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Nausea/Vomiting of Pregnancy and Hyperemesis Gravidarum
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Cimetidine, famotidine, ranitidine, and nizatidine are approved for use in pregnancy to treat symptoms of heartburn, acid reflux, and H. pylori, which can exacerbate n/v. They may be added if symptoms are present. No RCTs exist regarding their effectiveness for NVP or HG. A meta-analysis showed no increased risk of congenital malformations, risk of spontaneous abortions, or preterm delivery compared to controls [78]. In intractable cases of n/v with positive H. pylori serology, a non-randomized study suggested benefit with triple therapy of ranitidine/flagyl/ampicillin [79].
Autonomic Nervous System Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Metoclopramide 10 mg before meals and at night. Have caution with long-term use, where domperidone up to 10 mg three times per day in adults is preferable. Nizatidine may be helpful in some patients.
Psychotropic-Induced Weight Gain: Liability, Mechanisms and Treatment Approaches
Published in Susan L. McElroy, David B. Allison, George A. Bray, Obesity and Mental Disorders, 2006
Roger S. McIntyre, Jakub Z. Konarski, Paul E. Keck
Histamine antagonists have been employed as an antidote to medication-associated weight gain. Cimetidine has been reported to reduce appetite and weight via activation of the satiety peptide cholecystokinin (CCK) (254,255). Atmaca et al. (256) evaluated nizatidine as an antidote for olanzapine associated weight gain in patients with DSM-IV schizophrenia or related psychoses (n = 132). Patients were randomly assigned to receive olanzapine, 5–20 mg/dL, in combination with nizatidine (150 mg BID, 300 mg BID, or placebo). Patients received prospective repeated observations over 16 weeks. Statistically significant weight loss was noticed in the higher dose nizatidine group, compared with placebo, at week 3 and week 4 (p < 0.05). At 16 weeks, however, there were no significant differences between groups, albeit there was less overall weight gain in the 300 mg nizatidine group (3.9 kg vs. 4.8 kg). In two subsequent smaller double-blind studies, nizatidine treatment (150 mg BID) was associated with significant weight loss in olanzapine-treated patients and reduction in weight gain accrual in quetiapine-treated patients (257).
A multicenter cohort analysis of fractures in histamine-2-receptor antagonist treated pediatric patients
Published in Current Medical Research and Opinion, 2022
Nathan R. Fleishman, Troy Richardson, Thomas M. Attard
The more recent discovery of elevated albeit trace amounts of N‐nitrosodimethylamine (NDMA), a known potent carcinogen, led to the FDA order to withdraw all ranitidine products from the marketplace4. More recently, similar concerns have been raised with nizatidine5. Other concerns regarding H2RA exposure relate to both the drug class as well as the pathophysiologic potential of antisecretory therapy (AST) on gastric secretory germicidal function as well as intestinal absorption. AST has been related to infections most notably C. difficile, enteritis and community-acquired pneumonia in children and adults. Malabsorption or intestinal loss of magnesium, vitamin B12, calcium and iron in AST treated individuals has been supported by a spectrum of evidence. PPI therapy has also been linked to Acute Interstitial Nephritis (AIN) and chronic kidney disease6. Other speculative risks of AST in pediatric patients include Necrotizing Enteropathy (NEC), the later development of allergies and an increased risk of convulsions or seizures7,8.
Glutaraldehyde-crosslinked chitosan-polyethylene oxide nanofibers as a potential gastroretentive delivery system of nizatidine for augmented gastroprotective activity
Published in Drug Delivery, 2021
Walaa Ebrahim Abd El Hady, Osama Abd El-Aazeem Soliman, Hassan Mohamed El Sabbagh, Elham Abdelmonem Mohamed
Nizatidine (NIZ) is a histamine H2-receptor antagonist used for the treatment of ulcer and gastroesophageal reflux (Jain et al., 2015). It is preferentially absorbed in the parietal cells of the gastric mucosa. NIZ showed a high solubility as well as chemical and enzymatic stabilities in the acidic pH of the stomach, yet its therapeutic efficacy following oral administration is limited due to its short half-life (1–2 h), its metabolism by colonic bacteria and its rapid clearance (Jain et al., 2015). The long-term therapy with H2-receptor antagonist and the expected prolonged acid suppression may interfere with the absorption of some drugs, such as lutein, because they require some gastric acid to be absorbed. Hence, the improvement of NIZ delivery and efficacy may reduce the therapy duration and the incidence of this interaction. Accordingly, several studies have been carried out to develop NIZ GRDDSs such as floating pulsatile tablets (Rathnanand & Pannala, 2011), floating osmotic tablet (Sarkar et al., 2014), microballoons (Jain et al., 2015), effervescent gastroretentive tablets (Orugonda et al., 2017), floating tablets (Shahzad et al., 2019), and effervescent floating tablets (Reddy & Tahseen, 2020). These studies did not involve extensive in vivo evaluation. Moreover, NFs as a GRDDS offers a lot of advantages over these systems as discussed above. Thus, the purpose of this study was to prepare and investigate the effects of the optimized glutaraldehyde–crosslinked CS:PEO NFs on the delivery and the gastroprotective potential of NIZ against ethanol-induced gastric injury in rats.
Prescription changes in patients with gastrointestinal disorders after withdrawal of ranitidine: a nationwide population-based cohort study
Published in Current Medical Research and Opinion, 2023
The most prescribed alternative H2RA was famotidine (36.6%), followed by lafutidine (29.6%), cimetidine (16.8%), nizatidine (14.2%), and roxatidine (2.7%). Probably, cimetidine and nizatidine are less utilized because of the concerns about drug interactions attributable to the inhibition of cytochrome isozymes and subsequent NDMA issues21,22. Famotidine is preferred due to its safety and high potency23.