FAMOTIDINE

(fa-moe'ti-deen)
Pepcid, Pepcid AC
Classifications: gastrointestinal agent; antisecretory agent (h2-receptor antagonist)
Prototype: Cimetidine
Pregnancy Category: B

Availability
10 mg, 20 mg, 40 mg tablets; 40 mg/5 mL suspension; 10 mg/mL, 20 mg/50 mL injection

Actions
Thiazole derivative, structurally similar to histamine and pharmacologically similar to
cimetidine. A potent competitive inhibitor of histamine at histamine (H2) receptor sites in
gastric parietal cells. Inhibits basal, nocturnal, meal-stimulated, and pentagastrin-
stimulated gastric secretion; also inhibits pepsin secretion. Is 20–160 times more potent
than cimetidine and 3–20 times more potent than ranitidine. Does not affect gastric
emptying or exocrine pancreatic function.

Therapeutic Effects
Reduces parietal cell output of hydrochloric acid; thus, detrimental effects of acid on
gastric mucosa are diminished.

Uses
Short-term treatment of active duodenal ulcer. Maintenance therapy for duodenal ulcer
patients on reduced dosage after healing of an active ulcer. Treatment of pathologic
hypersecretory conditions (e.g., Zollinger-Ellison syndrome), benign gastric ulcer,
gastroesophageal reflux disease (GERD), gastritis.

Unlabeled Uses
Stress ulcer prophylaxis.

Contraindications
Safe use during pregnancy (category B), by nursing mothers.
Cautious Use
Renal insufficiency.

Route & Dosage

Duodenal Ulcer
Adult: PO 40 mg h.s. or 20 mg b.i.d. PO Maintenance Therapy 20 mg h.s. IV 20 mg
q12h
Child: PO/IV 0.5 mg/kg q8–12h (max: 40 mg/d)

Pathological Hypersecretory Conditions

Adult: PO 20–160 mg q6h

GERD, Gastritis
Adult: PO 10 mg b.i.d.
Child: PO 1 mg/kg/d in 2 divided doses (max: 40 mg b.i.d.)

Renal Impairment
Clcr <50 mL/min: 50% of usual dose or usual dose q36–48h for all indications

Administration
Oral
 Give with liquid or food of patient's choice; an antacid may also be given if
patient is also on antacid therapy.
 Store at 15°–30° C (59°–86° F). Protect from moisture and strong light; do not
freeze.

Intravenous
 Note: Verify correct IV concentration and rate of infusion/injection with
physician before administration to infants or children.

PREPARE: Direct: Dilute 20 mg (2 mL) famotidine IV solution (containing 10 mg/mL)

with D5W, NS, or other compatible IV diluent (see manufacturer's directions) to a total
volume of 5 or 10 mL.  IV Infusion: Dilute 2 mL famotidine IV with 100 mL
compatible IV solution.  

ADMINISTER: Direct: Give over not less than 2 min.  IV Infusion: Infuse over 15–30
min.  

INCOMPATIBILITIES Y-site: Amphotericin B cholesteryl complex, cefepime

  Store IV solution at 2°–8° C (36°–46° F); reconstituted IV solution is stable for 48
h at room temperature 15°–30° C (59°–86° F).

Adverse Effects ( 1%)

CNS: Dizziness, headache, confusion, depression. GI: Constipation, diarrhea. Skin: Rash,
acne, pruritus, dry skin, flushing. Hematologic: Thrombocytopenia. Urogenital: Increases
in BUN and serum creatinine.

Interactions
Drug: No clinically significant interactions established.

Pharmacokinetics
Absorption: Incompletely absorbed from GI tract (40%–50% reaches systemic
circulation). Onset: 1 h. Peak: 1–3 h PO; 0.5–3 h IV. Duration: 10–12 h. Metabolism:
Metabolized in liver. Elimination: Excreted in urine. Half-Life: 2.5–4 h.

NURSING IMPLICATIONS
Assessment & Drug Effects

 Monitor for improvement in GI distress.

 Monitor for signs of GI bleeding.

Patient & Family Education

 Be aware that pain relief may not be experienced for several days after starting
therapy.
 Do not breast feed while taking this drug without consulting physician.

Common adverse effects in italic, life-threatening effects underlined: generic names in

bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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