19 . January , 2019 - Saturday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Nizatidine

Big Image Pronouncation: (nye-ZA-ti-deen)
Class: Histamine H 2 antagonist

Trade Names:
- Solution, oral 15 mg/mL

Trade Names:
Axid AR
- Tablets 75 mg

Trade Names:
Axid Pulvules
- Capsules 150 mg
- Capsules 300 mg

Apo-Nizatidine (Canada)
Novo-Nizatidine (Canada)
PMS-Nizatidine (Canada)

Mechanism of Action


Reversibly and competitively blocks histamine at H 2 receptors, particularly those in gastric parietal cells, leading to inhibition of gastric acid secretion.



Absolute bioavailability is more than 70%, C max is 700 to 1,800 mcg/L (150 mg dose) and 1,400 to 3,600 mcg/L (300 mg dose), and T max is 0.5 to 3 h. Food increases nizatidine AUC and C max by approximately 10%.


Vd is 0.8 to 1.5 L/kg and the plasma protein binding is about 35%, mainly to alpha-1 acid glycoprotein.


Less than 7% of nizatidine is metabolized as N2-monodesmethylnizatidine (main metabolite). Other metabolites include N2-oxide (less than 5%) and S-oxide (less than 6%).


Eliminated in urine (90% excreted; 60% as unchanged) and feces (less than 6%). The t 1/ 2 is 1 to 2 h, plasma Cl is 40 to 60 L/h, and renal Cl is 500 mL/min.

Special Populations

Renal Function Impairment

Moderate to severe renal function impairment prolongs nizatidine t 1/ 2 and decreases Cl. Reduce amount and frequency of dose according to severity.

Indications and Usage

Treatment and maintenance of duodenal ulcer, gastroesophageal reflux disease (GERD) (including erosive or ulcerative disease), and benign gastric ulcer; prevention of heartburn, acid indigestion, and sour stomach brought on by consuming food and beverages.

Unlabeled Uses

Prevention of olanzapine-induced weight gain; prevention of NSAID-induced gastroduodenal ulcer, in combination with amoxicillin and clarithromycin for Helicobacter pylori infection.


Hypersensitivity to H 2 antagonists.

Dosage and Administration

Duodenal Ulcer (Active)

PO 300 mg at bedtime or 150 mg twice daily for up to 8 wk.


PO 150 mg at bedtime.

Benign Gastric Ulcer (Active)

PO 300 mg at bedtime or 150 mg twice daily.

Moderate to Severe Renal Function Impairment

Ccr 20 to 50 mL/min: 150 mg daily; maintenance dose 150 mg every other day. Ccr less than 20 mL/min: 150 mg every other day; maintenance dose 150 mg every 3 days.


PO 150 mg twice daily.

Children 12 yr of age and older

PO (oral solution) 150 mg twice daily for up to 8 wk (max, 300 mg/day).

Moderate to Severe Renal Function Impairment

Ccr 20 to 50 mL/min: 150 mg daily; maintenance dose 150 mg every other day. Ccr less than 20 mL/min: 150 mg every other day; maintenance dose 150 mg every 3 days.

Acid Reduction
Adults and Children 12 yr of age and older

PO 75 mg with water before eating or up to 1 h before consuming food and beverages that may cause symptoms. Can be used up to twice daily.


Oral solution: Store at 59° to 86°F. Protect from light. Capsules and tablets: Store at 68° to 77°F. Protect from light.

Drug Interactions


Increased salicylate levels in patients taking very high doses of aspirin (3.9 g/day).


Peak plasma ethanol levels may be increased.


Effects of ketoconazole may be reduced.

Laboratory Test Interactions

False-positive tests for urobilinogen with Multistix may occur.

Adverse Reactions


Ventricular tachycardia.


Headache (17%); dizziness (5%); asthenia, insomnia (3%); abnormal dreams, anxiety, somnolence (2%); nervousness (1%). Children: irritability, pyrexia (greater than 5%).


Pruritus, rash (2%).


Rhinitis (10%); pharyngitis (3%); amblyopia (1%). Children: nasal congestion, nasopharyngitis (greater than 5%).


Abdominal pain (8%); diarrhea (7%); dyspepsia, flatulence, nausea (5%); vomiting (4%); constipation (2%); anorexia, dry mouth, GI disorder, nausea and vomiting, tooth disorder (1%). Children: diarrhea, vomiting (greater than 5%).


Elevated liver enzymes.


Eosinophilia, thrombocytopenia, thrombocytopenic purpura.


Back pain, myalgia (2%).


Increased cough, sinusitis (2%). Children: cough (greater than 5%).


Pain (4%); chest pain, fever, infection (2%); accidental injury (1%); anaphylaxis, serum sickness–like reaction.



Category B .


Excreted in breast milk.


Safety and efficacy not established (capsules and tablets). Safety and efficacy not established in children younger than 12 yr of age (oral solution).

Renal Function

Decreased Cl may occur in patients with renal function impairment; reduced dosage may be needed.

Hepatic Function

Use drug with caution in patients with hepatic function impairment; decreased Cl may occur. In patients with uncomplicated hepatic function impairment, nizatidine disposition is generally normal.

Hepatocellular injury

Abnormalities appear to be reversible after discontinuation of drug.

Patient Information

  • Explain name, dose, action, and potential adverse reactions of drug.
  • Obtain patient history, including drug history and any known allergies.
  • Advise patient to take medication after breakfast and at bedtime if prescribed twice-daily regimen or at bedtime if prescribed once-daily dosage.
  • Caution patient to stay active and to increase fluid and roughage in diet to prevent constipation.
  • Instruct patient to take missed dose as soon as possible, and caution not to double doses.
  • Advise patient to avoid cigarette smoking, which increases gastric acid secretions and, therefore, decreases effectiveness of nizatidine therapy.
  • Instruct patient to report the following symptoms to health care provider: abdominal pain, coffee-ground emesis, extreme fatigue, tarry stools, or weakness.
  • Advise women to notify health care provider if pregnant, planning to become pregnant, or breast-feeding.
  • Caution patient not to take any prescription or OTC medications, herbal preparations, or dietary supplements unless advised by health care provider.
  • Advise patient that follow-up visits may be necessary and to keep appointments.

Recent Drug Updates at DrugIndexOnline:

albendazole albendazole
Generic Name: albendazole (al BEN da zole) Brand Names: Albenza What is albendazole? Albendazole is an anthelmintic (an-thel-MIN-tik) or anti-worm medication. It prevents newly hatched insect larvae (worms) from growing or multiplying in your body. Albendazole is used to treat certain in more...

Alupent Aerosol Alupent Aerosol
Generic Name: Metaproterenol Inhalation Aerosol (met-a-proe-TER-e-nol) Brand Name: AlupentAlupent Aerosol is used for:Treating or preventing symptoms of asthma, emphysema, bronchitis, and other reversible breathing problems. It may also be used for other conditions as determined by your doctor. more...

Aquachloral Supprettes Aquachloral Supprettes
Generic Name: chloral hydrate rectal (klor al HYE drate) Brand Names: Aquachloral Supprettes What is Aquachloral Supprettes (chloral hydrate rectal)? Chloral hydrate is a hypnotic and a sedative medication that slows the activity of your central nervous system. Chloral hydrate rectal is more...

Boniva Boniva
Generic Name: ibandronate sodium Dosage Form: Injection Boniva Description Boniva (ibandronate sodium) is a nitrogen-containing bisphosphonate that inhibits osteoclast-mediated bone resorption. The chemical name for ibandronate sodium is 3-(N-methyl-N-pentyl)amino-1-hydroxypropane-1,1-diphosphoni more...

Fempatch Fempatch
Generic Name: estradiol transdermal (ess tra DY ol tranz DERM al) Brand Names: Alora, Climara, Esclim, Estraderm, Fempatch, Menostar, Vivelle, Vivelle-Dot What is Fempatch (estradiol transdermal)? Estradiol is a form of estrogen, a female sex hormone the regulates many processes in th more...

guaifenesin and phenylephrine guaifenesin and phenylephrine
Generic Name: guaifenesin and phenylephrine (gwye FEH ne sin and feh nill EFF rin) Brand Names: Amidal, Amitex LA, Chemdal, Crantex, Crantex ER, Crantex LA Capsules, Crantex LA Tablets, Deconex, Deconsal II, Deconsal Pediatric, Despec, Duraphen II, Efasin, Endal, Entex, Entex ER, Entex LA more...

Naftifine Gel Naftifine Gel
Generic Name: Naftifine Gel (NAFF-tih-feen) Brand Name: NaftinNaftifine Gel is used for:Treating athlete's foot, jock itch, or ringworm. It may also be used for other conditions as determined by your doctor. Naftifine Gel is an antifungal gel. Exactly how it works is not known. It is thought to more...

Pernox (Lemon) Topical Pernox (Lemon) Topical
Some commonly used brand names are: In the U.S.— Essential Care Creamy Dandruff Shampoo Essential Care Maximum Strength Dandruff Shampoo Essential Care Medicated Dandruff Wash Meted Pernox (Lemon) Pernox (Regular) Pernox Lathering Abradant Scrub Cleanser (Fresh Scent) Sebex Sebulex (Regul more...