Dot gov

Official websites use the Texas HHS logo.
The Texas HHS logo means this is an official website of Texas Health and Human Services.

HTTPS

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

1.3. Dosage in Renal Impairment

H2RAs are primarily renally excreted. Dosage modifications for H2RA use in renal impairment are summarized in Table 6.

Table 6. H2RA Dosage Modifications in Renal Impairment1-10
Drug Name Dosage Adjustments in Renal Impairment
cimetidine
  • CrCl greater than or equal to 30 mL/min: No dose adjustment recommendations
  • CrCl less than 30 ml/min: 300 mg orally every 12 hours; may increase to every 8 hours cautiously based on patient response
famotidine
  • CrCl 30-60 mL/min
    • active duodenal ulcer, active gastric ulcer, and erosive esophagitis diagnosed by endoscopy: 20 mg orally daily; or 40 mg orally every other day 
    • symptomatic non-erosive GERD: 20 mg orally daily
    • risk reduction of duodenal ulcer recurrence: 20 mg orally every other day
    • pathological hypersecretory conditions: avoid use
  • CrCl less than 30 mL/min
    • active duodenal ulcer, active gastric ulcer, erosive esophagitis diagnosed by endoscopy, and symptomatic non-erosive GERD: 10 mg orally daily; or 20 mg orally every other day 
    • risk reduction of duodenal ulcer recurrence: 10 mg orally every other day
    • pathological hypersecretory conditions: avoid usenizatidine
nizatidine

active treatment:

  • CrCl 20-50 ml/min: 150 mg/day orally 
  • CrCl less than 20 ml/min: 150 mg orally every other day

maintenance therapy:

  • CrCl 20-50 ml/min: 150 mg every other day orally
  • CrCl less than 20 ml/min: 150 mg every 3 days orally