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Rare Fatality Attributed to an Overdose of Cimetidine

NCJ Number
201913
Journal
Canadian Society of Forensic Science Volume: 36 Issue: 2 Dated: June 2003 Pages: 73-76
Author(s)
G. R. Jones; P. P. Singer
Date Published
June 2003
Length
4 pages
Annotation
This article reports on a case study of a woman who overdosed on cimetidine, a widely available over-the-counter (OTC) medication that blocks gastric acid secretion.
Abstract
Cimetidine has been available in the United States since 1977 and is generally used for the treatment of peptic ulcers but has recently been widely available as an OTC medication for treating simple gastric acid reflux and related disorders. Cimetidine’s toxicity is very low and only one other known case of overdose has been fatal. This case study involved the fatal overdose by cimetidine of a 39-year-old woman who had a history of arthritis and non-specific gastrointestinal problems. Findings at autopsy revealed cardiac hypertrophy and micronodular cirrhosis and high concentrations of cimetidine. Femoral blood concentration of cimetidine was 310 mg/L. the only other significant toxicology finding was a blood ethanol level of 110 mg/100 mL. The primary mechanism of toxicity for cimetidine is unclear because of the rarity of overdose leading to death. The findings of this case indicate that the pre-existing medical conditions of cardiac hypertrophy and micronodular cirrhosis made the victim more susceptible to the extremely high concentration of cimetidine she ingested. References

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