NIZATIDINE

NIZATIDINE
(ni-za'ti-deen)
Axid, Axid AR
Classifications: h2-receptor antagonist; antisecretory;
Therapeutic: antiulcer
; h2-receptor antagonist
Prototype: Cimetidine
Pregnancy Category: B

Availability

75 mg tablets; 150 mg, 300 mg capsules; 15 mg/mL oral solution

Action

Inhibits secretion of gastric acid by reversible, competitive blockage of histamine at the H2 receptor, particularly those in the gastric parietal cells.

Therapeutic Effect

Significantly reduces nocturnal gastric acid secretion for up to 12 h.

Uses

Active duodenal ulcers; maintenance therapy for duodenal ulcers.

Contraindications

Hypersensitivity to nizatidine; lactation; children ≤12 y.

Cautious Use

Hypersensitivity to other H2-receptor antagonists; renal impairment or renal failure; older adults; pregnancy (category B).

Route & Dosage

Active Duodenal Ulcer
Adult: PO 150 mg b.i.d. or 300 mg h.s.

Maintenance Therapy
Adult: PO 150 mg h.s.

Administration

Oral
  • Give drug usually once daily at bedtime. Dose may be divided and given twice daily.
  • Administer oral liquid drug using a calibrated measuring device.
  • Be aware that antacids consisting of aluminum and magnesium hydroxides with simethicone decrease nizatidine absorption by about 10%. Administer the antacid 2 h after nizatidine.

Adverse Effects (≥1%)

CNS: Somnolence, fatigue. Skin: Pruritus, sweating. Metabolic: Hyperuricemia.

Interactions

Drug: May decrease absorption of delavirdine, didanosine, itraconazole, ketoconazole; antacids may decrease absorption of nizatidine. May increase alcohol levels.

Pharmacokinetics

Absorption: >90% from GI tract. Peak: 0.5–3 h. Metabolism: In liver. Elimination: 60% in urine unchanged. Half-Life: 1–2 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor patient for alleviation of symptoms. Most ulcers should heal within 4 wk.
  • Monitor cardiac patient's apical pulse because asymptomatic ventricular tachycardia is an adverse effect of the drug.
  • Monitor for persistence of ulcer symptoms in patients who continue to smoke during therapy.
  • Lab tests: Monitor liver enzyme studies (AST, ALT) and alkaline phosphatase. Nizatidine may cause hepatocellular injury.

Patient & Family Education

  • Take medications for the full course of therapy even though symptoms may be relieved.
  • Do not take other prescription or OTC medications without consulting physician.
  • Stop smoking; smoking adversely affects healing of ulcers and effectiveness of the drug.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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