Nizatidine
AXID
Pronunciation: ni-ZA-ti-deen
What it isH2 receptor antagonist; GERD and ulcer disease.
Why this oneNo CYP inhibition, unlike cimetidine, and it has mild prokinetic activity.
What limits itTachyphylaxis with scheduled use. Renally adjusted; largely displaced by famotidine.
FDA-approved for
- ulcers (1988)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Active duodenal ulcer | Adults | 300 mg QHS (or 150 mg BID) | 300 mg QHS | 300 mg/day |
| Maintenance of healed duodenal ulcer | Adults | 150 mg QHS | 150 mg QHS | 150 mg/day |
| GERD (erosions/ulcerations/heartburn) | Adults | 150 mg BID | 150 mg BID | 300 mg/day |
| Active benign gastric ulcer | Adults | 150 mg BID or 300 mg QHS | 300 mg/day | 300 mg/day |
Renal CrCl 20-50: 150 mg QD (150 mg QOD for maintenance); CrCl <20: 150 mg QOD (150 mg q3 days for maintenance)
Hepatic Undefined
Available strengths
- sol 15 mg/mL
- cap 150, 300 mg
- tab 75 mg
Contraindications
- History of hypersensitivity to other H2-receptor antagonists (class cross-sensitivity)
Cautions
- Hepatocellular injury / elevated liver enzymes (reversible on discontinuation)
- Reduce dose in moderate-to-severe renal impairment
- Rare reversible mental confusion
Adverse reactions
- Headache
- Dizziness
- Diarrhea
- Nausea
- Elevated liver enzymes
- Urticaria/sweating
Pregnancy Category B; no fetal harm in animal studies; use during pregnancy only if clearly needed
Lactation Undefined
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 15 mg/mL | sol | per unit | not offered |
Generic entry2002
NO BOXED WARNINGS
Principal riskTachyphylaxis; renally adjusted
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityLong-term infection, magnesium/B12 and bone risks; selected agents have clinically important CYP interactions.