In CrCl less than 50 mL/min, what adjustment is recommended for nizatidine?

• A. No adjustment
• B. Reduce dose
• C. Stop therapy
• D. Increase dose

Answer: (B)

When kidney function is reduced, drugs cleared by the kidneys require dosing adjustments to prevent accumulation and toxicity. Nizatidine is eliminated primarily by the kidneys, so with a creatinine clearance under 50 mL/min, the drug should be given at a lower dose (or with a longer dosing interval) to maintain therapeutic levels without causing adverse effects. This is why reducing the dose is the appropriate action. Not adjusting risks buildup; increasing the dose would worsen accumulation; stopping therapy isn’t necessary if there’s ongoing need and tolerable risk.