Nizatidine

How it works

It competitively blocks histamine H2 receptors on gastric parietal cells, reducing both basal and stimulated gastric acid secretion.

Prescribing in practice

• Exclude gastric malignancy before treatment, as acid suppression can mask the symptoms of gastric cancer.
• Dose adjustment is needed in renal impairment because the drug is largely renally cleared.
• It is generally well tolerated but its acid-lowering effect can alter absorption of pH-dependent medicines.

Monitoring

Routine laboratory monitoring is not usually required, but review symptom response and renal function where relevant.

Counselling the patient

• Advise patients to report persistent or alarm symptoms such as difficulty swallowing, weight loss or vomiting.
• Explain that the medicine reduces stomach acid and that lifestyle measures support reflux control.

Evidence & guidelines

H2-receptor antagonists such as nizatidine are well-established acid-suppressing agents, used in line with current prescribing references and NICE dyspepsia guidance.