Is cimetidine (histamine H2-receptor antagonist) safe during pregnancy?

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From the FDA Drug Label

Pregnancy Teratogenic Effects Pregnancy Category BReproduction studies have been performed in rats, rabbits and mice at doses up to 40 times the normal human dose and have revealed no evidence of impaired fertility or harm to the fetus due to cimetidine. There are, however, no adequate and well-controlled studies in pregnant women Because animal reproductive studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Cimetidine use during pregnancy should be approached with caution. While animal studies have shown no evidence of impaired fertility or harm to the fetus, there are no adequate and well-controlled studies in pregnant women. Therefore, cimetidine should be used during pregnancy only if clearly needed 1 1.

From the Research

Cimetidine Safety During Pregnancy

  • The safety of cimetidine, a histamine H2-receptor antagonist, during pregnancy has been evaluated in several studies 2, 3, 4, 5, 6.
  • A study published in the American Journal of Epidemiology in 1999 found that the use of cimetidine during the first trimester of pregnancy was not associated with a major teratogenic risk 2.
  • A meta-analysis published in Digestive Diseases and Sciences in 2009 found that H2 blockers, including cimetidine, can be used safely in pregnancy, with no increased risks for spontaneous abortions, preterm delivery, and small for gestational age 3.
  • Other studies have investigated the effects of cimetidine on maternal and fetal prolactin secretion during labor 5, and its use as an adjuvant treatment for recurrent respiratory papillomatosis in pregnancy 6.
  • A study published in the Journal of Perinatal Medicine in 1985 found that cimetidine crossed the placenta at a maternal/cord blood ratio of 3:1, but was not detected in any of the infants 2 hours after delivery 4.
  • Overall, the available evidence suggests that cimetidine is generally safe to use during pregnancy, but larger scale studies are warranted to assess its long-term efficacy and safety 6.

References

Research

Effect of cimetidine on maternal and fetal prolactin secretion during labor.

Journal of endocrinological investigation, 1988

Research

Cimetidine for recurrent respiratory papillomatosis in pregnancy as an alternative adjuvant treatment.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2024

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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