Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: famotidine

BRAND NAME: Pepcid

DRUG CLASS AND MECHANISM: Histamine is a chemical made by the body that stimulates cells lining the stomach to produce acid. Famotidine belongs to a class of medications called H2-blockers that blocks the action of histamine on stomach cells, thus reducing production of acid by the stomach. Other H2 blockers include cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid). Famotidine was approved by the FDA in November, 1986.

PRESCRIPTION: Yes.

GENERIC AVAILABLE: Yes.

PREPARATIONS: Tablets: 10, 20, and 40 mg. Suspension: 40 mg per 5 ml teaspoon. Injection: 10 mg/ml and 20 mg/50 ml.

STORAGE: Tablets and suspension should be stored at room temperature, 15 -30°C (59-86°F). Injection should be stored between 2-8°C (36-46°F).

PRESCRIBED FOR: Famotidine blocks the action of histamine on stomach cells, and reduces stomach acid production. Famotidine is useful in promoting the healing of stomach and duodenal ulcers and in reducing ulcer pain. Famotidine has been effective in preventing recurrence of ulcers when given in low doses for prolonged periods of time. Famotidine also is used for treating heartburn and in healing ulceration and inflammation of the esophagus (esophagitis) resulting from acid (gastroesophageal reflux disease or GERD). High doses are used for treating conditions in which there are marked increases in acid secretion such as Zollinger-Ellison syndrome.

DOSING: The recommended adult oral dose for treating duodenal ulcers is 40 mg once daily at bedtime or 20 mg twice daily. Most patients heal their ulcers within 4 weeks. The regimen for maintenance therapy after the ulcers are healed is 20 mg once a day at bedtime.

The recommended adult oral dose for treating gastric ulcer is 40 mg once a day at bedtime, and esophagitis is treated with 20-40 mg twice daily for 6-12 weeks. Zollinger-Ellison syndrome is treated with 20 mg every 6 hours.

Heartburn due to GERD is treated with 10-20 mg daily.

DRUG INTERACTIONS: No important drug interactions with famotidine have been identified.

PREGNANCY: Safe use of famotidine in pregnancy has not been established.

NURSING MOTHERS: Famotidine is secreted into breast milk. Due to the potential but unknown harm that famotidine might cause to the infant, nursing mothers should consider discontinuing famotidine.

SIDE EFFECTS: Side effects of famotidine are rare. Minor side effects include constipation, diarrhea, fatigue, headache, insomnia, muscle pain, nausea, and vomiting. Major side effects include agitation, anemia, confusion, depression, easy bruising or bleeding, hallucinations, hair loss, irregular heartbeat, rash, visual changes, and yellowing of the skin or eyes (jaundice).

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