Skip to main content

The effect of cimetidine on platelet function: a study involving gastric fluid measurements

Agents and Actions volume 19, pages 34–41 (1986)Cite this article

Summary

Gastric fluid samples were aspirated 30 and 60 minutes after the ingestion of two 200 mg tablets of cimetidine. The concentration of cimetidine in these samples was measured and their effect on platelet aggregation assessedin vitro. Gastric fluid samples significantly inhibited adrenaline- and ADP-induced platelet aggregationin vitro. In a further series of experiments, cimetidine solutions, at concentrations found in gastric fluid, inhibited platelet aggregation and thromboxane A2 (TXA2) release,in vitro. Ranitidine, another H2-receptor antagonist, was a more potent inhibitor of platelet aggregation than cimetidine. Since ranitidine is also the more potent H2-receptor antagonist which, unlike cimetidine, does not include an imidazole group (which is known to inhibit TXA2 synthesis) in its structure, we conclude that H2 blockade mediates the observed inhibition of aggregation. This platelet anti-aggregatory effect may be relevant to haemostatic mechanisms involved in bleeding peptic ulcers or gastric erosions exposed to high local concentrations of H2-receptor antagonists.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. D. P. Mikhailidis, A. M. Mikhailidis and P. Dandona,Prevention or cure for stress-induced internal bleeding, Br. Med. J.281, 1005–1006 (1980).

    Google Scholar 

  2. D. P. Mikhailidis, A. M. Mikhailidis and P. Dandona,Cimetidine and somatostatin in gastroduodenal haemorrhage, Lanceti, 274–275 (1981).

    Google Scholar 

  3. D. P. Mikhailidis, A. M. Mikhailidis and P. Dandona,Cimetidine and somatostatin in gastroduodenal haemorrhage, Lanceti, 784 (1981).

    Google Scholar 

  4. J. J. Schentag,False positive ‘Hemoccult’ reaction with cimetidine, N. Eng. J. Med.303, 110 (1980).

    Google Scholar 

  5. B. R. D. McDougall and R. Williams,A controlled clinical trial of cimetidine in the recurrence of variceal haemorrhage: implications about the pathogenesis of haemorrhage, Hepatology3, 69–73 (1983).

    Google Scholar 

  6. D. P. Mikhailidis, A. M. Mikhailidis, M. L. Woollard and P. Dandona,Protection of prostacyclin-like activity in human plasma — a non-enzymatic mechanism? Clin. Sci.62, 177–81 (1982).

    Google Scholar 

  7. D. P. Mikhailidis, R. A. Hutton, J. Y. Jeremy and P. Dandona,Cooling decreases the efficiency of prostaglandin inhibitors of platelet aggregation — a factor of possible relevance in cold-induced pathology, Microcirculation2, 413–23 (1983).

    Google Scholar 

  8. D. P. Mikhailidis, J. Y. Jeremy, M. A. Barradas, N. Green and P. Dandona,Effect of ethanol on vascular prostacyclin (prostaglandin I 2 )synthesis, platelet aggregation and platelet thromboxane release, Br. Med. J.287, 1495–1498 (1983).

    Google Scholar 

  9. J. Y. Jeremy, M. A. Barradas, D. P. Mikhailidis and P. Dandona,The effect of tiaprofenic acid and indomethacin on vascular prostacyclin and platelet thromboxane A 2 production, Pharmatherapeutica4, 260–265 (1985).

    Google Scholar 

  10. D. G. Altman, S. M. Gore, M. J. Gardner and S. J. Pocock,Statistical guidelines for contributors to medical journals, Br. Med. J.286, 1489–1493 (1983).

    Google Scholar 

  11. K. Diem, C. Lentner, Eds.Scientific Tables — Documenta Geigy 7th Edition, p. 647 Geigy Pharmaceuticals, Macclesfield (1975).

    Google Scholar 

  12. F. W. Green, M. M. Kaplan, L. E. Curtis and P. H. Levine,Effect of acid and pepsin on blood coagulation and platelet aggregation, Gastroenterology74, 38–43 (1978).

    Google Scholar 

  13. P. Lubke and W. Hermann,Effetti della cimetidina e della ranitidina sull'emocagulabilita plasmatica, Minerva Med.75, 627–631 (1984).

    Google Scholar 

  14. R. Chakrabarti and S. G. Thompson,Cimetidine and fibrinolysis, Lancetii, 962 (1979).

    Google Scholar 

  15. H. Kostering, U. Rotmann, J. Wieding, Ch. Hoffschmidt, B. Osburg and J. Schrader,Influence of cimetidine on platelet function, blood coagulation and fibrinolysis, Thromb Haemostas50, 432 (1983).

    Google Scholar 

  16. A. M. Hoare, G. V. H. Bradby, C. F. Hawkins, J. Y. Kang and P. W. Dykes,Cimetidine in bleeding peptic ulcer, Lancetii, 671–673 (1979).

    Google Scholar 

  17. J. B. Zeldis, L. S. Friedman and K. J. Isselbacher,Ranitidine: a new H 2 -receptor antagonist, N. Engl. J. Med.309, 1368–73 (1983).

    Google Scholar 

  18. R. Gachalyi, K. Tihanyi, A. Vas and A. Kaldor,In vitro effect of cimetidine on ADP-induced platelet aggregation and thromboxane A 2 synthesis in man, Thromb. Res.35, 105–109 (1984).

    Google Scholar 

  19. D. P. Mikhailidis, M. A. Barradas, J. Y. Jeremy and P. Dandona,In vitro effect of cimetidine on platelet aggregation, Thromb. Res.38, 307–308 (1985).

    Google Scholar 

  20. M. A. Horton, R. J. Amos and R. J. Jones,The effect of histamine H 2 receptor antagonists on platelet aggregation in man, Scand J Haematol31, 15–19 (1983).

    Google Scholar 

  21. M. C. Scrutton, Metiamide is not an α2-adrenoceptor antagonist in human platelets. J Pharm Pharmacol32, 438–439 (1980).

    Google Scholar 

  22. G. Allan and K. E. Eakins.Burinamide is a selective inhibitor of thromboxane-A biosynthesis in human platelet microsomes, Prostaglandins15, 659–661 (1978).

    Google Scholar 

  23. D. P. Mikhailidis, M. A. Barradas, J. Christofides, J. Y. Jeremy and P. Dandona.The misuse of cimetidine in patients with cirrhosis, Hepatology4, 573–574 (1984).

    Google Scholar 

  24. Anonymous,Prevention or cure for stress-induced gastrointestinal bleeding, Br. Med. J.281, 631–632 (1980).

  25. Anonymous,Non-ulcer uses of cimetidine, Br. Med. J.283, 89–90 (1981).

  26. A. E. Young,Stopping the haemorrhage from peptic ulcers, Br. Med. J.284, 530–531 (1982).

    Google Scholar 

  27. H. J. Price, J. J. Skillman, L. S. Bushnell, P. C. Long and W. Silen,Antacid versus cimetidine in preventing acute gastrointestinal bleeding, N. Engl. J. Med.302, 426–430 (1980).

    Google Scholar 

  28. Association of the British Pharmaceutical Industry Compendium 1985–86. Datapharm Publications Limited pp. 551–554 London (1985).

Download references

Author information

Affiliations

  1. Director, Metabolic Unit, Department of Chemical Pathology and Human Metabolism, Royal Free Hospital and School of Medicine, NW3, London, U.K.

    D. P. Mikhailidis, M. A. Barradas, J. Y. Jeremy &  P. Dandona

  2. Epsom Hospital Laboratories, West Park Hospital, Epsom, Surrey, U.K.

    J. Christofides

  3. Department of Gastroenterology Postgraduate, Inst. for Medical Education and Research, Chandigarh, India

    J. Dilawari

Authors
  1. D. P. Mikhailidis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Christofides
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. A. Barradas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Y. Jeremy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Dilawari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Dandona
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mikhailidis, D.P., Christofides, J., Barradas, M.A. et al. The effect of cimetidine on platelet function: a study involving gastric fluid measurements. Agents and Actions 19, 34–41 (1986). https://doi.org/10.1007/BF01977253

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01977253

Keywords

  • Imidazole
  • Platelet Aggregation
  • Peptic Ulcer
  • Cimetidine
  • Ranitidine