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Nizatidine is a member of the H-2 blocker (histamine blocker) family of drugs that prevents the release of acid into the stomach. Nizatidine is used to treat stomach and duodenal ulcers and reflux of stomach acid into the esophagus. Nizatidine is available as the prescription drug and as a nonprescription product for relief of heartburn, acid indigestion, and sour stomach.
Common brand names:Axid, Axid AR
Summary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
There is some evidence that other vitamins and minerals, such as folic acid1 and copper,2 require the presence of stomach acid for optimal absorption. Long-term use of H-2 blockers may therefore promote a deficiency of these nutrients. Individuals requiring long-term use of H-2 blockers may therefore benefit from a multiple vitamin/mineral supplement.
Folic acid is needed by the body to utilize vitamin B12. Antacids, including nizatidine, inhibit folic acid absorption.3 People taking antacids are advised to supplement with folic acid.
There is some evidence that other vitamins and minerals, such as folic acid4 and copper,5 require the presence of stomach acid for optimal absorption. Long-term use of H-2 blockers may therefore promote a deficiency of these nutrients. Individuals requiring long-term use of H-2 blockers may therefore benefit from a multiple vitamin/mineral supplement.
Stomach acid is needed for vitamin B12 in food to be absorbed by the body. H-2 blocker drugs reduce stomach acid and may therefore inhibit absorption of the vitamin B12 naturally present in food. However, the vitamin B12 found in supplements does not depend on stomach acid for absorption.6 Lab tests can determine vitamin B12 levels in people.
Omeprazole , a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene.7 It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Stomach acid may increase absorption of iron from food. H-2 blocker drugs reduce stomach acid and are associated with decreased dietary iron absorption.8 The iron found in supplements is available to the body without the need for stomach acid. People with ulcers may be iron deficient due to blood loss. If iron deficiency is present, iron supplementation may be beneficial. Iron levels in the blood can be checked with lab tests.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Reduce Side Effects
In healthy people, a magnesium hydroxide/aluminum hydroxide antacid, taken with nizatidine, decreased nizatidine absorption by 12%.9 People can avoid this interaction by taking nizatidine two hours before or after any aluminum/magnesium-containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
Potential Negative Interaction
1. Russell RM, Krasinski SD, Samloff IM. Correction of impaired folic acid (Pte Glu) absorption by orally administered HCl in subjects with gastric atrophy. Am J Clin Nutr 1984;39:656.
2. Tompsett SL. Factors influencing the absorption of iron and copper from the alimentary tract. Biochem J 1940;34:961-9.
3. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.
4. Russell RM, Krasinski SD, Samloff IM. Correction of impaired folic acid (Pte Glu) absorption by orally administered HCl in subjects with gastric atrophy. Am J Clin Nutr 1984;39:656.
5. Tompsett SL. Factors influencing the absorption of iron and copper from the alimentary tract. Biochem J 1940;34:961-9.
6. Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists.Med Toxicol Adverse Drug Exp 1988;3:430-48.
7. Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-6.
8. Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists.Med Toxicol Adverse Drug Exp 1988;3:430-48.
9. Bachmann KA, Sullivan TJ, Jauregui L, et al. Drug interactions of H2-receptor antagonists. Scand J Gastroenterol Suppl 1994;206:14-9.
Last Review: 03-18-2015
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