Adult Dosing

Duodenal ulcer, acute therapy

• 40 mg PO qhs x 4-6 wks
• Alt: 20 mg PO bid

Duodenal ulcer, maintenance therapy

• 20 mg PO qhs

Benign gastric ulcer

• 40 mg PO qhs

GERD

• 20-40 mg PO bid
• Max: 12 wks

Pathological hypersecretory conditions

• 20-160 mg PO qid
• Max: 640 mg/day

Pediatric Dosing

Peptic ulcer disease

• 1-16 yrs: 0.5 mg/kg/day PO divided qd-bid
• Max: 40 mg/day

GERD

• < 3 mo: 0.5 mg/kg/day PO qd
• 3-12 mo: 1 mg/kg/day PO divided bid
• 1-16 yrs: 1 mg/kg/day PO divided bid
• Max: 40 mg/day

[Outline]

• Adult Dosing
• Pediatric Dosing

• Short term treatment of active duodenal ulcers, active benign gastric ulcers and GERD
• Maintenance therapy of duodenal ulcer patients at reduced dosage after healing of an active ulcer
• Treatment of pathological hypersecretory conditions

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

• N/A

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

• 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
• Monitor Cr at baseline, then in elderly patients consider periodically

Cautions: Use cautiously in

• Renal impairment (increased susceptibility to CNS adverse events)
• Pregnancy
• Lactation
• Phenylketonuria (ODT forms)

Fluxid, Pepcid, Pepcid AC interacts with :

	Aptivus
	Atazanavir
	Cefditoren
	Cefpodoxime
	Ceftin
	Cefuroxime
	Crixivan
	DiaBeta
	Edurant
	Extina
	Fosamprenavir
	Glipizide
	Glucotrol
	Glucotrol XL
	Glucovance
	Glyburide
	Glynase
	Indinavir
	Itraconazole
	Ketoconazole
	Lexiva
	Nelfinavir
	Nizoral
	Nizoral A-D Shampoo
	Nizoral Shampoo
	Noxafil
	Onmel
	Posaconazole
	Reyataz
	Rilpivirine
	Spectracef
	Sporanox
	Tipranavir
	Vantin
	Viracept
	Xolegel
	Zinacef

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 18 July 2010). Manufacturer recommends discontinuation of breastfeeding, or postponing of treatment (taking into account the importance of the drug to the mother).

• 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
• CVS: Arrhythmia, AV block, palpitation
• RESP: Bronchospasm, interstitial pneumonia
• HEMA: Agranulocytosis(rare), pancytopenia, leukopenia, thrombocytopenia
• DERM: Alopecia, rash, acne, pruritus, dry skin
• EENT: Tinnitus, orbital or facial edema
• MUSC: Muscle pain, muscle cramps, arthralgia, rhabdomyolysis
• MISC: Anaphylaxis, angioedema, fever, asthenia, fatigue

• Famotidine selectively antagonizes histamine H2 receptors (H2 blocker)
• Bioavailability of oral doses is 40-45%
• Partially metabolized by liver
• Renally excreted (25-30% unchanged)
• Half-Life: 2.5-3.5 hrs; increased in renal impairment

US Trade Name(s)

• Fluxid (Discontinued)
• Pepcid
• Pepcid AC
• Pepcid RPD (discontinued)

US Availability

famotidine (generic)

• TABS: 10, 20, 40 mg
• CHEW TABS: 10 mg

Fluxid

• ODT: 20, 40 mg

Pepcid

• TABS: 20, 40 mg
• PWDR for SUSP: 40 mg/5 mL (400 mg)

Pepcid AC

• OTC TABS: 10, 20 mg
• OTC CHEW TABS: 20 mg
• OTC GELTABS: 10 mg

Pepcid RPD

• ODT: 20, 40 mg

Canadian Trade Name(s)

• Acid control
• Maalox H2 acid controller
• Maximum strength Pepcid AC
• Pepcid
• Pepcid AC
• Peptic guard
• Ulcidine

Canadian Availability

famotidine (generic)

• TABS: 10, 20, 40 mg

Acid control, Maalox H2 acid controller

• TABS: 10 mg

Maximum strength Pepcid AC

• TABS: 20 mg

Pepcid, Ulcidine

• TABS: 20, 40 mg

Pepcid AC, Peptic guard

• TABS: 10 mg

UK Trade Name(s)

• Pepcid

UK Availability

famotidine (generic)

• TABS: 20, 40 mg

Pepcid

• TABS: 20, 40 mg

Australian Trade Name(s)

• Ausfam
• Famohexal
• Pamacid
• Pepcidine
• Pepcidine M
• Pepzan

Australian Availability

famotidine (generic)

• TABS: 20, 40 mg

Ausfam, Famohexal, Pamacid, Pepzan

• TABS: 20, 40 mg

Pepcidine

• TABS: 40 mg

Pepcidine M

• TABS: 20 mg

[Outline]

Gastrointestinal

Antiulcer Agents

Histamine H2 Antagonists

Pricing data from www.DrugStore.com in U.S.A.

• Pepcid AC 10 MG TABS [Box] (MCNEIL CONSUMER PHARMACEUTICAL)
  30 mg = $19.99
  90 mg = $59.97
• Pepcid 40 MG/5ML SUSR [Bottle] (SALIX PHARMACEUTICALS)
  INC. 5ml = $50
  5ml = $150
• Pepcid 40 MG TABS [Bottle] (MARATHON PHARMACEUTICALS LLC)
  30 mg = $125.99
  90 mg = $359.97
• Pepcid 20 MG TABS [Bottle] (MARATHON PHARMACEUTICALS LLC)
  30 mg = $71.99
  90 mg = $206.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Famotidine 10 MG Oral Tablet (Amerisource Bergen)
• Famotidine 10 MG Oral Tablet (HyVee Inc)
• Famotidine 10 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Famotidine 10 MG Oral Tablet (Major Pharmaceuticals)
• Famotidine 10 MG Oral Tablet (McKesson)
• Famotidine 10 MG Oral Tablet (Rite Aid Corporation)
• Famotidine 10 MG Oral Tablet (Target Corporation)
• Famotidine 10 MG Oral Tablet (Topco Associates LLC)
• Famotidine 10 MG Oral Tablet (Walgreen Company)
• Famotidine 20 MG Oral Tablet (Cardinal Health)
• Famotidine 20 MG Oral Tablet (Dr.Reddy's Laboratories Limited)
• Famotidine 20 MG Oral Tablet (Genpharm)
• Famotidine 20 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Famotidine 20 MG Oral Tablet (Major Pharmaceuticals)
• Famotidine 20 MG Oral Tablet (McKesson Packaging Services Business Unit of McKesson Corporation)
• Famotidine 20 MG Oral Tablet (McKesson)
• Famotidine 20 MG Oral Tablet (Mylan Pharmaceuticals Inc.)
• Famotidine 20 MG Oral Tablet (NorthStar RxLLC)
• Famotidine 20 MG Oral Tablet (Physicians Total Care, Inc.)
• Famotidine 20 MG Oral Tablet (TEVA PHARMACEUTICALS USA)
• Famotidine 20 MG Oral Tablet (Topco Associates LLC)
• Famotidine 20 MG Oral Tablet (Wal-Mart Stores Inc)
• Famotidine 40 MG Oral Tablet (Dr.Reddy's Laboratories Limited)
• Famotidine 40 MG Oral Tablet (Genpharm)
• Famotidine 40 MG Oral Tablet (IVAX Pharmaceuticals, Inc.)
• Famotidine 40 MG Oral Tablet (Legacy Pharmaceutical Packaging)
• Famotidine 40 MG Oral Tablet (Major Pharmaceuticals)
• Famotidine 40 MG Oral Tablet (McKesson Packaging Services Business Unit of McKesson Corporation)
• Famotidine 40 MG Oral Tablet (NorthStar RxLLC)
• Famotidine 40 MG Oral Tablet (Physicians Total Care, Inc.)
• Famotidine 40 MG Oral Tablet (TEVA PHARMACEUTICALS USA)
• Famotidine 40 MILLIGRAM in 1 TABLET (Mylan Pharmaceuticals Inc.)
• Fluxid 20 MG Disintegrating Tablet (Schwarz Pharma)
• Fluxid 40 MG Disintegrating Tablet (Schwarz Pharma)
• Pepcid 40 MG Oral Tablet (Merck Sharp & Dohme Corp.)
• Pepcid AC 20 MG Oral Tablet (Merck Sharp & Dohme Corp.)