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A Unique Molecule with Prokinetic Activity. --Nizatidine is different from other histamine H2-receptor antagonists and has unique properties other than its gastric antisecretory activity.1. 

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A Unique Molecule with Prokinetic Activity

--Nizatidine is different from other histamine H2-receptor antagonists and  has unique properties other than its gastric antisecretory activity.1

Multiple studies have reported the prokinetic activity for         -Nizatidine that is comparable to that of the prokinetic agent cisapride.2
 This prokinetic activity is due to          ’s-Nizatidine noncompetitive inhibition of acetylcholinesterase.2

1. Ueki S, Matsunaga Y, Yoneta T, Tamaki H, Itoh Z. Gastroprokinetic activity of nizatidine during the digestive state in the dog and rat. Arzneimittelforschung. 1999;49(7):618-25. 2. Zarling EJ. Prokinetic activity of nizatidine: implications for the management of patients with gastroesophageal reflux disease. Clin Ther. 1999;21(12):2038-46. 3. IWAKIRI K, KAWAMIN, SANO H, et al. The effects of nizatidine on transient lower esophageal sphincter relaxations (TLESRs) and acid reflux in healthy subjects. J. Smooth Muscle Res. 2011;47(6):157–166. 4. Takeuchi K, Kawauchi S, Araki H, Ueki S, Furukawa O. Stimulation by nizatidine, a histamine H2-receptor antagonist, of duodenal HCO3- secretion in rats: relation to anti-cholinesterase activity. World J Gastroenterol. 2000;6(5):651-658.

-Nizatidine increases the lower esophageal sphincter pressure.3 -Nizatidine stimulates gastric emptying.3 -Nizatidine stimulates duodenal bicarbonate secretion.4

A very Safe H2 Antagonist. Nizatidine FDA prescribing information. Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications Ther Adv Drug Saf. 2013;4(3):125-133. Eom CS, Park SM, Myung SK, Yun JM, Ahn JS. Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies. Ann Fam Med. 2011;9(3):257-267.. 

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Nizatidine FDA prescribing information. Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications Ther Adv Drug Saf. 2013;4(3):125-133. Eom CS, Park SM, Myung SK, Yun JM, Ahn JS. Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies. Ann Fam Med. 2011;9(3):257-267.

-Nizatidine doesn’t affect serum gastrin with no rebound rate.1

-Nizatidine had no demonstrable antiandrogenic action.1

-Nizatidine does not lower serum vitamin B12 level.2

-Nizatidine is not associated with an increased fracture risk.3

Why Fixit?. Potent histamine H2 receptor antagonist.1. 

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1. Nizatidine summary of product characteristics. Available at: https://www.medicines.org.uk/emc/product/2711/smpc/print. Last accessed at: 11.10.2023. 2. Baraka A, Jabbour-Khoury S, Karam V, et al. Correlation of the end-tidal PCO2 during laparoscopic surgery with the pH of the gastric juice. JSLS: Journal of the Society of Laparoendoscopic Surgeons.  1998;2(2):163-167 3. Zarling EJ. Prokinetic activity of nizatidine: implications for the management of patients with gastroesophageal reflux disease. Clinical therapeutics. 1999;21(12):2038-46. 4. Kovacs TO, Van Deventer GM, Maxwell V, Sytnik B, Walsh JH. The effect of an oral evening dose of nizatidine on nocturnal and peptone-stimulated gastric acid and gastrin secretion. Scand J Gastroenterol Suppl. 1987;136:41-6. 5. Simon B, Müller P. Nizatidine in therapy and prevention of non-steroidal anti-inflammatory drug-induced gastroduodenal ulcer in rheumatic patients. Scand J Gastroenterol Suppl. 1994;206:25-8. 6. Futagami S, Shimpuku M, Song JM, et al. Nizatidine Improves Clinical Symptoms and Gastric Emptying in Patients with Functional Dyspepsia Accompanied by Impaired Gastric Emptying. Digestion. 2012;86:114–121. 7. Battaglia G, Mario FD, Vigneri S, Santo PD, Pilotto A, Mazzacca G, GISU (INTERDISCIPLINARY ULCER STUDY GROUP), ITALIAN CENTRES. Peptic ulcer in the elderly—a double-blind, short-term study comparing nizatidine 300 mg with ranitidine 300 mg. Alimentary pharmacology & therapeutics. 1993;7(6):643-8. 8. Nizatidine FDA prescribing information. 9. Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Ther Adv Drug Saf. 2013;4(3):125-133. 10. Eom CS, Park SM, Myung SK, Yun JM, Ahn JS. Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies. Ann Fam Med. 2011;9(3):257-267. 11. H. Pylori Urea Breath Test. Standard Health Care. Available at: https://stanfordhealthcare.org/content/dam/SHC/clinics/menlo-medical clinic/docs/gastroenterology/MMC_HPyloriUreaBreathTest.pdf. Last accessed at: 11.10.2023. 12. Hamamoto N, Hashimoto T, Adachi K, et al. Comparative study of nizatidine and famotidine for maintenance therapy of erosive esophagitis. Journal of gastroenterology and hepatology. 2005;20(2):281-6.

NSAIDS: Non-steroidal anti-inflammatory drugs; GI: Gastrointestinal; FD: Functional dyspepsia.

Potent histamine H2 receptor antagonist.1

Characterized by short onset to peak effect.2

Produces long-lasting suppression of overnight acid secretion.4

Effective in the therapy as well as in the prevention of NSAID-induced gastroduodenal ulcers in the upper GI tract.5

Significantly improved both gastric emptying and clinical symptoms in FD patients with impaired gastric emptying.6

Effective treatment for acute peptic ulcer in the elderly.7

More effective than famotidine in the maintenance therapy of patients with reflux esophagitis.12

Dosage Regimen. Condition OERD Active benign gastric ulcer •nd•nal Maintenance of healed duodenal ulcer Recommended dose 300 mg given either as 150 mg twice daily or 300 mg once daily at bedtime 150 mg once g daily at bedtime Alternative dose Duration UP to 8 weeks. 

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Condition
OERD
Active benign
gastric ulcer
•nd•nal
Maintenance of
healed duodenal
ulcer
Recommended dose
300 mg given either as 150 mg
twice daily or
300 mg once daily at bedtime
150 mg once g daily at bedtime
Alternative dose
Duration
UP to 8 weeks

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 1. Nizatidine summary of product characteristics. Available at: https://www.medicines.org.uk/emc/product/2711/smpc/print. Last accessed at: 11.10.2023. 2. Baraka A, Jabbour-Khoury S, Karam V, et al. Correlation of the end-tidal PCO2 during laparoscopic surgery with the pH of the gastric juice. JSLS: Journal of the Society of Laparoendoscopic Surgeons.  1998;2(2):163-167 3. Zarling EJ. Prokinetic activity of nizatidine: implications for the management of patients with gastroesophageal reflux disease. Clinical therapeutics. 1999;21(12):2038-46. 4. Kovacs TO, Van Deventer GM, Maxwell V, Sytnik B, Walsh JH. The effect of an oral evening dose of nizatidine on nocturnal and peptone-stimulated gastric acid and gastrin secretion. Scand J Gastroenterol Suppl. 1987;136:41-6. 5. Simon B, Müller P. Nizatidine in therapy and prevention of non-steroidal anti-inflammatory drug-induced gastroduodenal ulcer in rheumatic patients. Scand J Gastroenterol Suppl. 1994;206:25-8. 6. Futagami S, Shimpuku M, Song JM, et al. Nizatidine Improves Clinical Symptoms and Gastric Emptying in Patients with Functional Dyspepsia Accompanied by Impaired Gastric Emptying. Digestion. 2012;86:114–121. 7. Battaglia G, Mario FD, Vigneri S, Santo PD, Pilotto A, Mazzacca G, GISU (INTERDISCIPLINARY ULCER STUDY GROUP), ITALIAN CENTRES. Peptic ulcer in the elderly—a double-blind, short-term study comparing nizatidine 300 mg with ranitidine 300 mg. Alimentary pharmacology & therapeutics. 1993;7(6):643-8. 8. Nizatidine FDA prescribing information. 9. Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Ther Adv Drug Saf. 2013;4(3):125-133. 10. Eom CS, Park SM, Myung SK, Yun JM, Ahn JS. Use of Acid-Suppressive Drugs and Risk of Fracture: A Meta-analysis of Observational Studies. Ann Fam Med. 2011;9(3):257-267. 11. H. Pylori Urea Breath Test. Standard Health Care. Available at: https://stanfordhealthcare.org/content/dam/SHC/clinics/menlo-medical clinic/docs/gastroenterology/MMC_HPyloriUreaBreathTest.pdf. Last accessed at: 11.10.2023. 12. Hamamoto N, Hashimoto T, Adachi K, et al. Comparative study of nizatidine and famotidine for maintenance therapy of erosive esophagitis. Journal of gastroenterology and hepatology. 2005;20(2):281-6.

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