Drug reference

Nizatidine

h2 Receptor Antagonist · Gastric Acid Reducer

Also known as AXID

h2 Receptor AntagonistGastric Acid Reducer

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

7 major

SEVERE in our sources

PREGNANCY

Manufacturer advises avoid unless essential.

FDA category + note

Top interactionssee all 7 →

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Mechanism

Nizatidine is an H2 receptor antagonist that inhibits acid production by reversibly competing with histamine for binding to H2 receptors on the basolateral membrane of parietal cells. These drugs predominantly inhibit basal acid secretion, which accounts for their efficacy in suppressing nocturnal acid secretion.

Indications

Benign gastric, duodenal or NSAID-associated ulcerationGastro-oesophageal reflux diseaseGastric ulcer (to promote healing)Duodenal ulcer (to promote healing)Gastroesophageal reflux disease (uncomplicated)Prevention of stress ulcers

Dosing

Adult: Benign gastric, duodenal or NSAID-associated ulceration: BY MOUTH, 300 mg once daily for 4–8 weeks, dose to be taken in the evening, alternatively 150 mg twice daily for 4–8 weeks; maintenance 150 mg once daily, dose to be taken at night. Gastro-oesophageal reflux disease: BY MOUTH, 150–300 mg twice daily for up to 12 weeks.
Pediatric: <12 years: 5–10 mg/kg/day divided every 12 h; >12 years: 150 mg twice daily
Renal adjustment: Use half normal dose if eGFR 20–50 mL/minute/1.73 m2. Use one-quarter normal dose if eGFR less than 20 mL/minute/1.73 m2.
Hepatic adjustment: Manufacturer advises caution.
Geriatric: In the elderly, there is a decline of up to 50% in drug clearance as well as a significant reduction in volume of distribution.
Max dose: 600 mg daily

Pharmacokinetics

Onset

Therapeutic levels achieved rapidly after intravenous dosing.

Half-life

1 to 3 h

Bioavailability

Little first-pass metabolism, rapidly absorbed after oral administration.

Protein binding

Only a small fraction is protein bound.

Metabolism

Little first-pass metabolism; hepatic metabolism.

Excretion

Cleared by a combination of hepatic metabolism, glomerular filtration, and renal tubular secretion.

Contraindications

Preparations withdrawn from use due to contamination issues
Avoided in pregnancy due to adverse data from animal studies

Side effects

Common

DiarrheaHeadacheDrowsinessFatigueMuscular painConstipation

Serious

Anaemia
Hyperuricaemia
Serum sickness
CNS effects (confusion, delirium, hallucinations, slurred speech, headaches), primarily with IV administration or in elderly
Various blood disorders (e.g., thrombocytopenia)
Vitamin B12 deficiency