Famotidine

Indications
 Oral
Benign gastric and duodenal ulceration
Adult: 40 mg daily at bedtime for 4-8 wk or 20 mg bid. To prevent recurrence of duodenal ulceration: 20 mg at bedtime may be taken.
CrCl (ml/min)Dosage Recommendation
<50Halve the dose or increase dosing interval to 36-48 hr.

Oral
Gastro-oesophageal reflux disease
Adult: 20 mg bid for 6-12 wk or up to 40 mg bid if there is oesophageal ulceration. Maintenance dose: 20 mg bid may be given to prevent recurrence.
Child: 1-16 yr: 1-2 mg/kg/day divided bid up to 40 mg bid.
CrCl (ml/min)Dosage Recommendation
<50Halve the dose or increase dosing interval to 36-48 hr.

Oral
Zollinger-Ellison syndrome
Adult: Initially, 20 mg every 6 hr, up to 800 mg daily if necessary.
Child: 1-16 yr: 0.5-1 mg/kg/day up to 40 mg/day, given once at bedtime or taken bid.
CrCl (ml/min)Dosage Recommendation
<50Halve the dose or increase dosing interval to 36-48 hr.

Oral
Non-ulcer dyspepsia
Adult: 10 mg bid.
CrCl (ml/min)Dosage Recommendation
<50Halve the dose or increase dosing interval to 36-48 hr.

Oral
Heartburn
Adult: 10 mg bid.
CrCl (ml/min)Dosage Recommendation
<50Halve the dose or increase dosing interval to 36-48 hr.

Intravenous
Benign gastric and duodenal ulceration
Adult: 20 mg every 12 hr, as an inj over at least 2 minutes or as an infusion over 15-30 minutes.
CrCl (ml/min)Dosage Recommendation
<50Halve the dose or increase dosing interval to 36-48 hr.


Special Populations: Reduce dose to 50% in patients with renal impairment (CrCl <10 mL/min).
Contraindications
 Hypersensitivity; lactation.
Warnings / Precautions
 Impaired renal function, liver cirrhosis; pregnancy. Possibility of malignancy should be considered prior to initiating treatment as drug may mask symptoms and delay diagnosis. No safety and efficacy data is available for children <1 yr.
Adverse Reactions
 Headache, dizziness, constipation, diarrhoea, nausea, rash, GI discomfort, fatigue, gynaecomastia, impotence.
Drug Interactions
 Reduced absorption of famotidine with antacids hence admin should be separated by 2 hr. Reduced absorption of ketoconazole and itraconazole. Avoid ethanol (may cause gastric mucosal irritation).
See Below for More famotidine Drug Interactions
Mechanism of Actions
 Famotidine competitively blocks histamine H2-receptors thus reducing basal, nocturnal and stimulated gastric acid secretion. Pepsin secretion is reduced resulting in decreased peptic activity. It effectively heals duodenal and gastric ulcers and prevents recurrence.
Absorption: Readily but incompletely absorbed from the GI tract; peak plasma concentrations after 1-3 hr (oral).
Distribution: Enters the breast milk. Protein-binding: 15-20%.
Metabolism: Hepatic (small proportion); converted to famotidine S-oxide.
Excretion: Urine (as unchanged) within 24 hr; 2.5-3.5 hr (elimination half-life).
Administration
 May be taken with or without food.
Storage Conditions
 Intravenous: Refrigerate at 2-8°C. Do not freeze. Oral: Store below 25°C.
ATC Classification
 A02BA03 - famotidine ; Belongs to the class of H2-receptor antagonists. Used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).
Storage
 Intravenous: Refrigerate at 2-8°C. Do not freeze. Oral: Store below 25°C.
Available As
  • Famotidine 10 mg
  • Famotidine 20 mg
  • Famotidine USP 20 mg
  • Famotidine BP 20 mg
  • Famotidine 40 mg

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