famotidine (Rx, OTC)Brand and Other Names:Pepcid, Act, more...Dyspep HB, Fluxid, Acid Controller

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection solution

  • 10mg/mL
  • 0.4mg/mL

oral suspension

  • 40mg/5mL

tablet

  • 10mg
  • 20mg
  • 40mg

tablet, chewable

  • 10mg
  • 20mg
more...

Duodenal Ulcer

Acute treatment: 20 mg PO/IV q12hr or 40 mg PO at bedtime for 4-8 weeks

Maintenance: 20 mg PO at bedtime

Benign Gastric Ulcer

40 mg PO at bedtime

Gastroesophageal Reflux Disease

20 mg PO q12hr for 6 weeks

With esophagitis: 20-40 mg PO q12hr for up to 12 weeks

Hypersecretory Conditions

20 mg PO/IV q6hr; may increase up to 160 mg q6hr

Heartburn

10-20 mg q12 hr; may take 15-60 min before eating foods that could cause heartburn

Dosing Modifications

CrCl <50 mL/min: Give 50% of usual dose, or prolong dosing interval to q36-48hr

Dosage Forms & Strengths

injection solution

  • 10mg/mL
  • 0.4mg/mL

oral suspension

  • 40mg/5mL

tablet

  • 10mg
  • 20mg
  • 40mg

tablet, chewable

  • 10mg
  • 20mg
more...

Peptic Ulcer

1-16 years: 0.25 mg/kg IV q12hr or 0.5 mg/kg PO at bedtime; not to exceed 40 mg/day  

Gastroesophageal Reflux Disease

<3 months: 0.5 mg/kg PO once daily for up to 8 weeks  

3-12 months: 0.5 mg/kg PO q12hr for up to 8 weeks

1-16 years: 1 mg/kg/day PO divided q12hr; individual dose not to exceed 40 mg

Heartburn

<12 years: Not established

>12 years: 10-20 mg q12 hr; may take 15-60 min before eating foods that could cause heartburn

Next

Interactions

Interaction Checker

famotidine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            1-10%

            Headache (4.7%)

            Diarrhea (1.7%)

            Dizziness (1.3%)

            Constipation (1.2%)

            Frequency Not Defined

            Body as a whole: Fever, asthenia, fatigue

            Cardiovascular: Arrhythmia, AV block, palpitation; prolonged QT interval in patients with impaired renal function, has been reported very rarely

            Gastrointestinal: Cholestatic jaundice, hepatitis, liver enzyme abnormalities, vomiting, nausea, abdominal discomfort, anorexia, dry mouth

            Hematologic: Rare cases of agranulocytosis, pancytopenia, leukopenia, thrombocytopenia

            Hypersensitivity: Anaphylaxis, angioedema, orbital or facial edema, urticaria, rash, conjunctival injection

            Musculoskeletal: Rhabdomyolysis, musculoskeletal pain including muscle cramps, arthralgia

            Nervous system/psychiatric: Grand mal seizure; psychic disturbances, which were reversible in cases for which follow-up was obtained, including hallucinations, confusion, agitation, depression, anxiety, decreased libido; paresthesia; insomnia; somnolence; convulsions, in patients with impaired renal function, have been reported very rarely

            Respiratory: Bronchospasm, interstitial pneumonia

            Skin: Toxic epidermal necrolysis/Stevens-Johnson syndrome (very rare), alopecia, acne, pruritus, dry skin, flushing

            Special senses: Tinnitus, taste disorder

            Rare cases of impotence and rare cases of gynecomastia

            Previous
            Next

            Warnings

            Contraindications

            Hypersensitivity to famotidine or other H2-receptor antagonists

            Cautions

            Use caution in renal impairment; dosage adjustment recommended in moderate to severe renal impairment (CrCl <50 mL/min)

            Prolonged QT interval reported rarely in patients with renal impairment whose dose or dosing interval may not have been adjusted appropriately

            Central nervous system (CNS) adverse effects reported with moderate-to-severe renal impairment

            Relief of symptoms does not eliminate the presence of gastric malignancy

            State of confusion reported with use; risk increased in >50 years of age and/or renal/hepatic impairment

            Prolonged treatment (>2 years) may lead to vitamin B12 malabsorption, which can result in vitamin B12 deficiency; magnitude of deficiency is dose related; occurs most frequently in females and those younger then 30 years

            Patients should not use OTC if difficulty swallowing, vomiting blood, have bloody or black stools

            Not for OTC use with other acid reducers

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy category: B

            Lactation: Drug enters breast milk; use not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Blocks H2 receptors of gastric parietal cells, leading to inhibition of gastric secretions

            Absorption

            Bioavailability: 40-45% (PO; minimal 1st-pass metabolism)

            Onset: <1 hr (PO); <30 min (IV)

            Duration: 10-12 hr

            Peak plasma time: IV, 20 min; PO, 1-4 hr

            Distribution

            Protein bound: 15-20%

            Vd: 1.1-1.4 L/kg (Adults); 1.5-2.07 L/kg (children); 1.4-1.8 L/kg (infants <3 months); 2.3 L/kg (infants 3-12 months)

            Metabolism

            Metabolized in liver

            Metabolites: Famotidine S-oxide (inactive)

            Elimination

            Half-life: 2.5-4 hr (adults; increases with renal impairment; eg, 20 hr with CrCl <10 mL/min); 3-4 hr (children); 4.5 hr (infants 3-12 months); 8-10.5 hr (infants < 3 months)

            Dialyzable: No

            Renal clearance: 250-450 mL/min

            Total body clearance: 381-483 mL/min

            Excretion: Urine (25-30% as unchanged drug when administered PO; 70% when adminsitered IV)

            Previous
            Next

            Administration

            IV Incompatibilities

            Additive: Piperacillin-tazobactam

            Y-site: Cefepime, piperacillin-tazobactam, amphotericin B, azithromycin, furosemide (at 2 mg/mL famotidine; compatible at 0.2 mg/mL)

            IV Compatibilities

            Additive: Aztreonam, ceftazidime, dobutamine, dopamine, furosemide, gentamicin, imipenem, thiamine

            Y-site: Atropine, cefazolin, furosemide, gentamicin, heparin, norepinephrine, thiamine

            IV Preparation

            Dilute 20 mg to total of 5 or 10 mL with NS, D5W, or LR

            Also available in premixed bag containing 20 mg in 50 mL NS

            IV Administration

            Infuse at rate no faster than 10 mg/min

            Storage

            Premixed: Store at room temperature

            Unmixed: Store in refrigerator at 2-8°C (36-46°F)

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.