Famotidine

Introduction

  • Generic Name: Famotidine
  • Brand Names: Pepcid, Pepcid AC
  • Pharmacological Class: Histamine H2-receptor antagonist
  • Mechanism of Action: Blocks H2 receptors in the stomach lining, reducing the production of stomach acid.

Indications

  • Primary Use: Treatment and prevention of ulcers in the stomach and intestines. Also used to treat gastroesophageal reflux disease (GERD) and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome.
  • Other Uses: Occasionally used to treat heartburn and indigestion.

Dosage

  • Adults: For GERD, 20 mg twice daily or 40 mg once daily. For ulcers, the typical dose is 40 mg at bedtime.
  • Elderly: Dose adjustment may not be necessary, but care should be taken due to potentially increased risk of side effects.
  • Children: Dosage must be adjusted based on the child’s weight and the specific condition being treated.

Administration

  • Method: Oral tablets, chewable tablets, or suspension.
  • Precautions: Can be taken with or without food. However, if taking to prevent heartburn, it should be taken 15 to 60 minutes before eating food or drinking beverages that may cause heartburn.

Forms Available

  • Tablets: 10 mg, 20 mg, 40 mg
  • Chewable Tablets: 10 mg, 20 mg
  • Oral Suspension: 40 mg/5 mL

Side Effects

  • Common: Constipation, diarrhea, nausea, headache.
  • Less Common: Dizziness, fatigue, mood changes.
  • Rare but Serious: Severe allergic reactions, QT prolongation, arrhythmias, agranulocytosis.

Warnings

  • Black Box Warning: None.
  • Contraindications: Hypersensitivity to famotidine or other H2-receptor antagonists.

Precautions

  • General: Use with caution in patients with renal impairment as dosage adjustments may be necessary.
  • Health Conditions: Monitor for symptoms of acute porphyria in at-risk patients.

Interactions

  • Medications: May reduce the absorption of drugs that require an acidic pH for absorption, such as itraconazole or ketoconazole.
  • Food: No significant food interactions, but spacing out certain foods or medications may be advised.

Monitoring Parameters

  • Renal Function: Assess renal function regularly, especially in elderly patients or those with renal impairment.
  • Symptom Relief: Monitor the effectiveness of the treatment in relieving symptoms of GERD or other related conditions.

Use in Children

  • Guidelines: Safe for use in children when dosed appropriately. Recommended for children for the treatment of GERD, ulcers, and heartburn.

Use in Pregnancy

  • FDA Category: B. Generally considered safe, but should only be used if clearly needed.

Use in Elderly

  • Considerations: May require dose adjustments based on renal function. Monitor closely for adverse effects.

Use in Kidney Disease

  • Adjustments: Dose reduction may be required depending on the severity of renal impairment.

Use in Liver Disease

  • Caution: Use with caution; although not extensively metabolized by the liver, monitoring is advised.

Patient Counselling Points

  • Medication Use: Take as directed, and do not exceed the recommended dose.
  • Side Effects: Report any severe or persistent side effects, especially signs of allergic reactions.
  • Lifestyle: Discuss lifestyle changes that might improve symptoms of acid-related disorders, such as dietary adjustments and weight management.

Table of Brand Names, Manufacturer, and Prices in USD

Brand NameManufacturerStrength/Dosage FormPrice (USD)
PepcidJohnson & Johnson20 mg Tablet$0.50
Pepcid ACJohnson & Johnson10 mg Chewable Tablet$0.30

15 FAQs with Answers

  1. What is Famotidine used for? – Primarily to treat and prevent ulcers and manage GERD.
  2. How does Famotidine work? – It blocks H2 receptors in the stomach to reduce acid production.
  3. Can I take Famotidine every day? – Yes, as prescribed by your doctor, especially for chronic conditions.
  4. What are the side effects of Famotidine? – Common side effects include constipation, diarrhea, and headache.
  5. Is Famotidine safe during pregnancy? – Rated FDA Category B. It’s generally safe but consult your doctor.
  6. Can Famotidine be used in children? – Yes, when dosed correctly according to weight and condition.
  7. How long does it take for Famotidine to work? – It can start reducing stomach acid within an hour of ingestion.
  8. Can Famotidine cause allergic reactions? – Rare, but severe allergic reactions can occur.
  9. What should I do if I miss a dose? – Take it as soon as you remember, unless it is almost time for your next dose.
  10. Can Famotidine be taken with other medications? – Be cautious as it may affect the absorption of certain medications.
  11. Does Famotidine affect kidney function? – Use with caution in renal impairment; dose adjustments may be needed.
  12. What dietary changes should I consider while taking Famotidine? – Avoid foods that trigger heartburn and eat smaller, more frequent meals.
  13. Is it safe to drink alcohol with Famotidine? – Alcohol can increase stomach acid production and worsen side effects.
  14. How should Famotidine be stored? – Store at room temperature, away from moisture and heat.
  15. Who should not take Famotidine? – Those with a history of hypersensitivity to H2-receptor antagonists.