Cimetidine and Mental Confusion

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Abstract
To the Editor.— In the last year several cases of mental confusion associated with cimetidine therapy have been reported in the literature,1-3yet this side effect is not widely known. In fact, this side effect is not reported in the product literature. In the cases reported, these mental changes occurred after accidental overdosage or in patients with suspected renal impairment. Cimetidine is excreted primarily unchanged by the kidney, but neither the literature nor the manufacturer furnish definitive guidelines for the use of cimetidine in patients with renal failure. We would like to report a possible case of drug-induced encephalopathy associated with the administration of normal doses of cimetidine to a patient with a moderate degree of renal failure. Report of a Case.— A 53-year-old woman was transferred to our service from the coronary care unit with multiple medical problems. At the time of transfer, her severe problem was a

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