about Famotidine class, uses, side effects contraindications
Famotidine
Short Description
Famotidine uses include the treatment of peptic ulcers and the treatment of cases of excessive acid production in the digestive system.
Famotidine is also used to treat Zollinger-Ellison syndrome, which is characterized by increased?gastrin?secretion , which in turn leads to increased acid secretion and thus causes ulcers.
Category
Chemical class: Thiazole derivative
Therapeutic class: Antiulcer agent, gastric acid secretion inhibitor
Pregnancy category: B
Indications
To provide short-term treatment of famotidine 421 E F
Mechanism of Action
Reduces blood cholesterol by inhibiting its absorption through the small intestine. Normally, in the intestinal lumen, lipids break down to cholesterol and other substances that create smaller droplets called micelles, as shown below left. The micelles enter intestinal epithelial cells called enterocytes, where they combine with triglycerides, cholesterol, and other substances to form chylomicrons. Chylomicrons then pass through to the lymphatic system to be carried to the blood. Ezetimibe blocks cholesterol absorption into enterocytes and keeps cholesterol from moving through the intestinal wall, as shown below right. Reduced cholesterol absorption from the intestine decreases chylomicron and LDL cholesterol content. active duodenal ulcer ORAL SUSPENSION,(CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents.40 mg daily at bedtime or 20 mg b.i.d. Children.0.5 mg/kg daily as a single dose at bedtime or in divided doses b.i.d.
IV: OR INJECTION Adults and adolescents over age 16. 20 mg every 12 hr, infused over 15 to 30 min or injected over at least 2 min. Children ages 1 to 16. Initial: 0.25 mg/kg every 12 hr, infused over 15 to 30 min or injected over at least 2 min. Maximum: 40 mg daily. To prevent recurrence of duodenal ulcer ORAL SUSPENSION,(CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents. 20 mg daily at bedtime. To provide short-term treatment for active, benign gastric ulcer ORAL SUSPENSION,(CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents.40 mg daily at bedtime. Children.0.5 mg/kg daily as a single dose at bedtime or in divided doses b.i.d.
IV: OR INJECTION Adults and adolescents over age 16. 20 mg every 12 hr. Children ages 1 to 16. Initial: 0.25 mg/kg every 12 hr. Maximum: 40 mg daily. To treat gastroesophageal reflux disease (GERD) ORAL SUSPENSION,(CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents.20 mg b.i.d. for up to 6 wk. Children weighing more than 10 kg (22 lb). 1 to 2 mg/kg daily in divided doses b.i.d. Children weighing less than 10 kg. 1 to 2 mg/kg daily in divided doses t.i.d. ORAL SUSPENSION Infants age 4 months to 1 year.0.5 mg/kg daily in divided doses b.i.d. for up to 8 wk. Infants age 3 months or less. 0.5 mg/kg daily for up to 8 wk.
IV: OR INJECTION Children ages 1 to 16. Initial: 0.25 mg/kg every 12 hr. Maximum: 40 mg daily. To treat esophagitis caused by gastroesophageal reflux ORAL SUSPENSION,(CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents.20 to 40 mg b.i.d. for up to 12 wk. To treat gastric hypersecretory conditions, such as Zollinger-Ellison syndrome ORAL SUSPENSION,(CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents. Initial: 20 mg every 6 hr. Dosage adjusted, if needed, based on patient response.
IV: OR INJECTION Adults and adolescents.20 mg every 12 hr. To prevent heartburn and indigestion (CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents.10 mg 1 hr before eating. Maximum: 20 mg every 24 hr. To treat heartburn and indigestion (CHEWABLE, ORAL DISINTEGRATING, AND REGULAR) Adults and adolescents.10 mg at onset of symptoms. Maximum: 20 mg every 24 hr for up to 2 wk unless prescribed otherwise.
DOSAGE ADJUSTMENT Oral or parenteral dosage reduced or dosing interval increased (to 36 to 48 hr), if needed, in patients with renal insufficiency and creatinine clearance of 49 ml/min/1.73 m2or less. Route Onset Peak Duration P.O. 1 hr 1–4 hr 10–12 hr I.V. In 30 min 0.5–3 hr 10–12 hr
Contraindications
Hypersensitivity to famotidine, other H2receptor antagonists, or their components
Interactions
antacids, sucralfate: Possibly decreased absorption of famotidine bone marrow depressants: Increased risk of blood dyscrasias itraconazole,
ketoconazole: Possibly decreased absorption of these
alcohol use: Possibly increased blood alcohol level
Side Efect
CNS: Agitation (infants), anxiety, asthenia, confusion, depression, dizziness, fatigue, fever, hallucinations, headache, insomnia, famotidine 422 mental or mood changes, paresthesia, seizures, somnolence
CV: Arrhythmias, AV block, palpitations
EENT: Dry mouth, laryngeal edema, taste alteration, tinnitus
GI: Abdominal pain, anorexia, cholestatic jaundice, constipation, diarrhea, elevated liver enzymes, hepatitis, nausea, vomiting
GU: Decreased libido
HEME: Agranulocytosis, aplastic anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia
MS: Arthralgia, muscle cramps
RESP: Bronchospasm, dyspnea, interstitial pneumonia, wheezing
SKIN: Acne, alopecia, dry skin, erythema multiforme, exfoliative dermatitis, flushing, jaundice, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Other: Anaphylaxis, angioedema, facial edema, hyperuricemia
Cautions
Shake famotidine oral suspension vigorously for 5 to 10 seconds before administration. Dilute injection form (2 ml) with normal saline solution or other solution to 5 to 10 ml; give I.V. injection over at least 2 minutes. Or dilute in 100 ml of D5W and infuse over 15 to 30 minutes. Or infuse premixed injection (20 mg/50 ml normal saline solution) over 15 to 30 minutes.
WARNING Be aware that Pepcid AC chewable tablets contain aspartame, which can be dangerous for patients who have phenylketonuria. PATIENT SAFTY
Instruct patient to store famotidine oral suspension at room temperature (below 86° F [30° C]) and to protect it from freezing. Tell her to shake the bottle vigorously for 5 to 10 seconds after adding water and right before use. Advise patient who uses Pepcid RPD to store drug in unopened package. For each dose, instruct her to open blister pack with dry hands, place a tablet on her tongue, let it dissolve, and swallow it with saliva. If patient uses chewable tablets, instruct her to chew them thoroughly before swallowing. If patient also takes antacids, instruct her to wait 30 to 60 minutes after taking famotidine, if possible, before taking antacid. Caution patient to avoid alcohol and smoking during famotidine therapy because they irritate the stomach and can delay ulcer healing. Advise patient to notify prescriber if she famotidine 423 E F Mechanism of Action
In normal digestion, parietal cells in the gastric epithelium secrete hydrogen (H+) ions, which combine with chloride ions (Cl–) to form hydrochloric acid (HCl), as shown below left. However, HCl can inflame, ulcerate, and perforate gastric and intestinal mucosa normally protected by mucus. Famotidine, an H2-receptor antagonist, reduces HCl formation by preventing histamine from binding with H2receptors on the surface of parietal cells, as shown below right. By doing so, drug helps prevent peptic ulcers from forming and helps heal existing ones. Parietal cell Histamine HCl H+ ClH2 receptor Histamine Famotidine Parietal cell Histamine HCl H+ ClH2 receptor Histamine Famotidine develops pain or has trouble swallowing or if she has bloody vomit or black stools. Caution patient not to take famotidine with other acid-reducing products.
Trade Name & Company Name
effect of Famotidine in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. There are no adequate reports or well-controlled studies of famotidine in pregnant women. There are only rare reports of its use during pregnancy. A single dose of famotidine administered to parturients PO 3h before surgery is more effective neutralizing gastric secretion than omeprazole. One epidemiologic study concluded the use of H2antagonists during Pregnancy
was associated with a higher prevalence of preterm birth. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. Famotidine crosses the placenta, achieving an F:M ratio approximating 0.40. Rodent studies are reassuring, revealing no evidence of teratogenicity or IUGR despite the use of doses higher than those used clinically. Breastfeeding
There are no adequate reports or well-controlled studies in nursing women. Famotidine is excreted into human milk to a 386 lesser extent than cimetidine and ranitidine and is thus the preferred agent if a drug of this class is indicated. The daily infant dose has been estimated to be 10.8mcg/kg/d.
the follwing drugs will increse Famotidine by inhepiting cyp450
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the follwing drugs will decrease Famotidine by inhancing cyp450
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trad drugs based on Famotidine
| Gen name | Trade name | Catagory name |
| calcium carbonate / famotidine / magnesium hydroxide | Acid Controller Complete | H2 antagonists |
| calcium carbonate / famotidine / magnesium hydroxide | Acid Controller Complete Dual Action | H2 antagonists |
| calcium carbonate / famotidine / magnesium hydroxide | Acid Reducer Plus Antacid | H2 antagonists |
| calcium carbonate / famotidine / magnesium hydroxide | Dual Action Complete | H2 antagonists |
| calcium carbonate / famotidine / magnesium hydroxide | Duo Fusion | H2 antagonists |
| calcium carbonate / famotidine / magnesium hydroxide | Pepcid Complete | H2 antagonists |
| famotidine | Acid Controller Maximum Strength | H2 antagonists |
| famotidine | Acid Controller Original Strength | H2 antagonists |
| famotidine | Acid Reducer Maximum Strength | H2 antagonists |
| famotidine | Acid Reducer Original Strength | H2 antagonists |
| famotidine | Fluxid | H2 antagonists |
| famotidine | Heartburn Relief | H2 antagonists |
| famotidine | Heartburn Relief Maximum Strength | H2 antagonists |
| famotidine | Pepcid | H2 antagonists |
| famotidine | Pepcid AC | H2 antagonists |
| famotidine | Pepcid AC Chewable Tablets | H2 antagonists |
| famotidine | Pepcid Oral Suspension | H2 antagonists |
| famotidine / ibuprofen | Duexis | Nonsteroidal anti-inflammatory drugs |
| Famotidine | FAMODAR | |
| Famotidine | FAMOGEN | |
| Famotidine | PEPCIDIN 20MG TAB | |
| Famotidine | PEPCIDIN 40MG TAB | |
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