin changes, and increased susceptibility to infection.

Editorial Note

The information presented here covers some of the nutrients that may be lowered when you take certain medications. The signs and symptoms listed can be caused by other conditions. If you have these signs and symptoms, it doesn't always mean you have low levels of these nutrients. Many things affect the level of nutrients, including your medical history, diet, and lifestyle, as well as how long you have been taking the medication. Please talk with your health care provider. He or she can best address your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists. Med Toxicol Adverse Drug Exp. 1988;3(6):430-448.

Bengoa JM, Bolt MJ, Rosenberg IH. Hepatic vitamin D 25-hydroxylase inhibition by cimetidine and isoniazid. JLab Clin Med. 1984;104(4):546-552.

Berger W. Incidence of severe side effects during therapy with sulfonylureas and biguanides. Horm Metab Res Suppl. 1985;15:111-115.

Bo-Linn GW, Davis GR, Buddrus DJ, et al. An evaluation of the importance of gastric acid secretion in the absorption of dietary calcium. J Clin Invest. 1984;73(3):640-647.

Caron P, Gaillard J, Barousse C, et al. [Cimetidine treatment of primary hyperparathyroidism]. BiomedPharmacother. 1987;41(3):143-146.

Carpentier JL, Bury J, Luyckx A, Lefebvre P. Vitamin B12 and folic acid serum levels in diabetics under various therapeutic regimens. Diabetes Metab. 1976;2(4):187-190.

Cashman K, Flynn A. Optimal nutrition: calcium, magnesium and phosphorus. Proc Nutr Soc. 1999;58:477-487.

Covington T, ed. Nonprescription Drug Therapy Guiding Patient Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.

Falchuk KH. Disturbances in Trace Elements. In: Fauci A, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill Companies Health Professional Division; 1998:490-491.

Festen HP. Intrinsic factor secretion and cobalamin absorption. Physiology and pathophysiology in the gastrointestinal tract. Scand J Gastroenterol. 1991;188:1-7.

Force RW, Nahata MC. Effect of histamine H2-receptor antagonists on vitamin B12 absorption. Ann Pharmacother. 1992;26(10):1283-1286.

Ghishan FK, Walker F, Meneely R, Patwardhan R, Speeg KV. Intestinal calcium transport: effect of cimetidine. J Nutr. 1981;111(12):2157-2161.

Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S Suppl):1344S-1349S.

Henderson LM, et al. Effect of intragastric pH on the absorption of oral zinc acetate and zinc oxide in young healthy volunteers. J Parenter Enteral Nutr. 1995;19(5):393-397.

Holick MF, Krane SM, Potts JT. Calcium, phosphorus, and bone metabolism: calcium-regulating hormones. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:2221-2222.

National Research Council. Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press; 1989.

Odes HS, Fraser GM, Krugliak P, et al. Effect of cimetidine on hepatic vitamin D metabolism in humans. Digestion. 1990;46(2):61-64.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:484-489.

Pinelli P, Trivulzio S, Colombo R, et al. Antiprostatic effect of cimetidine in rats. Agents Actions. 1987;22(3-4):197-201.

Potts JT. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York: McGraw-Hill Companies Health Professional Division; 1998:2241.

Rakel: Textbook of Family Medicine, 8th ed. Philadelphia, PA: Saunders Elsevier; 2011.

Rao DS. Perspective on assessment of vitamin D nutrition. J Clin Densitom. 1999:2(4):457-464.

Ruscin JM, Page RL, Valuce RJ. Vitamin B (12) deficiency associated with histamine (2)-receptor antagonists and a proton pump inhibitor. Ann. Pharmacother. 2002;36(5):812-16.

Russell RM, Golner BB, Kransinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med. 1988;112(4):458-463.

Skikne BS, Lynch SR, Cook JD. Role of gastric acid in food iron absorption. Gastroenterol. 1981;81(6):1068-1071.

Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr. 1991;10(4):372-375.

Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999;69:842-856.

Review Date: 9/25/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.
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