From the Guidelines
H2 blockers are used to suppress gastric acid production and are effective in treating conditions such as peptic ulcers, gastroesophageal reflux disease (GORD), and preventing NSAID-induced ulcers.
Uses of H2 Blockers
- Peptic Ulcer Disease: H2 blockers, such as famotidine, can reduce the risk of duodenal ulcers associated with NSAID use 1.
- Gastroesophageal Reflux Disease (GORD): H2 blockers can improve control of GORD symptoms in some patients, especially when used in addition to proton pump inhibitors (PPIs) 1.
- NSAID-induced Ulcers: H2 blockers can prevent NSAID-induced ulcers, especially in patients with a history of prior ulcers 1.
Efficacy of H2 Blockers
- Standard Doses: Standard doses of H2 blockers can reduce gastric acid production by 37% to 68% over 24 hours 1.
- Comparison to PPIs: While PPIs may be more effective than H2 blockers in preventing upper GI bleeding 1 and symptom control in patients with reflux disease 1, H2 blockers are still a useful treatment option.
Important Considerations
- Side Effects: Long-term side effects of H2 blockers, such as osteoporosis, GI infections, and pneumonia, should be taken into account when prescribing these medications 1.
- Subgroup Benefits: The major benefit from H2 blockers might be limited to those with H. pylori infection 1.
From the Research
Uses of H2 Blockers
- H2 blockers, also known as histamine H2 receptor antagonists, are used to reduce the production of stomach acid [(2,3,4)].
- They are commonly used to treat conditions such as peptic ulcer disease, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome [(2,3,4)].
- H2 blockers can also be used to prevent stress ulcers and hypersecretory states 3.
- In some cases, H2 blockers may be used in combination with other medications, such as proton pump inhibitors (PPIs), to eliminate nocturnal acid breakthrough episodes 2.
Mechanism of Action
- H2 blockers work by blocking the action of histamine on parietal cells in the stomach, which reduces the production of gastric acid [(2,3,4)].
- They are highly selective and do not affect H1 receptors or have anticholinergic effects 2.
Special Considerations
- In elderly patients, the dosage of H2 blockers may need to be lowered due to poor renal function 5.
- Certain H2 blockers, such as cimetidine, may interact with other medications and should be used with caution 5.
- The use of H2 blockers in hospitalized patients should be rigorously controlled to avoid unnecessary costs and adverse effects 6.