famotidine [IV]

Adult Dosing

Duodenal ulcer, acute therapy

20 mg IV q12 hrs

Benign gastric ulcer

20 mg IV q12 hrs

GERD

20 mg IV q12 hrs

Pathological hypersecretory conditions

20 mg IV q12 hrs

Intractable ulcers

20 mg IV q12 hrs

Pediatric Dosing

Peptic ulcer disease

0.25 mg/kg IV q12 hrs
Max: 40 mg/day

GERD

0.25 mg/kg IV q12 hrs
Max: 40 mg/day

[Outline]

Adult Dosing
Pediatric Dosing

Indications ⬆ ⬇

Treatment of active duodenal ulcers, active benign gastric ulcers and GERD
Treatment of pathological hypersecretory conditions

Contraindications ⬆ ⬇

Hypersensitivity to famotidine, other H2 antagonists, or any component of the formulation

Black Box Warnings ⬆ ⬇

Dosing Adjustment ⬆ ⬇

Renal Dose Adjustment

Moderate/Severe impairment: Reduce dose by 50% or increase dosing interval to 36-48 hrs
Hemodialysis: Give dose after dialysis, no supplement

Hepatic Dose Adjustment

Hepatic Impairment: Dose adjustments not defined

Warnings/Precautions ⬆ ⬇

Relief of symptoms does not preclude the presence of a gastric malignancy
CNS adverse reactions have been reported in patients with renal impairment. Dose adjustments are required in moderate to severe renal impairment
Injection contains benzyl alcohol which has been associated with gasping syndrome in neonates
Use in very low birth weight increased risk of developing necrotizing enterocolitits
Monitor Cr at baseline, then in elderly patients consider periodically

Use cautiously in

Renal impairment (increased susceptibility to CNS adverse events)
Pregnancy
Lactation

Interactions ⬆ ⬇

Pepcid interacts with :

Pregnancy/Breast Feeding ⬆ ⬇

Pregnancy Category:B

Breastfeeding: Famotidine has been used in newborn infants in higher dosages than are transmitted in breastmilk. It would not be expected to cause any adverse effects in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 July 2010). Manufacturer recommends discontinuation of breastfeeding, or postponing of treatment (taking into account the importance of the drug to the mother).

Adverse Reactions ⬆ ⬇

CNS: Headache, dizziness, grand mal seizure, hallucinations, confusion, agitation, depression, anxiety, decreased libido, paresthesia, insomnia, somnolence, convulsions
GI: Constipation, diarrhea, taste changes, vomiting, nausea, cholestatic jaundice, hepatitis, liver enzyme abnormalities, abdominal discomfort, anorexia, dry mouth, in fetus or newborn necrotizing enterocolitis
CVS: Arrhythmia, AV block, palpitation
RESP: Bronchospasm, interstitial pneumonia
HEMA: Agranulocytosis, pancytopenia, leukopenia, thrombocytopenia
DERM: Alopecia, rash, acne, pruritus, dry skin, Stevens-Johnson Syndrome, toxic epidermal necrolysis
EENT: Tinnitus, orbital or facial edema
MUSC: Muscle pain, muscle cramps, arthralgia
LOCAL: Application-site reactions including mild local erythema
MISC: Anaphylaxis, angioedema, fever, asthenia, fatigue

Clinical Pharmacology ⬆ ⬇

Histamine h2 antagonist; selectively antagonizes histamine H2 receptors (H2 blocker)
Partially metabolized by liver
Renally excreted (65-70% unchanged)
Half-life: 2.5-3.5 hrs; increased in renal impairment

Brands and Availability ⬆ ⬇

US Trade Name(s)

Pepcid

US Availability

famotidine (generic)

INJ: 10 mg/mL
INJ: 0.4 mg/mL

Pepcid

INJ: 10 mg/mL (2, 4, 20 mL vial)
INJ: 20 mg/50 mL

Canadian Trade Name(s)

Only generic available

Canadian Availability

famotidine (generic)

INJ: 10 mg/mL (2, 4, 20 mL vial)

UK Trade Name(s)

UK Availability

Australian Trade Name(s)

Australian Availability