Nizatidine; Uses, Dosage, Side Effects, Interactions

Nizatidine also treats heartburn and erosive esophagitis caused by gastroesophageal reflux disease(GERD), a condition in which acid backs up from the stomach into the esophagus.

Mechanism of Action of Nizatidine

Nizatidine competes with histamine for binding at the H₂-receptors on the gastric basolateral membrane of parietal cells. Competitive inhibition results in the reduction of basal and nocturnal gastric acid secretions. The drug also decreases the gastric acid response to stimuli such as food, caffeine, insulin, betazole, or pentagastrin. By inhibiting the action of histamine on stomach cells, nizatidine reduces stomach acid production. Nizatidine had no demonstrable antiandrogenic action. Full-dose therapy for the problems treated by nizatidine lasts no longer than 8 weeks. It has been demonstrated that treatment with a reduced dose of nizatidine is effective as maintenance therapy following healing of active duodenal ulcers.

Indications of Nizatidine

• Gastro-esophageal Reflux Disease 
• Heartburn
• Hypersecretion gastric
• Bronchogenic carcinoma
• Duodenal ulcer prophylaxis
• Erosive esophagitis
• Indigestion
• Stomach ulcer
• Upper GI Hemorrhage
• Zollinger-Ellison Syndrome
• Active Duodenal ulcer
• Benign gastric ulcers
• Maintenance therapy Duodenal ulcer
• Relief of heartburn, acid indigestion, and sour stomach
• Treatment for gastric and duodenal ulcers
• Treatment for pathologic gastrointestinal hypersecretory conditions such as Zollinger–Ellison syndrome and multiple endocrine adenomas)
• Part of a multidrug regimen for Helicobacter pylori eradication, although omeprazole may be somewhat more effective.
• Prevention of NSAID-induced peptic ulcers.
• Given to surgery patients before operations to reduce the risk of aspiration pneumonitis.

Contra-Indications of Nizatidine

• Clostridium difficile infection
• Inadequate Vitamin B12
• Stomach Cancer
• Liver problems
• Moderate to severe kidney impairment
• Low amount of magnesium in the blood
• Liver problems
• Interstitial Nephritis
• Hepatic disease, QT prolongation, renal disease, renal failure, renal impairment.
• Osteoporosis
• Broken Bone
• Allergies to Proton Pump Inhibitors

Dosage of Nizatidine

Strengths: 150 mg; 300 mg; 75 mg; 15 mg/mL

Duodenal Ulcer

• Initial: 300 mg orally once a day at bedtime, or alternatively may use 150 mg orally twice a day.
• Maintenance: 150 mg orally once a day at bedtime.

Duodenal Ulcer Prophylaxis

• 150 mg orally once a day at bedtime.

Gastric Ulcer

• 300 mg orally once a day at bedtime, or alternatively may use 150 mg orally twice a day.

Erosive Esophagitis

• 150 mg twice daily.

Gastroesophageal Reflux Disease

• 150 mg twice daily.

Dyspepsia

• 75 mg orally once or twice a day, taken right before or up to 60 minutes before eating.

Pediatric Gastroesophageal Reflux Disease

Investigational

• Greater than 1 year (n=26): In mild to moderate reflux esophagitis: 10 mg/kg/day divided into two doses for 8 weeks.
• Greater than or equal to 4 to 11 years (n=104): 6 mg/kg/day divided into two doses, one dose is given at 9 PM the night before surgery, and the other given at 6:30 AM the day of surgery.

Side Effects of Nizatidine

The most common

• Nausea and vomiting
• Severe stomach ache
• Severe diarrhea
• Vaginal thrush
• Skin rash
• A headache
• chest pain
• constipation
• a cough
• diarrhea or loose stools
• difficulty with breathing
• dizziness
• heartburn
• muscle pain

More common

• Abdominal or stomach pain, discomfort, or tenderness
• chills or fever
• difficulty with moving
• a headache, severe and throbbing
• joint or back pain
• muscle aching or cramping
• muscle pains or stiffness
• chest pressure or squeezing pain in the chest
• discomfort in arms, shoulders, neck or upper back
• excessive sweating
• feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
• sudden tingling or coldness in an arm or leg
• sudden slow or difficult speech
• sudden drowsiness or need to sleep
• fast breathing
• sharp pain when taking a deep breath
• fast or slow heartbeat
• coughing up blood
• rust colored urine
• decreased amount of urine

Rare

• Anxiety
• change in vision
• seizures
• abnormal or fast heart rate
• tremors
• weight loss
• chest pain or tightness
• confusion
• a cough
• Agitation
• arm, back, or jaw pain
• blurred vision
• chest pain or discomfort
• convulsions
• extra heartbeats
• fainting
• hallucinations
• a headache
• irritability
• lightheadedness
• mood or mental changes
• muscle pain or cramps
• muscle spasm or jerking of all extremities

Drug Interactions of Nizatidine

Nizatidine may interact with the following drugs, supplements, & may change the efficacy ofthe drug

• amiodarone
• azole antifungal medications (e.g., fluconazole, ketoconazole)
• caffeine
• calcium channel blockers (e.g., diltiazem, nifedipine, verapamil)
• carbamazepine
• carvedilol
• benzodiazepines (alprazolam, chlordiazepoxide, clonazepam, diazepam, flurazepam, midazolam, and triazolam)
• clopidogrel
• clozapine
• dasatinib
• glyburide (and other “sulfonylurea” diabetes medications)
• lidocaine
• metformin
• metoprolol
• pentoxifylline
• phenytoin
• propranolol
• salmeterol
• SSRIs (e.g., citalopram, fluoxetine, sertraline)
• sucralfate
• theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
• tramadol
• tricyclic antidepressants(e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• warfarin

Pregnancy Catagory of Nizatidine

FDA Pregnancy Category B

Pregnancy

The safety of this medication for use during pregnancy has not been established. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Lactation

You should not take nizatidine if you are breastfeeding. It may be excreted in your breast milk and may harm your nursing child.

Reference

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