Antihistamines, h2-antagonists

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.09.2021

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Synonym(s)

H2 antagonists; H2-receptor blockers

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.

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 hepatic dysfunction, anuria .

Tables
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Major interactions of H2 antagonists

Acenocoumarol

Bleeding tendency ↑

Barbiturates

Barbiturate levels ↑

Captopril

Neuropathy ↑

Carbamazepine

Carbamazepine levels ↑

Carmustine

Carmustine toxicity ↑, myelosuppression ↑

Chlordiazepoxide

Chlordiazepoxide levels ↑

Chlorpromazine

Fatigue ↑

Clomethiazole

Clomethiazole levels ↑

Digitoxin

Digitoxin toxicity ↑

Diltiazem

Diltiazem toxicity ↑

Iron

Iron level ↓

Erythromycin

Erythromycin toxicity ↑, hearing impairment ↑.

Halofrantine

Halofrantine bioavailability ↓, avoid combination.

Hydromorphone

Hydromorphone levels ↑

Isradipine

Isradipine levels ↑, RR drop, halve dose of isradipine

Itraconazole

Itraconazole levels ↓, take 2 hrs apart.

Ketoconazole

Ketoconazole level ↓

Labetalol

Labetalol level ↑

Levomethadone

Levomethadone level ↑

Lidocaine i.v.

Lidocaine level ↑, halve lidocaine dose.

Magnesium antacids

H2 antagonist levels ↓, take 2 hrs apart.

Mebendazole

Mebendazole levels ↑

Metformin

Metformin levels↑, lactic acidosis

Metoclopramide

H2 antagonist levels ↓, take 2 hrs apart.

Metoprolol

Metoprolol levels ↑, bradycardia

Nifedipine

Nifedipine level ↑, RR drop.

Nicotine abuse

H2 antagonist effect ↓

Opioid analgesics

Opioid toxicity ↑, seizures, confusional states, respiratory failure

Phenytoin

Phenytoin levels ↑.

Procainamide

Procainamide levels ↑, 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 main H2 antagonists and their dosage.

Active ingredient

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

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Last updated on: 13.09.2021