Antihistamines, h2-antagonists

Synonym(s)

H2 antagonists

Definition
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Drugs that block H2-receptors of the document cells in the stomach and lead to the healing of ventricular and duodenal ulcers by reducing acid secretion.

Indication
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H2-antagonists are used in dermatology as concomitant medication in systemic glucocorticoid, immunosuppressive or cytostatic therapy.

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Allergology

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Limited indication
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Pregnancy, nursing, renal failure.

Dosage and method of use
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S. Tab.

Undesirable effects
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Allergic reactions, CNS disorders, dizziness, blood formation disorders, eosinophilia, bronchospasms, gastrointestinal disorders.

Interactions
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S. Tab.

Contraindication
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Paragroup allergy (applies only to suspensions), sorbitol intolerance (applies only to suspensions), children and adolescents < 16 years, porphyria, severe liver dysfunction, anuria.

Tables
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Essential interactions of H2-antagonists

Acenocoumarol	Bleeding tendency ↑
Barbiturates	Barbiturate levels ↑
Captopril	Neuropathy ↑
Carbamazepine	Carbamazepine levels ↑
Carmustin	Carmustine toxicity ↑, myelosuppression ↑
Chlordiazepoxide	Chlordiazepoxide levels ↑
Chlorpromazine	Tiredness ↑
Clomethiazole	Clomethiazole levels ↑
Digitoxin	Digitoxin toxicity ↑
Diltiazem	Diltiazem toxicity ↑
Iron	Iron Mirrors ↓
Erythromycin	Erythromycin toxicity ↑, hearing impairment ↑
Halofrantin	Halofrantin bioavailability ↓, avoid combination
Hydromorphone	Hydromorphone mirrors ↑
Isradipin	Isradipine levels ↑, RR drop, halve the Isradipine dose
Itraconazole	Itraconazole level ↓, intake 2 hours apart
Ketoconazole	Ketoconazole levels ↓
Labetalol	Labetalol mirrors ↑
Levomethadone	Levomethadone levels ↑
Lidocaine IV.	Lidocaine levels ↑, halve lidocaine dose
Magnesium Antacids	H2-antagonist mirror ↓, to be taken 2 hours apart
Mebendazole	Mebendazole level ↑
Metformin	Metformin-Spiegel↑, Lactate Acidosis
Metoclopramide	H2-antagonist mirror ↓, to be taken 2 hours apart
Metoprolol	Metoprolol levels ↑, bradycardia
Nifedipine	Nifedipine levels ↑, RR waste
Nicotine abuse	H2-antagonist effect ↓
Opioid analgesics	Opioid toxicity ↑, seizures, confusion, respiratory arrest
Phenytoin	Phenytoin levels ↑
Procainamide	Procainamide level ↑, excitation conduction disorders
Propanolol	Propanolol levels ↑, bradycardia
Rifabutin	Rifabutin levels ↑
Sulfonylurea antidiabetics	antidiabetic effect ↑
Terbinafine	Terbinafine levels ↑
Tetracyclines	Tetracycline effect ↓
Theophylline	Theophylline levels ↑
Valproic acid	Valproic acid level ↑
Warfarin	Bleeding tendency ↑
Zidovudine	Zidovudine toxicity ↑

Overview of the most important H2-antagonists and their dosage

Active substance	Dosage	Preparation
Cimetidine	400 mg/day p.o.	Tagamet
Famotidine	20 mg/day p.o. in the evening	Pepdul
Nizatadine	200 mg/day p.o. in the evening	Nizax
Ranitidine	300 mg/day p.o. in the evening	Sostril, Zantic