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CAM: Cimetidine (Tagamet)

devotion10's picture
devotion10
Posts: 642
Joined: Jan 2010

I have heard several people discuss adding Cimetidine (Tagamet) to their treatment for its possible anti-tumor action ... could those who use it or are familiar please discuss it in really simply laymen (or laywomen) terms?

The medication has been spoken of favorably and also suggested to newcomers. Seems it would be nice to have some simple, straight-forward information accumulated so that it could be easily searched on the forum.

I am thinking of this as simply an informational thread. Of course, healthy discussion encouraged but please play nice.

Here is all I know or think I know:

1)  It is an over-the-counter medication marketed as Tagamet, Tagamet HB, and Tagamet HB200 typically prescribed to relieve and prevent heartburn by suppressing gastric acid secretion. 

2)  It comes in tablets, liquid, and injectable.

3)  The commercial name Tagamet stems from fusing the two words antagonist and cimetidine.  

4)  Off-label uses have included relieving pain and symptoms of herpes zoster

5)  It seems that studies in Asia have linked cimetidine combined with long term, continuous low dose 5FU has resulted in unusually long survival for Stage 3 cancer colorectal patients. Also, I found some positive articles in the Britsh Journal of Cancer from 2002.

6) Possible postive effects for colorectal cancer: a) it acts against metastases via inhibition of tumor cell adhesivenes; b) histamine acts as a growth factor in various tumor cell types via the activation of H2 receptors; and cimetidine antagonizes this effect as an anti-histamine; c) Cimetidine acts as an immunomodulator by enhancing the host’s immune response to tumor cells, via inhibition on T-cell suppressor activity; d) acts as an antiangiogenic (inhibit growth of blood vessels).

7) Possible adverse effects: Since cimetidine is a known inhibitor of multiple forms of enzymes that are the major enzymes involved in drug metabolism and bioactivation -- this inhibition forms the basis of some of the numerous drug interations that occur between cimetidine and other drugs. It is listed as having a potential increase on the effects of certain opiod medications. It can also interact with certain psychoactive medications such as tricyclic antidepressants and SSRIs causing increased blood levels.  

Smile -- C

 

gizzyluv's picture
gizzyluv
Posts: 143
Joined: Feb 2013

I, like you, only know what I have read & what I've been told about Cimetidine. That being said, my husband Jason has been taking 400 mg. twice a day. His doctor knows he is taking it, but really didn't have an opinion one way or the other, he just basically said it wouldn't hurt him to take it. So, I figure if there is even a slight chance of it having a positive affect why not try it?

renw's picture
renw
Posts: 282
Joined: Jan 2013

Based on the evidence I am taking it as well now together with Celebrex, naltrexone, aspirin and Metformin.

annalexandria's picture
annalexandria
Posts: 2268
Joined: Oct 2011

I took it before and after my last surgery and will do so again if/when I need another one.  I think the only real issue is with getting your stomach acids out of whack if you take it long term, as some do, but I believe there are ways to keep an eye on that and do some tinkering as necessary.  AA

smokeyjoe
Posts: 1428
Joined: Feb 2011

RENW .... how are you taking these drugs,  are you taking them in cycles, or small amounts each day??

renw's picture
renw
Posts: 282
Joined: Jan 2013

Low dose aspirin every day.
Naltrexone I take every second day in evening, during vit c and alphalipoic acid infusions
Celebrex and Cimetidine I take together lunch and dinner. cimetidine has the added benefit of reducing celebrex side effects.
metformin i take with each meal 3x daily.

tetrathiomolybdate I take once a day.
about to try emend, a 300mg dose once a day, but only for a month and will stop if no results.

jen2012
Posts: 1208
Joined: Aug 2012

I mentioned in my post about upcoming surgery that I asked the surgeon about this and he just said there's no truth that it could be helpful.  However, the oncologist was more open to it and discussed with the oncology pharmacist.  I heard from the pharmacist today and she said there is limited data on using it, but feels it's worth a try.   She did say that it may interact with my husband's blood pressure meds, so he should let them know if he notices any changes in his blood pressure or how he's feeling.

She's also willing to check interactions on any other supplements, so I may do some searching and send her a list. 

annalexandria's picture
annalexandria
Posts: 2268
Joined: Oct 2011

Did you ask him why he had such a definitive opinion about it not working?  My surgeon is super-experienced, but had never heard of it.  Read the study I gave him, said it looked interesting, and couldn't hurt to try.  Although he did warn me that even if I reached remission (as I have), we would never know if the drug helped or not.  Duh.  I'm not a one-woman clinical study, so I don't really care about that. It's easy to do, and if it doesn't interact badly with your other meds, why not try it?

jen2012
Posts: 1208
Joined: Aug 2012

Nope Ann..he didnt explain his response..and i didnt question him...figured we'd just do it anyhow.

tanstaafl's picture
tanstaafl
Posts: 976
Joined: Oct 2010

...why not try it?

Yes.  After all what does one have to lose if they're still not studied up and experienced on this particular subject?

tanstaafl's picture
tanstaafl
Posts: 976
Joined: Oct 2010

At the time of my wife's initial diagnosis 3 years ago, I was aware of the cimetidine story, and also LEF.org.   So I spent my first hour reading everything I could find on cimetidine, before telling my wife she better go to the drugstore and buy the cimetidine, and raid the old folks supply for some targeted supplements, too.   And of course, she didn't.  

[2010] So a day or so later, I asked, and she'd blown it off.  Because I  recognized the association between histamine levels, VEGF and CA19-9+CSLEX1,  I was very suspicious that she was "cimetidine deficient".   So I pointed out that the Japanese stage II and III crc patients with  **both**  CA19-9 and CSLEX1 markers, like a strong supermajority of stage IV's and II - III's with fatal recurrences,  were at 100% die off within 6 years without the added cimetidine vs less than 5% deaths from mCRC in 10 years for the cimetidine treated patients with double positive markers.   "So which group do you want to be in, A or B?"    Light dawns, she gets it.

[2010] After 4 weeks and surgery - "I didn't get it all", then the storm blows over.   "Never mind," it is some weird granulocytic inflammation with a lot of necrotic tissue.  Hmmmm. To me, just like some of the cimetidine research literature.   But(t) surgeon says stage III.  But what if there was more cancer?  One small obscure study in Japanese for certain stage IVs shows big gains for 5FU with cimetidine, so cimetidine again looks like a potential insurance policy.

[2010] I can't get straight numbers or answers about serious chemo side effects with standard therapies.  I am getting hostility and snickers from the oncologists about cimetidine, and non American chemo.  I feel like I am whizzing through used car lots for chemo.  After several disconnects and unresolved issues, I really don't trust the sales reps.  I don't like the sticker, the looks, the mileage guarantees, or the ride quality.  What do we do about cimetidine long term?   Which chemo?  The clock is ticking.

[2010] I decided that while I was searching for someplace to get the pathology stains on CSLEX1 and CA19-9 done, I needed to probabilistically interpret her presurgery serum CA19-9 reading against a number of papers for maximum utility.  I finally decided that if CA19-9 was less than 2 units, we would discontinue the cimetidine 14-21 days after surgery because she would be definitively in a group of 10% that can't benefit from long term cimetidine.    If her blood CA19-9 was over 25 units, we would  use cimetidine at least until the tissue assays for CSLEX1 and CA19-9 were in, whenever, and despite any naysaying.   2 - 10 units, no mans land, continue cimetidine, do more research.  10-25 units, very probably would do cimetidine for 12 months (per "stage III") without tissue stains, but I really, really want the tissue biomarker results.  

[2010] How much cimetidine? My personal decision analysis, presuming histamine reactive tumors with CA19-9+CSLEX1 - if no side effects, stage 2, 3, or 4 x 400 mg daily per stage (800, 1200, or 1600 mg respectively) with daily low dose UFT-LV or xeloda, plus other LEF and orthomolecular stuff.   Lower dosages were still viable if necessary.  We started from putative stage III, but upped to 1600 mg at any moments of concern.  There are gassy side effects without sufficient digestive support from betaine HCl and pancreatin. 

[2010] Her pre-surgery serum CA19-9 turned out to be in the 30s, near a Japanese median for CA19-9 at discovery with stage IV CRC.  [2011] After the second surgery, the CSLEX and CA19-9 tissue stains were obtained through academic labs.  The biomarkers are highly positive, like 2/3 to 3/4 of advanced and mCRC patients. [2012-3] Then, after a long, long roller coaster with several CT scans, stage IVb appears correct with 2-3+ cm "cysts" that were likely [partly] necrosed liver mets on the first CT scan after two weeks of immunotherapy.  

 

myd
Posts: 30
Joined: Apr 2013

I'm new to this board.  I'm not the one with cancer, but it is my wife.  She was diagnosed with Stage IIa at first on December 2009.  We had a couple of years of peace.  However, Stage IV was diagnosed on January, 2012.  You all know that this is a horrible desease.  My wife looks and feels strong at the moment.  However, last year was pretty bad with the surgery to remove lung nodules.  The chemo only added to the misfortune. 

I'm read some of the threads about Tagamet.  If someone is not going to have surgery, is it ok for them to take Tagamet?  I asked the oncologist and he said, "if your wife has acid reflux, sure, take the medication."  He did not offer an opinion regarding the possbility that, it may be a tumor inhibitor.  I would appreciate, if someone can provide an opinion to my question.  I understand that none of you are doctors, but people who have a vested interested. 

Thank you so much for your cooperation.  I've been reading your exchanges for about a year.  I'm very happy to have found this forum.  It has provided me with a lot of information.  I'm also very sorry for you guys to have lost so many f your friends.  This desease breaks your heart.  I know my wife is with me, but I also know that we will most likely not grow old together.  It's just hard.

thank you,

myd 

Chelsea71
Posts: 1170
Joined: Sep 2012

Hi myd,

Welcome. I'm happy that you decided to post and introduce yourself. The stage 4 diagnosis must have come as a devastating blow. It's great that your wife is feeling great now. That is what's important. Try not to think down the road. Just take each day as it comes. My husband, Steve, was diagnosed with stage four, two years ago. I get a panicky feeling when I start to focus too far down the road.

As for the Tagamet, I cannot explain the science behind it, however, my understanding is that there may be some benefit to taking it on a regular, daily basis regardless of upcoming surgery. I'm not sure what to do about Steve. He may be having surgery in a couple months, however, he is on a blood thinner and I'm worried about an interaction. He's had a rough time with clots lately and I'd hate to do anything that would cause problems. I will ask his onc, but I'm sure she will respond similarly to your onc.

Hope you continue to post.

Chelsea

tanstaafl's picture
tanstaafl
Posts: 976
Joined: Oct 2010

Targeted cimetidine use is clearest for stage II and III patients to help prevent metastasis and improve immune response, especially at diagnosis and surgery for CA19-9 biomarked patients.  The documentation for stage IV is thin at best, but we use it without oxaliplatin or radiation.  Oxaliplatin and radiation have been used with temporary, low dose cimetidine for normal purposes,  but as a basic science question, I suspect that some separation in time is better. 

We count lack of oncological support for cimetidine as a lack of basic professional knowledge and interest, however common.   In the US, MDs and maybe NDs interested in complementary off label treatments and (super) nutrition for cancer, might be more likely to support specific requests for help on cimetidine with chemo and blood thinners.    

In the end, for us, it has been easier to rely on several other physicians' internal medicine and oncology skills for support.   After the second surgery, I asked the head surgeon, "we never quite found that magic oncologist, do you know of any I might be able to work with?" Recognizing our level of expectations and requirements, he replied that they (these two senior surgeons) were still looking themselves, and that we were doing pretty well with our consulting set up. 

In most locales, patients working with conventional doctors and oncologists, in tandem or independently with the alternative MD/DO/ND, are common options.

jen2012
Posts: 1208
Joined: Aug 2012

Welcome myd...sorry about your wife. Does she take vit D? My husbands onc said ok to 10000 iu a day.

Tans and others...have you found the cimetidine in greater than 200 mg? Hubby isnt thrilled about another handful of pills. May ask the onc pharmacist about grape seed extract too...

myd
Posts: 30
Joined: Apr 2013

Chelsea71, thank you for your reply.  I agree, try to take it one day at a time.  She takes eye drops for an eye condition, but she only takes baby aspirin and vitamins.  I will be getting some tagamet.  It seems that this is a horrible game of numbers.  One can only hope their loved ones fall in the right percentile.  Thank you once again, myd

Chelsea71
Posts: 1170
Joined: Sep 2012

So I talked to Steve's oncology pharmacist at chemo today. Asked her about cimetidine before and after surgery. She did not laugh at me. A couple months ago I asked about Milk Thistle and she laughed her head off. She said taking it with blood thinners would not be a problem. Said it was fine with the blood pressure med too. Said not to take it while on Folfiri. Apparently the Cimetidine combined with Irenotecan can cause liver toxicity. Said to wait until at least two weeks after stopping Irenotecan before starting Cimetidine.

Ann - if you are reading this. I know I've asked you before. 400mg daily or 800mg daily? This will be the last time I ask.

Thanks

jen2012
Posts: 1208
Joined: Aug 2012

I think Ann did 800...tans wife 1000? We got an ok for 1000....which i accidently added an extra 0 to on the psper for his primary care doc and she freaked out :)...

tanstaafl's picture
tanstaafl
Posts: 976
Joined: Oct 2010

1600 mg/day normally, 3200 mg divided for last surgery.    

annalexandria's picture
annalexandria
Posts: 2268
Joined: Oct 2011

glad someone knew the answer and was able to tell you!  I had to actually think about it for a minute.  Brain isn't what it used to be.

AA

Fucc
Posts: 92
Joined: Sep 2012

Are there any Canadians on here who were prescribed cimetidine? Inasked my oncologist about this months ago and he refused to prescribe it to me, said the studies are old and that it doesn't work. I have toyed with making a trip across the border to get it,nut haven't doNe so as of yet. I'm not sure if it is worth it at this point where my surgeries were months ago and I have now finished chemo. Has anyone started it late? I'm still mixed in if it is worthwhile. I am taking a lot of other supplements.  I don't understand why it's not available over the counter here in Canada. 

Chelsea71
Posts: 1170
Joined: Sep 2012

I live right on the border so it's only a ten minute drive for me.  Funny to just go into Walmart and get it when we need a prescription here.  Plan to ask Steve's onc for a prescription just to see how she will react.  I suspect she will refuse.  What part of Canada are you from?  How far to cross the border?

 

chelsea

Fucc
Posts: 92
Joined: Sep 2012

I'm in Toronto. It'sabout a 90 min drive to the Boarder. I wonder if the boarder guards would give me a hard time if I wanted tobring it back and declare it. 

Chelsea71
Posts: 1170
Joined: Sep 2012

Not sure. I know since our pesticide ban was implemented, they certainly check carefully for those kinds of chemicals. Medications though, I'm not sure. Interesting question. It think I will look into that.

tanstaafl's picture
tanstaafl
Posts: 976
Joined: Oct 2010

In the US a physicians asst, or in many countries/states a registered nurse or even the pharmacy, may have some prescription powers.   I stock up on a trip and buy mine small wholesale without showing our paperwork.  Apparently they think I'm a clinic.Laughing 

 

Maybe a side trip to Mexico, etc.  I suspect a prescription would be pretty affordable too.

devotion10's picture
devotion10
Posts: 642
Joined: Jan 2010

is spam or not, but trying to keep info current here. -- Cynthia

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