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Peds Calc

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Nizatidine Indications & Clinical Uses

Evidence-based guide for pediatric prescribing

Nizatidine is an H2 receptor antagonist used when short-term acid suppression is required and drug–drug interaction risk needs to be minimized compared with cimetidine.

Primary FDA-Approved Indications

Consider nizatidine for mild GERD symptoms, nocturnal acid breakthrough, or as a bridge while awaiting proton pump inhibitor effect. Reassess the need for therapy after 2–4 weeks to avoid tachyphylaxis.

Symptomatic gastroesophageal reflux disease (without erosive disease)

FDA Approved
Children ≥12 years (label); off-label specialist use down to infantsModerate

Dosed 5–10 mg/kg/day divided BID; reassess for PPI transition if symptoms persist beyond 4 weeks.

Evidence Sources

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Secondary Clinical Uses

Bedtime adjunct for nocturnal acid breakthrough on optimized PPI therapy

Secondary Use
AdolescentsLow

Use 75–150 mg at bedtime for ≤14 nights while troubleshooting lifestyle triggers or PPI timing.

Evidence Sources

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Off-Label Uses

Note: Off-label uses may be clinically appropriate based on evidence and expert consensus, but are not FDA-approved for these indications. Always consider the evidence base and document clinical reasoning.

Stress ulcer prophylaxis in critically ill adolescents

Off-Label
ICU patients when PPIs are contraindicated

Reserved for short courses with close monitoring of renal function and mental status.

Evidence Sources

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•Evidence quality: 75/10
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