famotidine

(fa moe' ti deen)

Apo-Famotidine (CAN), Novo-Famotidine (CAN), Pepcid, Pepcid AC, Pepcid IV,
Pepcid RPD

Pregnancy Category B

Drug class
Histamine 2 (H2) receptor antagonist

Therapeutic actions
Competitively blocks the action of histamine at the histamine (H2) receptors of the parietal cells
of the stomach; inhibits basal gastric acid secretion and chemically induced gastric acid
secretion.

Indications
• Short-term treatment and maintenance of duodenal ulcer
• Short-term treatment of benign gastric ulcer
• Treatment of pathologic hypersecretory conditions (eg, Zollinger-Ellison syndrome)
• Short-term treatment of gastroesophageal reflux disease (GERD), esophagitis due to
GERD
• OTC: Relief of symptoms of heartburn, acid indigestion, sour stomach

Contraindications and cautions

• Contraindicated with allergy to famotidine; renal failure; lactation.
• Use cautiously with pregnancy, renal or hepatic dysfunction.

Available forms
Tablets—10, 20, 40 mg; chewable tablets—10 mg; orally disintegrating tablets—20, 40 mg;
gelcaps—10 mg; powder for oral suspension—40 mg/5 mL; injection—10 mg/mL; injection,
premixed—20 mg/50 mL in 0.9% sodium chloride

Dosages
ADULTS
• Acute treatment of active duodenal ulcer: 40 mg PO or IV at bedtime or 20 mg bid PO or
IV. Therapy at full dosage should generally be discontinued after 6–8 wk.
• Maintenance therapy for duodenal ulcer: 20 mg PO at bedtime.
• Benign gastric ulcer: 40 mg PO daily at bedtime.
• Hypersecretory syndrome: 20 mg q 6 hr PO initially. Doses up to 160 mg q 6 hr have
been administered. 20 mg IV q 12 hr in patients unable to take oral drugs.
• GERD: 20 mg bid PO for up to 6 wk. For patients with esophagitis, the dose is 20–40 mg
bid PO for up to 12 wk.
• Heartburn, acid indigestion: 10 mg PO for relief; 10 mg PO 1 hr before eating for
prevention. Do not exceed 20 mg/24 hr.
PEDIATRIC PATIENTS 1–16 YR
 • Peptic ulcer: 0.5 mg/kg/day PO at bedtime or divided in 2 doses up to 40 mg/day;
0.25 mg/kg q 12 hr IV up to 40 mg/day.
• GERD with or without esophagitis: 1 mg/kg/day PO divided in 2 doses up to 40 mg bid.
GERIATRIC PATIENTS OR PATIENTS WITH RENAL IMPAIRMENT
Reduce dosage to 20 mg PO at bedtime or 40 mg PO q 36–48 hr.

Pharmacokinetics
Route Onset Peak Duration
Oral Slow 1–3 hr 6–12 hr
IV < 1 hr 0.5–3 hr 8–15 hr

Metabolism: Hepatic; T1/2: 2.5–3.5 hr

Distribution: Crosses placenta; enters breast milk
Excretion: Urine

IV facts
Preparation: For direct injection, dilute 2 mL (solution contains 10 mg/mL) with 0.9% sodium
chloride injection, water for injection, 5% or 10% dextrose injection, lactated Ringer’s injection,
or 5% sodium bicarbonate injection to a total volume of 5–10 mL. For infusion, 2 mL diluted
with 100 mL 5% dextrose solution or other IVs. Stable for 48 hr at room temperature, 14 days if
refrigerated.
Infusion: Inject directly slowly, over not less than 2 min. Infuse over 15–30 min; continuous
infusion: 40 mg/24 hr.

Adverse effects
• CNS: Headache, malaise, dizziness, somnolence, insomnia
• Dermatologic: Rash
• GI: Diarrhea, constipation, anorexia, abdominal pain
• Other: Muscle cramp, increase in total bilirubin, sexual impotence

Nursing considerations
Assessment
• History: Allergy to famotidine; renal failure; lactation, pregnancy, hepatic impairment
• Physical: Skin lesions; liver evaluation, abdominal exam, normal output; renal function
tests, serum bilirubin

Interventions
• If using one dose a day, administer drug at bedtime.
• Decrease doses with renal failure.
• Arrange for administration of concurrent antacid therapy to relieve pain.

Teaching points
• Take this drug at bedtime (or in the morning and at bedtime). Therapy may continue for
4–6 wk or longer. Place RPD tablet on tongue and swallow with or without water.
• Take antacid exactly as prescribed, being careful of the times of administration.
• Have regular medical follow-up while using this drug to evaluate your response.
 • Take over-the-counter drug 1 hr before eating to prevent indigestion. Do not take more
than two per day.
• You may experience these side effects: Constipation or diarrhea; loss of libido or
impotence (reversible); headache (adjust lights, temperature, noise levels).
• Report sore throat, fever, unusual bruising or bleeding, severe headache, muscle or joint
pain.

Adverse effects in Italic are most common; those in Bold are life-threatening.