Drug Interaction Report

Cimetidine and Nisoldipine: Interaction Details

A pharmacist-reviewed analysis of the Cimetidine and Nisoldipine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Cimetidine

Tagamet
+

Nisoldipine

Sular Sular®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 83 documented Cimetidine interactions, 22 are rated moderate — including this one.
Onset
rapid
Evidence
probable
Severity
Moderate

What happens

Increased bioavailability of nisoldipine

Interaction Deep Dive

Concomitant administration of nisoldipine and cimetidine has produced a 30% to 45% increase in peak concentration and area under the concentration-time curve (AUC) of nisoldipine21.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) Concomitant administration of oral nisoldipine (10 mg as solution) and oral cimetidine in healthy subjects was reported to result in an increase in the mean bioavailability of nisoldipine. Peak nisoldipine plasma concentrations increased from a mean of 5.8 ng/mL to 8.8 ng/mL during cimetidine administration. Cimetidine had no effect on the elimination half-life of nisoldipine. Despite these changes in nisoldipine pharmacokinetics, concurrent cimetidine had no significant effect on the hemodynamic profile of nisoldipine in study subjects 1.

Common questions

Can I take Cimetidine and Nisoldipine together?

Increased bioavailability of nisoldipine Always confirm with your pharmacist or prescriber before making any change.

How serious is the Cimetidine and Nisoldipine interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Cimetidine or Nisoldipine need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (2)

  1. van Harten J, van Brummelen P, Lodewijks MTM, et al: Pharmacokinetics and hemodynamic effects of nisoldipine and its interaction with cimetidine. Clin Pharmacol Ther 1988; 43:332-341. PubMed
  2. Product Information: Sular(R), nisoldipine. Zeneca Pharmaceuticals, Wilmington, DE, 1996. DailyMed
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Cimetidine

Keep reading about Cimetidine

All Cimetidine interactions (83)
Also serious with: Dofetilide Colchicine Octreotide Injection Meloxicam Injection
Nisoldipine

Keep reading about Nisoldipine

All Nisoldipine interactions (86) Nisoldipine drug information
Also serious with: Ketoconazole Ensitrelvir Levoketoconazole Itraconazole
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Cimetidine + Activated Charcoal Pu-erh Tea St. John's Wort Adrafinil African Wild Potato Banderol Beer Bitter Melon + 87 more
Nisoldipine + Activated Charcoal American Hellebore American Mistletoe Coleus Grapefruit St. John's Wort Tyramine Acacia Rigidula + 224 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.