Negative effects of famotidine on cardiac performance assessed by noninvasive hemodynamic measurements

Kirch, Wilhelm; Halabi, Atef; Linde, M; Santos, Sílvia Regina Cavani Jorge; Ohnhaus, E. E.

doi:10.1016/0016-5085(89)90503-9

Cited by 44 publications

(17 citation statements)

References 18 publications

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“…Kirch rt al. [86] reported a decrease in cardiac output and stroke volume (impedance cardiography) and comparable results for STI after oral administration of famotidine. Hinrichsen el a/.…”

Section: Description Of Investigations Perjormedmentioning

confidence: 66%

Haemodynamic effects of H₂‐receptor antagonists

Hinrichsen

Halabi

Kirch

1992

Eur J Clin Investigation

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Section: Description Of Investigations Perjormedmentioning

confidence: 66%

Haemodynamic effects of H₂‐receptor antagonists

Hinrichsen

Halabi

Kirch

1992

Eur J Clin Investigation

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“…3 While the well established H2 receptor blocking agents cimetidine and ranitidine do not seem to have negative influences on cardiac performance,`a recent study indicated that a more potent and longer acting H2 blocker such as famotidine may have these. 8 Nizatidine is a new treatment for peptic ulcer disease. Its effectiveness when administered once daily (300 mg at night)9`0 suggests that it is a potent H2 receptor blocker.…”

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confidence: 99%

Negative chronotropic effects of nizatidine.

Halabi

Kirch

1991

Gut

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Twelve healthy volunteers were given one week's oral treatment with each of 300 mg nizatidine, 40 mg famotidine, and placebo once daily in a randomised, placebo controlled, double blind study. Three hours after administration, nizatidine led to a significant reduction in the mean (SD) resting heart rate compared with placebo (63.6 (6.4) beats/minute on placebo to 55.9 (7.2) beats/minute on nizatidine (p<005)), whereas famotidine did not influence the heart rate significantly. Both drugs, however, increased significantly the preejection period and the ratio of pre-ejection period to left ventricular ejection time on mechanocardiography and led to a significant decrease in cardiac output on impedance cardiography. The exercise heart rate on nizatidine as well as the resting heart rate on concurrent administration ofnizatidine and the P receptor blocking agent atenolol were subsequently investigated in the same volunteers. Nizatidine slightly inhibited exercise tachycardia by 4.4% (p<0.05). When compared with placebo, the mean resting heart rate was decreased on atenolol alone by a mean of 10.6 beats/minute (p<0.01) and fell further on coadministration with nizatidine to a total of 16.1 beats/minute (p<005 versus atenolol alone).In conclusion, the effect of nizatidine in reducing the heart rate needs careful evaluation in elderly patients with heart failure or those also taking P3 blockers. In contrast to famotidine, long term treatment with 300 mg nizatidine a day has mainly negative chronotropic effects. Haemodynamic parameters were measured non-invasively using mechanocardiography (systolic time intervals) and impedance cardiography. Blood pressure (Riva-Rocci method) was also determined. Subjects were tested on the first and seventh treatment days before and at 90 minutes and three, six, and 12 hours after administration of the test substances, thereby permitting determination of haemodynamic effects after single and repeated dosing of these drugs.The results of the preceding study prompted us to perform additional investigations. Firstly, the effects of nizatidine on non-invasively measured haemodynamic parameters were studied when combined with the P adrenergic blocking agent atenolol. This was a placebo controlled, randomised, double blind, cross over study wherein the same 12 healthy volunteers were each treated for one week periods with either placebo, 100 mg atenolol (plus one tablet placebo), or 300 mg nizatidine combined with 100 mg atenolol taken once daily; cross over was again separated by two week, wash out periods. All drugs were prepared as identically looking capsules. Impedance-and mechanocardiographic parameters were measured on the seventh treatment day before and at 90 minutes and three, six, and 12 hours after administration of the drugs.Secondly, changes in heart rate after submaximal ergometric bicycle exercise were also determined. Testing of the same 12 subjects was carried out in a double blind fashion after treatment for one week on placebo and after one week on oral nizatidine...

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“…Bei der in-traven6sen Bolusapplikation von H2-Blockern, insbesondere von Cimetidin, wurden negative chrono-und inotrope kardiale Effekte beobachtet, die durch eine kontinuierliche intraven6se Applikation vermieden werden [5,31]. Bei der in-traven6sen Bolusapplikation von H2-Blockern, insbesondere von Cimetidin, wurden negative chrono-und inotrope kardiale Effekte beobachtet, die durch eine kontinuierliche intraven6se Applikation vermieden werden [5,31].…”

Section: Durchf• Der Prophylaxeunclassified