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famotidine (Pepcid, Apogastine)

Tradename: Pepcid, Pepcid AC. Indications: - dyspepsia - prevention of peptic ulcer disease & erosive esophagitis in patients taking low-dose aspirin [4] - prevention of GERD in patient with hiatal hernia - stress ulceration & stress ulcer prophylaxis [5] - investigational use for treatment of COVID-19 [7] - 80 mg of famotidine TID of modest & controversial benefit [8] Dosage: 1) 20 mg IV every 12 hours. 2) 20-40 mg PO QHS. 3) 10 mg with water 15-60 minutes before eating 4) 60-240 mg PO QD used for treatment of non-hospitalized patients with COVID-19 [6] - 89 mg PO TID most frequent dose [6] Tabs: 10, 20 & 400 mg Suspension: 40 mg/5 mL Dosage adjustment for renal insufficiency: - reduce dose with eGFR < 50 mL/min [6] - 36-48 hour dosing in patients with renal insufficiency [2]. Adverse effects: 1) adverse effects of 40 mg QHS similar to placebo [3] 2) adverse effects which may be related to famotidine [3] a) headache 4.7% b) dizziness 1.3% c) constipation 1.2% d) diarrhea 1.7% Toxicity: 1) no data on deliberate overdose 2) adults have been given up to 640 mg/day with no serious adverse effects [3] Laboratory: - famotidine in serum/plasma

Interactions

drug interactions drug adverse effects of H2-receptor antagonists

General

antiulcer agent H2 receptor antagonist

Properties

MISC-INFO: elimination route LIVER KIDNEY pregnancy-category B safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Prescriber's Letter 8(5):26 2001
  3. Physician's Desk Reference (PDR) 56th edition, Medical Economics, 2002
  4. Taha AS Famotidine for the prevention of peptic ulcers and oesophagitis in patients taking low-dose aspirin (FAMOUS): a phase III, randomised, double-blind, placebo-controlled trial. Lancet, Volume 374, Issue 9684, Pages 119-125, 11 July 2009 PMID: 19577798
  5. Deprecated Reference
  6. A Pocket Guide to the 2019 Beer's Criteria. American Geriatrics Society.
  7. Cohen E, Nigam M Study shows Covid-19 patients who took heartburn drug were less likely to die, but researchers caution more research is needed. CNN Health. May 9, 2020. https://www.cnn.com/2020/05/09/health/famotidine-covid-19-correlation-study/index.html - Freedberg DE, Conigliaro J, Sobieszczyk ME et al Famotidine Use is Associated with Improved Clinical Outcomes in Hospitalized COVID-19 Patients: A Retrospective Cohort Study. medRxiv. May 8, 2020 Not indexed in PubMed https://www.medrxiv.org/content/10.1101/2020.05.01.20086694v1 - Freedberg DE, Conigliaro J, Wang TC et al Famotidine Use is Associated with Improved Clinical Outcomes in Hospitalized COVID-19 Patients: A Propensity Score Matched Retrospective Cohort Study. Gastroenterology. 2020 May 22:S0016-5085(20)34706-5 PMID: 32446698 Free PMC article - Walker M More Evidence Heartburn Drug May Help COVID-19 Patients - Another observational study adds fuel to the fire, but more research is needed. MedPage Today August 17, 2020 https://www.medpagetoday.com/infectiousdisease/covid19/88119 - Mather JF, Seip RL, McKay RG et al Impact of famotidine use on clinical outcomes of hospitalized COVID-19 patients. Am J Gastroenterol; August 26, 2020. PMID: 32852338 https://journals.lww.com/ajg/Documents/AJG-20-2074_R1.pdf - Swift D Common Heartburn Drug for COVID-19 Symptoms? In case series, non-hospitalized patients felt better within 1-2 days of starting famotidine MedPage Today. June 4, 2020 https://www.medpagetoday.com/infectiousdisease/covid19/86893
  8. Cohen E After hopeful early signs, study of popular heartburn drug shows mixed results against Covid-19. CNN Health. Feb 10, 2022 https://www.cnn.com/2022/02/10/health/covid-famotidine-study-results/index.html
  9. Department of Veterans Affairs, VA National Formulary

Component-of

calcium carbonate/famotidine/magnesium hydroxide (Pepcid complete) famotidine/ibuprofen (Duexis)