nizatidine (Rx)

Brand and Other Names:Axid
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 150mg
  • 300mg

oral solution

  • 15mg/mL

tablet

  • 75mg

Doage Forms & Strengths

capsule

  • 150mg
  • 300mg

oral solution

  • 15mg/mL

tablet

  • 75mg

Active Duodenal Ulcer

300 mg PO qHS OR

150 mg PO q12hr

Most heal after 4 weeks

Duodenal Ulcer Maintenance

150 mg PO qHS

Benign Gastric Ulcer

300 mg PO qHS OR

150 mg PO q12hr

GERD

150 mg PO q12hr OR

300 mg PO qHS

Renal Impairment

Active duodenal ulcer, gastric ulcer, GERD

  • CrCl 20-50 mL/min: 150 mg PO qDay
  • CrCl <20 mL/min: 150 mg PO qOTHERday

Duodenal ulcer maintenance

  • CrCl 20-50 mL/min: 150 mg PO qOTHERday
  • CrCl < 20 mL/min: 150 mg PO q3Days

Other Indications & Uses

Heartburn (OTC product)

Dosage Forms & Strengths

capsule

  • 150mg
  • 300mg

oral solution

  • 15mg/mL

tablet

  • 75mg

GERD

<12 years: 5-10 mg/kg/day PO divided q12hr (limited data)  

Active duodenal ulcer

300 mg PO qHS OR

150 mg PO q12hr

Most heal after 4 weeks

Duodenal ulcer maintenance

150 mg PO qHS

Benign gastric ulcer

300 mg PO qHS OR150 mg PO q12hr

GERD

150 mg PO q12hr OR

300 mg PO qHS

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Interactions

Interaction Checker

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            Contraindicated (0)

              Serious - Use Alternative (19)

              • atazanavir

                nizatidine will decrease the level or effect of atazanavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Atazanavir solubility decreases as pH increases. Substantially reduced plasma concentrations of atazanavir are expected if H2-receptor antagonists (H2RA) are coadministered. For treatment-naïve patients, take atazanavir simultaneously with the H2RA or at least 10 h afterwards. See dosage adjustment recommendations if coadministered in treatment-experienced patients.

              • bosutinib

                nizatidine will decrease the level or effect of bosutinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • dasatinib

                nizatidine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • digoxin

                nizatidine will increase the level or effect of digoxin by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • erlotinib

                nizatidine will decrease the level or effect of erlotinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • indinavir

                nizatidine will decrease the level or effect of indinavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • infigratinib

                nizatidine will decrease the level or effect of infigratinib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer infigratinib 2 hr before or 10 hr after administration of a H2-antagonist.

              • itraconazole

                nizatidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • ketoconazole

                nizatidine will decrease the level or effect of ketoconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • lonafarnib

                nizatidine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

              • mesalamine

                nizatidine will decrease the level or effect of mesalamine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • neratinib

                nizatidine will decrease the level or effect of neratinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • pazopanib

                nizatidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

              • pexidartinib

                nizatidine will increase the level or effect of pexidartinib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate pexidartinib by 2 hr before or 10 hr after taking an H2-antagonist.

              • pimozide

                nizatidine will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

              • ponatinib

                nizatidine decreases levels of ponatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • risedronate

                nizatidine will increase the level or effect of risedronate by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Applies only to delayed release formulation; accelerates pH-sensitive dissolution of delayed release risedronate

              • secretin

                nizatidine, secretin. Other (see comment). Avoid or Use Alternate Drug. Comment: Concomitant use of H2-receptor antagonists may cause a hyperresponse in gastrin secretion in response to stimulation testing with secretin, falsely suggesting gastrinoma. Discontinue H2-receptor antagonists at least 2 days before administering secretin to aid in the diagnosis of gastrinoma.

              • sotorasib

                nizatidine will decrease the level or effect of sotorasib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer sotorasib 4 hr before or 10 hr after administration of a locally-acting antacid.

              Monitor Closely (47)

              • acalabrutinib

                nizatidine decreases levels of acalabrutinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Acalabrutinib solubility decreases with increasing gastric pH. Administer acalabrutinib 2 hr before an H2-receptor antagonist.

              • alendronate

                nizatidine will increase the level or effect of alendronate by unknown mechanism. Use Caution/Monitor.

              • aripiprazole

                nizatidine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

              • avapritinib

                nizatidine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • axitinib

                nizatidine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • budesonide

                nizatidine decreases effects of budesonide by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Enteric-coated budesonide dissolves at pH >5.5. Also, dissolution of extended-release budesonide tablets is pH dependent. Coadministration with drugs that increase gastric pH may cause these budesonide products to prematurely dissolve, and possibly affect release properties and absorption of the drug in the duodenum.

              • carbonyl iron

                nizatidine will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefdinir

                nizatidine will decrease the level or effect of cefdinir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefditoren

                nizatidine will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefpodoxime

                nizatidine will decrease the level or effect of cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefuroxime

                nizatidine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • crizotinib

                nizatidine decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .

              • cyclosporine

                nizatidine will increase the level or effect of cyclosporine by unknown mechanism. Use Caution/Monitor.

              • dabrafenib

                nizatidine will decrease the level or effect of dabrafenib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that alter upper GI tract pH (eg, PPIs, H2-blockers, antacids) may decrease dabrafenib solubility and reduce its bioavailability

              • dexmethylphenidate

                nizatidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. applies only to extended release formulation

              • dofetilide

                nizatidine will increase the level or effect of dofetilide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

              • erlotinib

                nizatidine decreases levels of erlotinib by Other (see comment). Use Caution/Monitor. Comment: Avoid combination when possible. If concurrent use is required erlotinib should be taken 10 hours after a H2-antagonist and at least 2 hours before the next dose of H2-antagonist.

              • ferric maltol

                nizatidine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous fumarate

                nizatidine will decrease the level or effect of ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous gluconate

                nizatidine will decrease the level or effect of ferrous gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous sulfate

                nizatidine will decrease the level or effect of ferrous sulfate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • finerenone

                nizatidine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

              • flibanserin

                nizatidine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

              • fosamprenavir

                nizatidine will decrease the level or effect of fosamprenavir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • gefitinib

                nizatidine decreases levels of gefitinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Separate gefitinib and H2-antagonist doses by at least 6 hr.

              • iron dextran complex

                nizatidine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • iron sucrose

                nizatidine will decrease the level or effect of iron sucrose by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ivacaftor

                nizatidine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

              • ledipasvir/sofosbuvir

                nizatidine decreases levels of ledipasvir/sofosbuvir by Other (see comment). Use Caution/Monitor. Comment: Ledipasvir solubility decreases as pH increases; drugs that increase gastric pH are expected to decrease levels of ledipasvir; H2-receptor antagonists may be administered simultaneously with or 12 hr apart from ledipasvir/sofosbuvir at a dose that does not exceed doses comparable to famotidine 40 mg BID.

              • lemborexant

                nizatidine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

              • lomitapide

                nizatidine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

              • metformin

                nizatidine will increase the level or effect of metformin by decreasing renal clearance. Modify Therapy/Monitor Closely.

              • methylphenidate

                nizatidine will increase the level or effect of methylphenidate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies only to extended release formulation

                nizatidine decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.

              • midazolam intranasal

                nizatidine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

              • mycophenolate

                nizatidine will decrease the level or effect of mycophenolate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • nelfinavir

                nizatidine will decrease the level or effect of nelfinavir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • nilotinib

                nizatidine decreases levels of nilotinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Avoid this interaction by administering H2 antagonists 10 hr after or 2 hr before nilotinib.

              • polysaccharide iron

                nizatidine will decrease the level or effect of polysaccharide iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • posaconazole

                nizatidine will decrease the level or effect of posaconazole by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • rilpivirine

                nizatidine will decrease the level or effect of rilpivirine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Concurrent use, may cause treatment failure and/or the development of rilpivirine or NNRTI resistance owing to decreased levels. Administer H2 antagonists at least 12 hours before or at least 4 hours after rilpivirine.

              • rose hips

                nizatidine will decrease the level or effect of rose hips by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • saquinavir

                nizatidine will increase the level or effect of saquinavir by unspecified interaction mechanism. Use Caution/Monitor.

              • sofosbuvir/velpatasvir

                nizatidine will decrease the level or effect of sofosbuvir/velpatasvir by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Velpatasvir solubility decreases as gastric pH increases (practically insoluble at pH >5). H2 receptor antagonists may be administered simultaneously with or 12 hr apart from sofosbuvir/velpatasvir at a dose that does not exceed doses comparable to famotidine 40 mg BID.

              • tazemetostat

                nizatidine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tinidazole

                nizatidine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • varenicline

                nizatidine will increase the level or effect of varenicline by decreasing renal clearance. Use Caution/Monitor.

              • vismodegib

                nizatidine will decrease the level or effect of vismodegib by Other (see comment). Use Caution/Monitor. Drugs that increase gastric pH alter vismodegib solubility and therefore reduce bioavailability; effect on efficacy unknown

              Minor (8)

              • blessed thistle

                blessed thistle decreases effects of nizatidine by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

              • ceftibuten

                nizatidine will increase the level or effect of ceftibuten by unspecified interaction mechanism. Minor/Significance Unknown.

              • cyanocobalamin

                nizatidine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • devil's claw

                devil's claw decreases effects of nizatidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • glipizide

                nizatidine will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

              • glyburide

                nizatidine will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

              • phytoestrogens

                nizatidine decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • tolbutamide

                nizatidine will increase the level or effect of tolbutamide by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Headache (17%)

              1-10%

              Abdominal pain

              Anxiety

              Constipation

              Diarrhea

              Dizziness

              Insomnia

              Nausea/vomiting

              Pruritus

              <1%

              Anemia

              Increased LFT's

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              Warnings

              Contraindications

              Hypersensitivity to nizatidine or other H2 receptor antagonists

              Cautions

              Adjust dosage in renal impairment; patients with kidney disease should ask doctor before use

              If patient taking a prescription drug, the patient should ask a doctor or a pharmacist whether acid reducers can be taken concomitantly with it

              Prolonged therapy may lead to vitamin B12 malabsorption and subsequently, deficiency

              Relief of symptoms does not preclude absence of malignancy

              Increased risk for development of acute gastroenteritis and community acquired pneumonia associated reported in pediatric patients

              May see false positive urobilinogen secondary to nizatidine

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              Pregnancy & Lactation

              Pregnancy

              There are no adequate and well-controlled studies in pregnant women

              Animal data

              • Oral reproduction studies in pregnant rats at doses up to 1500 mg/kg/day (9000 mg/m2/day, 40.5 times the recommended human dose based on body surface area [BSA]) and in pregnant rabbits at doses up to 275 mg/kg/day (3245 mg/m2/day, 14.6 times the recommended human dose based on BSA) have revealed no evidence of impaired fertility or harm to the fetus
              • Because animal reproduction studies are not always predictive of human response, use only during pregnancy if clearly needed

              Lactation

              Studies conducted in lactating women showed that 0.1% of orally administered nizatidine is secreted in human milk in proportion to plasma concentrations

              Because of the growth depression in pups reared by lactating rats treated with nizatidine, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              H2-receptor antagonist; blocks H2-receptors of gastric parietal cells, leading to inhibition of gastric secretions

              Pharmacokinetics

              Half-Life: 2.5-3hr (PO); 2-2.5hr (IV)

              Peak Plasma Time: 2-3hr (PO); <15 min (IM)

              Absorption: 50% (oral)

              Bioavailability: 48-50% (PO); 90-100% (IM)

              Protein Bound: 15%

              Vd: 0.8-1.5 L/kg

              Metabolism: Liver, unlike cimetidine, nizatidine does not inhibit microsomal enzymes

              Metabolites: N-desmethylnizatidine (active), nizatidine N-oxide (inactive), nizatidine S-oxide (inactive)

              Dialyzable: No

              Clearance

              • Total Body: 660-1000 mL/min
              • Renal: 500 mL/min (Not dialyzable by HD)

              Excretion

              • Urine: 30% (PO); 70% (IV)
              • Feces: <6%
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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              nizatidine oral
              -
              300 mg capsule
              nizatidine oral
              -
              150 mg/10 mL solution
              nizatidine oral
              -
              300 mg capsule
              nizatidine oral
              -
              150 mg capsule
              nizatidine oral
              -
              150 mg capsule
              nizatidine oral
              -
              150 mg capsule
              nizatidine oral
              -
              300 mg capsule
              nizatidine oral
              -
              150 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              nizatidine oral

              NIZATIDINE - ORAL

              (nye-ZA-ti-deen)

              COMMON BRAND NAME(S): Axid

              USES: Nizatidine is used to treat ulcers of the stomach and intestines and prevent them from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems (such as erosive esophagitis, gastroesophageal reflux disease-GERD). It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as cough that doesn't go away, stomach pain, heartburn, and difficulty swallowing. Nizatidine belongs to a class of drugs known as H2 blockers.

              HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once or twice a day. If you are taking this medication once daily, it is usually taken right before bedtime. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.The dosage and length of treatment are based on your medical condition and response to treatment. Follow your doctor's instructions carefully.If needed, antacids may be taken along with this medication.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Continue to take this medication for the prescribed length of treatment even if you are feeling better.Tell your doctor if your condition does not improve or if it worsens.

              SIDE EFFECTS: Headache or diarrhea may occur. If either of these effects persists or worsens, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine, confusion, breast swelling/soreness in males, easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever, chills), fast/pounding heartbeat, unusual tiredness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking nizatidine, tell your doctor or pharmacist if you are allergic to it; or to other H2 blockers (cimetidine, famotidine, ranitidine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: immune system problems, kidney problems, liver problems, certain lung diseases (such as chronic obstructive pulmonary disease-COPD), other stomach problems (such as tumors).Some symptoms may actually be signs of a more serious condition. Get medical help right away if you have: heartburn with lightheadedness/sweating/dizziness, chest/jaw/arm/shoulder pain (especially with shortness of breath, unusual sweating), unexplained weight loss.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products need stomach acid so that the body can absorb them properly. Nizatidine decreases stomach acid, so it may change how well these products work. Some affected products include atazanavir, dasatinib, delavirdine, certain azole antifungals (such as itraconazole, ketoconazole), pazopanib, among others.Do not take this medication with other products that contain nizatidine or other H2 blockers (cimetidine, famotidine, ranitidine).This medication may interfere with certain laboratory tests (including certain urine protein tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.Lifestyle changes such as stress reduction programs, stopping smoking, limiting alcohol, and diet changes (such as avoiding caffeine and certain spices) may help this medication work better. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Laboratory and/or medical tests (such as endoscopy, kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.