FAMOTIDINE
Indications
Peptic ulcer disease (PUD); Gastro-oesophageal reflux disease (GORD); Dyspepsia.
Specific considerations
Phenylketonuria: effervescent tablets contain aspartame.
Renal impairment: Although renally cleared, dosage reduction is rarely required in renal impairment.
Surgery: Continue treatment throughout perioperative period.
Pregnancy: Safe to use; ADEC category B1.
Breastfeeding: No adverse effects reported.
Adverse effects
Infrequent: hypotension.
Rare: headache, tiredness, dizziness, confusion (especially in elderly people), diarrhoea, constipation, rash;
thrombocytopenia, agranulocytosis, hepatitis, vasculitis, interstitial nephritis.
Dosage
PUD: Initially, 40 mg once daily in the evening for 4–8 weeks. Maintenance 20 mg once daily in the evening.
GORD: 20 mg twice daily.
Dyspepsia: 20 mg once or twice daily for 4–8 weeks.
Practice points
- in maintenance treatment of PUD and GORD, some specialists use larger doses (up to double those quoted); however there is no evidence of increased benefit and cost advantages over PPIs may be lost
- the efficacy of H2 antagonists for stress ulcer prophylaxis is controversial; meta-analysis indicates some benefit over placebo in reducing clinically significant bleeding but cost efficacy is questioned; stop prophylaxis when stressors are removed.
Mode of action
Competitively block H2 receptors on parietal cells, reducing gastric acid secretion.
Products
FAMOTIDINE TABS 10 MG (ACIFAM®, FAMODINE®, GASTRIFAM®)
FAMOTIDINE TABS 20 MG (ACIFAM®, AMODINE®, FAMODAR®, FAMODINE®, GASTRIFAM®,
PEPCIDIN®)
FAMOTIDINE TABS 40 MG (ACIFAM®, AMODINE®, FAMODAR®, FAMODINE®, GASTRIFAM®,
PEPCIDIN®)