Drug Classes

H2 Blocker Drug Class

H2 blockers (histamine H2 receptor antagonists) reduce stomach acid by blocking H2 receptors on gastric parietal cells. In compounded form, they are used for MCAS, GERD, mastocytosis, and patients requiring customized doses or excipient-free liquid formulations.

How It Works

H2 blockers competitively inhibit histamine at H2 receptors on gastric parietal cells, reducing cyclic AMP production and decreasing gastric acid secretion by 70–95% compared to baseline.

Why Compounded?

Liquid formulations for pediatric or dysphagic patients, dye-free and preservative-free formulations, customized doses outside commercial strengths, and combinations with H1 antihistamines for MCAS protocols all require compounding.

Common Uses

  • MCAS (as part of H1/H2 antihistamine protocol)
  • GERD and acid reflux
  • Peptic ulcer disease
  • Systemic mastocytosis
  • Zollinger-Ellison syndrome
  • Pediatric acid hypersecretion

Common Compounded Medications

  • Famotidine Liquid (custom dose, dye-free)
  • Famotidine Capsules (custom strength)
  • Cimetidine Capsules (compounded)
  • Famotidine / Antacid Combination

Regulatory & Safety Notes

Famotidine (Pepcid) and cimetidine are FDA-approved and commercially available. Compounded H2 blockers are indicated when patients need preservative-free formulations, customized doses for pediatric use, or excipient-free capsules for MCAS or food sensitivity patients.

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