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
|
