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Nizatidine oral

Updated 2 Feb 2023 | H2 receptor antagonists


Oral formulations containing nizatidine

Drugs List

  • nizatidine 150mg capsules
  • nizatidine 300mg capsules
  • Therapeutic Indications


    Benign gastric ulcer
    Duodenal ulcer
    Gastric and/or duodenal ulcer associated with NSAIDs
    Gastro-oesophageal reflux disease - treatment
    Prevention of duodenal or benign gastric ulcer recurrence



    Duodenal or benign gastric ulcers (including NSAID associated)
    300 mg every evening or 150 mg in the morning and 150 mg in the evening for 4 weeks.
    Treatment may be stopped earlier than 4 weeks if healing is confirmed by endoscopy
    If ulcer has not healed continue treatment for another 4 weeks. Maximum duration of treatment is 8 weeks.

    During treatment of NSAID associated gastric and/or duodenal ulcer, the use of NSAID may continue.

    Duodenal or benign gastric ulcer prophylactic maintenance therapy
    150 mg in the evening

    Gastric oesophageal reflux disease
    150 mg to 300 mg twice daily. Therapy for up to 12 weeks in indicated for erosions and ulcerations and associated heartburn.

    Patients with Renal Impairment

    Dosage reduction is required in patient with moderate (creatinine clearance less than 50 ml/minute) to severe (creatinine clearance less than 20 ml/minute) renal impairment.

    Creatinine clearance less than 50 ml/minute
    Duodenal ulcer: 150 mg in the evening
    Benign gastric ulcer: 150 mg in the evening
    Prevention of duodenal or benign gastric ulcer recurrence: 150 mg in the evening on alternate days
    Gastric oesophageal reflux disease: from 150 mg daily, up to 150 mg twice daily
    Gastric and/or duodenal ulcer associated with concomitant use of NSAIDs: 150 mg in the evening

    Creatinine clearance less than 20 ml/minute
    Duodenal ulcer: 150 mg on alternate days
    Benign gastric ulcer: 150 mg on alternate days
    Prevention of duodenal or benign gastric ulcer recurrence: 150 mg in the evening every third day
    Gastric oesophageal reflux disease: from 150 mg on alternate days, up to 150 mg daily
    Gastric and/or duodenal ulcer associated with concomitant use of NSAIDs: 150 mg on alternate days

    The Renal Drug Handbook suggests:
    Glomerular filtration rate of 20 to 50 ml/minute: 150 mg every 12 to 48 hours
    Glomerular filtration rate of less than 20 ml/minute: 150 mg every 24 to 72 hours


    Children under 18 years

    Precautions and Warnings

    Hepatic impairment
    Renal impairment - creatinine clearance below 50ml/minute

    Exclude gastric cancer before commencing treatment

    Symptomatic response to nizatidine therapy does not preclude the presence of gastric malignancy.

    Pregnancy and Lactation


    Use nizatidine with caution during pregnancy.

    Nizatidine should only be used in pregnant women if the expected benefits are likely to outweigh any potential risks to the foetus.

    Schaefer (2015) suggests that H2 receptor antagonists may be used during pregnancy, with ranitidine being the drug of choice.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Use nizatidine with caution during breastfeeding.

    Nizatidine is excreted in breast milk, with 0.1% of the administered oral dose being secreted in milk in proportion to plasma concentration.

    Schaefer (2015) indicates that famotidine is the H2 receptor blocker of choice whilst breastfeeding. The American Academy of Paediatrics classifies a similar H2 receptor blocker, cimetidine, as compatible with breastfeeding (Briggs, 2015).

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Cholestatic liver changes
    Exfoliative dermatitis
    Increase in alkaline phosphatase
    Increases in hepatic enzymes (reversible)
    Reversible confusional states
    Reversible liver damage
    Thrombocytopenic purpura


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: May 2017

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Nizatidine Capsules. Flynn Pharma Ltd. Revised November 2015.

    The Renal Drug Handbook. Fourth Edition (2014) ed. Ashley, C and Dunleavy, A, Radcliffe Publishing Ltd, London.

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Nizatidine. Last revised: 10 March 2015
    Last accessed: 12 May 2017

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