famotidine (Rx, OTC)

Brand and Other Names:Pepcid, Act, more...Dyspep HB, Fluxid, Acid Controller
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection solution

  • 10mg/mL
  • 0.4mg/mL

oral suspension

  • 40mg/5mL

tablet

  • 10mg
  • 20mg
  • 40mg

tablet, chewable

  • 10mg
  • 20mg

Duodenal Ulcer

Acute treatment: 20 mg PO/IV q12hr or 40 mg PO at bedtime for 8 weeks

Maintenance: 20 mg PO at bedtime

Reduction of recurrence risk: 20 mg PO qDay for 1 year or as clinically indicated

Benign Gastric Ulcer

40 mg PO at bedtime up to 8 weeks

Gastroesophageal Reflux Disease

Nonerosive: 20 mg q12hr; up to 6 weeks

Erosive diagnosed by endoscopy: 20-40 mg PO q12hr for up to 12 weeks

Hypersecretory Conditions

20 mg PO/IV q6hr; may increase up to 160 mg q6hr

Heartburn

10-20 mg q12 hr; may take 15-60 min before eating foods that could cause heartburn

Dosing Modifications

CrCl <50 mL/min: Give 50% of usual dose, or prolong dosing interval to q36-48hr

Dosage Forms & Strengths

injection solution

  • 10mg/mL
  • 0.4mg/mL

oral suspension

  • 40mg/5mL

tablet

  • 10mg
  • 20mg
  • 40mg

tablet, chewable

  • 10mg
  • 20mg

Peptic Ulcer

1-17 years: 0.25 mg/kg IV q12hr or 0.5 mg/kg PO at bedtime; may increase to 1 mg/kg once daily at bedtime or 0.5 mg/kg twice daily for up to 8 weeks; not to exceed 40 mg/day  

Gastroesophageal Reflux Disease

<3 months: 0.5 mg/kg PO once daily; may increase to 1 mg/kg once daily for up to 8 weeks  

3-12 months: 0.5 mg/kg PO q12hr; may increase to 1 mg/kg twice daily; for up to 8 weeks; not to exceed 40 mg/day

1-17 years with or without esophagitis and ulceration: 0.5 mg/kg twice daily; for 6-12 weeks; not to exceed 40 mg twice daily

Heartburn

<12 years: Not established

>12 years: 10-20 mg q12 hr; may take 15-60 min before eating foods that could cause heartburn

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Interactions

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              Serious - Use Alternative (22)

              • atazanavir

                famotidine will decrease the level or effect of atazanavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Atazanavir solubility decreases as pH increases. Substantially reduced plasma concentrations of atazanavir are expected if H2-receptor antagonists (H2RA) are coadministered. For treatment-naïve patients, take atazanavir simultaneously with the H2RA or at least 10 h afterwards. See dosage adjustment recommendations if coadministered in treatment-experienced patients.

              • bosutinib

                famotidine will decrease the level or effect of bosutinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • dapsone

                famotidine will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • dasatinib

                famotidine will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • digoxin

                famotidine will increase the level or effect of digoxin by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • indinavir

                famotidine will decrease the level or effect of indinavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • infigratinib

                famotidine will decrease the level or effect of infigratinib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer infigratinib 2 hr before or 10 hr after administration of a H2-antagonist.

              • itraconazole

                famotidine will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • ketoconazole

                famotidine will decrease the level or effect of ketoconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • mefloquine

                mefloquine increases toxicity of famotidine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.

              • neratinib

                famotidine will decrease the level or effect of neratinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • pazopanib

                famotidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

              • pexidartinib

                famotidine will increase the level or effect of pexidartinib by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate pexidartinib by 2 hr before or 10 hr after taking an H2-antagonist.

              • pimozide

                famotidine, pimozide. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug.

                pimozide, famotidine. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug.

              • ponatinib

                famotidine decreases levels of ponatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • pretomanid

                pretomanid will increase the level or effect of famotidine by Other (see comment). Avoid or Use Alternate Drug. In vitro studies demonstrated that pretomanid significantly inhibits OAT3; monitor for increased adverse effects and consider dosage reduction for OAT3 substrates.

              • risedronate

                famotidine will increase the level or effect of risedronate by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Applies only to delayed release formulation; accelerates pH-sensitive dissolution of delayed release risedronate

              • secretin

                famotidine, secretin. Other (see comment). Avoid or Use Alternate Drug. Comment: Concomitant use of H2-receptor antagonists may cause a hyperresponse in gastrin secretion in response to stimulation testing with secretin, falsely suggesting gastrinoma. Discontinue H2-receptor antagonists at least 2 days before administering secretin to aid in the diagnosis of gastrinoma.

              • sotorasib

                famotidine will decrease the level or effect of sotorasib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If use with an acid-reducing agent cannot be avoided, administer sotorasib 4 hr before or 10 hr after administration of a locally-acting antacid.

              • tafenoquine

                tafenoquine will increase the level or effect of famotidine by Other (see comment). Avoid or Use Alternate Drug. Tafenoquine inhibits organic cation transporter-2 (OCT2) and multidrug and toxin extrusion (MATE) transporters in vitro. Avoid coadministration with OCT2 or MATE substrates. If coadministration cannot be avoided, monitor for substrate-related toxicities and consider dosage reduction if needed based on product labeling of the coadministered drug.

              • trilaciclib

                trilaciclib will decrease the level or effect of famotidine by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of trilaciclib (OCT2, MATE1, and MATE-2K inhibitor) with substrates where minimal increased concentration in kidney or blood may lead to serious or life-threatening toxicities.

              • vandetanib

                famotidine, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug.

                vandetanib, famotidine. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug.

              Monitor Closely (39)

              • acalabrutinib

                famotidine decreases levels of acalabrutinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Acalabrutinib solubility decreases with increasing gastric pH. Administer acalabrutinib 2 hr before an H2-receptor antagonist.

              • budesonide

                famotidine decreases effects of budesonide by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Enteric-coated budesonide dissolves at pH >5.5. Also, dissolution of extended-release budesonide tablets is pH dependent. Coadministration with drugs that increase gastric pH may cause these budesonide products to prematurely dissolve, and possibly affect release properties and absorption of the drug in the duodenum.

              • carbonyl iron

                famotidine will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefdinir

                famotidine will decrease the level or effect of cefdinir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefditoren

                famotidine will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefpodoxime

                famotidine will decrease the level or effect of cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cefuroxime

                famotidine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • crizotinib

                famotidine decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .

              • cyclosporine

                famotidine will increase the level or effect of cyclosporine by unknown mechanism. Use Caution/Monitor. Delayed resorption of cyclosporine has been reported when famotidine is coadministered with cyclosporine.

              • dabrafenib

                famotidine will decrease the level or effect of dabrafenib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that alter upper GI tract pH (eg, PPIs, H2-blockers, antacids) may decrease dabrafenib solubility and reduce its bioavailability

              • dexmethylphenidate

                famotidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies only to extended release formulation

              • erdafitinib

                famotidine increases levels of erdafitinib by decreasing renal clearance. Modify Therapy/Monitor Closely. Consider alternatives that are not OCT2 substrates or consider reducing the dose of OCT2 substrates based on tolerability.

              • erlotinib

                famotidine decreases levels of erlotinib by Other (see comment). Use Caution/Monitor. Comment: Avoid combination when possible. If concurrent use is required erlotinib should be taken 10 hours after a H2-antagonist and at least 2 hours before the next dose of H2-antagonist.

              • ferric maltol

                famotidine will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous fumarate

                famotidine will decrease the level or effect of ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous gluconate

                famotidine will decrease the level or effect of ferrous gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferrous sulfate

                famotidine will decrease the level or effect of ferrous sulfate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • fosamprenavir

                famotidine will decrease the level or effect of fosamprenavir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • gefitinib

                famotidine decreases levels of gefitinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Separate gefitinib and H2-antagonist doses by at least 6 hr.

              • glipizide

                famotidine will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • glyburide

                famotidine will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • iron dextran complex

                famotidine will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • iron sucrose

                famotidine will decrease the level or effect of iron sucrose by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • ledipasvir/sofosbuvir

                famotidine decreases levels of ledipasvir/sofosbuvir by Other (see comment). Use Caution/Monitor. Comment: Ledipasvir solubility decreases as pH increases; drugs that increase gastric pH are expected to decrease levels of ledipasvir; H2-receptor antagonists may be administered simultaneously with or 12 hr apart from ledipasvir/sofosbuvir at a dose that does not exceed doses comparable to famotidine 40 mg BID.

              • mesalamine

                famotidine will decrease the level or effect of mesalamine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely.

              • methylphenidate

                famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies only to extended release formulation

                famotidine decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.

              • mifepristone

                famotidine, mifepristone. Either increases toxicity of the other by QTc interval. Use Caution/Monitor.

                mifepristone, famotidine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor.

              • mycophenolate

                famotidine will decrease the level or effect of mycophenolate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • nelfinavir

                famotidine will decrease the level or effect of nelfinavir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • nilotinib

                famotidine decreases levels of nilotinib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Avoid this interaction by administering H2 antagonists 10 hr after or 2 hr before nilotinib.

              • polysaccharide iron

                famotidine will decrease the level or effect of polysaccharide iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • posaconazole

                famotidine will decrease the level or effect of posaconazole by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • rilpivirine

                famotidine will decrease the level or effect of rilpivirine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Concurrent use, may cause treatment failure and/or the development of rilpivirine or NNRTI resistance owing to decreased levels. Administer H2 antagonists at least 12 hours before or at least 4 hours after rilpivirine.

              • rose hips

                famotidine will decrease the level or effect of rose hips by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • saquinavir

                famotidine will increase the level or effect of saquinavir by unspecified interaction mechanism. Use Caution/Monitor.

              • sofosbuvir/velpatasvir

                famotidine will decrease the level or effect of sofosbuvir/velpatasvir by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Velpatasvir solubility decreases as gastric pH increases (practically insoluble at pH >5). H2 receptor antagonists may be administered simultaneously with or 12 hr apart from sofosbuvir/velpatasvir at a dose that does not exceed doses comparable to famotidine 40 mg BID.

              • tolbutamide

                famotidine will increase the level or effect of tolbutamide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • varenicline

                famotidine will increase the level or effect of varenicline by decreasing renal clearance. Use Caution/Monitor.

              • vismodegib

                famotidine will decrease the level or effect of vismodegib by Other (see comment). Use Caution/Monitor. Drugs that increase gastric pH alter vismodegib solubility and therefore reduce bioavailability; effect on efficacy unknown

              Minor (9)

              • alendronate

                famotidine increases levels of alendronate by unspecified interaction mechanism. Minor/Significance Unknown. Monitor for increase in alendronate side effects.

              • aripiprazole

                famotidine decreases levels of aripiprazole by unspecified interaction mechanism. Minor/Significance Unknown.

              • axitinib

                famotidine will decrease the level or effect of axitinib by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

              • blessed thistle

                blessed thistle decreases effects of famotidine by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

              • ceftibuten

                famotidine will decrease the level or effect of ceftibuten by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

              • cyanocobalamin

                famotidine decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • devil's claw

                devil's claw decreases effects of famotidine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • metformin

                famotidine increases levels of metformin by decreasing renal clearance. Minor/Significance Unknown.

              • phytoestrogens

                famotidine decreases levels of phytoestrogens by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Headache (4.7%)

              Diarrhea (1.7%)

              Dizziness (1.3%)

              Constipation (1.2%)

              Frequency Not Defined

              Body as a whole: Fever, asthenia, fatigue

              Cardiovascular: Arrhythmia, AV block, palpitation; prolonged QT interval in patients with impaired renal function, has been reported very rarely

              Gastrointestinal: Cholestatic jaundice, hepatitis, liver enzyme abnormalities, vomiting, nausea, abdominal discomfort, anorexia, dry mouth

              Hematologic: Rare cases of agranulocytosis, pancytopenia, leukopenia, thrombocytopenia

              Hypersensitivity: Anaphylaxis, angioedema, orbital or facial edema, urticaria, rash, conjunctival injection

              Musculoskeletal: Rhabdomyolysis, musculoskeletal pain including muscle cramps, arthralgia

              Nervous system/psychiatric: Grand mal seizure; psychic disturbances, which were reversible in cases for which follow-up was obtained, including hallucinations, confusion, agitation, depression, anxiety, decreased libido; paresthesia; insomnia; somnolence; convulsions, in patients with impaired renal function, have been reported very rarely

              Respiratory: Bronchospasm, interstitial pneumonia

              Skin: Toxic epidermal necrolysis/Stevens-Johnson syndrome (very rare), alopecia, acne, pruritus, dry skin, flushing

              Special senses: Tinnitus, taste disorder

              Rare cases of impotence and rare cases of gynecomastia

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              Warnings

              Contraindications

              Hypersensitivity to famotidine or other H2-receptor antagonists

              Cautions

              Use caution in renal impairment; dosage adjustment recommended in moderate to severe renal impairment (CrCl <50 mL/min)

              Prolonged QT interval reported rarely in patients with renal impairment whose dose or dosing interval may not have been adjusted appropriately

              Central nervous system (CNS) adverse effects, including confusion, delirium, hallucinations, disorientation, agitation, seizures, and lethargy, reported with moderate-to-severe renal impairment; since famotidine blood levels are higher in patients with renal impairment than in patients with normal renal function, dosage adjustments are recommended in patients with renal impairment

              Relief of symptoms does not eliminate the presence of gastric malignancy; consider evaluation for gastric malignancy in adult patients who have a suboptimal response or an early symptomatic relapse after completing treatment

              State of confusion reported with use; risk increased in >50 years of age and/or renal/hepatic impairment

              Prolonged treatment (>2 years) may lead to vitamin B12 malabsorption, which can result in vitamin B12 deficiency; magnitude of deficiency is dose related; occurs most frequently in females and those younger then 30 years

              Patients should not use OTC if difficulty swallowing, vomiting blood, have bloody or black stools

              If patient taking a prescription drug, the patient should ask a doctor or a pharmacist whether acid reducers can be taken concomitantly with it

              Patients with kidney disease should ask doctor before use

              Drug interaction overview

              • Treatment can reduce absorption of other drugs, due to effect on reducing intragastric acidity, leading to loss of efficacy of the concomitant drug; concomitant administration with dasatinib, delavirdine mesylate, cefditoren, and fosamprenavir not recommended
              • See prescribing information for other drugs dependent on gastric pH for absorption for administration instructions, including atazanavir, erlotinib, ketoconazole, itraconazole, ledipasvir/sofosbuvir, nilotinib, and rilpivirine
              • Although not studied clinically, drug is considered a weak CYP1A2 inhibitor and may lead to substantial increases in blood concentrations of tizanidine, a CYP1A2 substrate; avoid concomitant use; if concomitant use necessary, monitor for hypotension, bradycardia or excessive drowsiness; refer to full prescribing information for tizanidine
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              Pregnancy & Lactation

              Pregnancy

              Available data in pregnant women are insufficient to establish a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes

              Animal data

              • Animal reproduction studies have shown no adverse development effects at doses up to approximately 243 times, the recommended human dose of 80 mg per day for treatment of erosive esophagitis

              Lactation

              There are limited data available on presence in human breast milk; there were no effects on breastfed infant; there are no data on famotidine effects on milk production; drug reported present in milk of lactating rats; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for famotidine and any potential adverse effects on breastfed child or from underlying maternal condition

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Blocks H2 receptors of gastric parietal cells, leading to inhibition of gastric secretions

              Absorption

              Bioavailability: 40-45% (PO; minimal 1st-pass metabolism)

              Onset: <1 hr (PO); <30 min (IV)

              Duration: 10-12 hr

              Peak plasma time: IV, 20 min; PO, 1-4 hr

              Distribution

              Protein bound: 15-20%

              Vd: 1.1-1.4 L/kg (Adults); 1.5-2.07 L/kg (children); 1.4-1.8 L/kg (infants <3 months); 2.3 L/kg (infants 3-12 months)

              Metabolism

              Metabolized in liver

              Metabolites: Famotidine S-oxide (inactive)

              Elimination

              Half-life: 2.5-4 hr (adults; increases with renal impairment; eg, 20 hr with CrCl <10 mL/min); 3-4 hr (children); 4.5 hr (infants 3-12 months); 8-10.5 hr (infants < 3 months)

              Dialyzable: No

              Renal clearance: 250-450 mL/min

              Total body clearance: 381-483 mL/min

              Excretion: Urine (25-30% as unchanged drug when administered PO; 70% when adminsitered IV)

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              Administration

              IV Incompatibilities

              Additive: Piperacillin-tazobactam

              Y-site: Cefepime, piperacillin-tazobactam, amphotericin B, azithromycin, furosemide (at 2 mg/mL famotidine; compatible at 0.2 mg/mL)

              IV Compatibilities

              Additive: Aztreonam, ceftazidime, dobutamine, dopamine, furosemide, gentamicin, imipenem, thiamine

              Y-site: Atropine, cefazolin, furosemide, gentamicin, heparin, norepinephrine, thiamine

              IV Preparation

              Dilute 20 mg to total of 5 or 10 mL with NS, D5W, or LR

              Also available in premixed bag containing 20 mg in 50 mL NS

              IV Administration

              Infuse at rate no faster than 10 mg/min

              Storage

              Premixed: Store at room temperature

              Unmixed: Store in refrigerator at 2-8°C (36-46°F)

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              40 mg/5 mL (8 mg/mL) suspension
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              Pepcid AC oral
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              Pepcid AC oral
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              Heartburn Prevention oral
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              Pepcid AC Maximum Strength oral
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              Acid-Pep oral
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              Pepcid oral
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              40 mg/5 mL (8 mg/mL) suspension
              Pepcid oral
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              Pepcid oral
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              Heartburn Relief (famotidine) oral
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              20 mg tablet
              Heartburn Relief (famotidine) oral
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              10 mg tablet

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              Patient Education
              famotidine intravenous

              FAMOTIDINE - INJECTION

              (fam-OH-tih-dine)

              COMMON BRAND NAME(S): Pepcid

              USES: Famotidine is used to treat ulcers of the stomach and intestines and to prevent intestinal ulcers from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems (such as erosive esophagitis, gastroesophageal reflux disease-GERD, Zollinger-Ellison syndrome). It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as cough that doesn't go away, stomach pain, heartburn, and difficulty swallowing. Famotidine belongs to a class of drugs known as H2 blockers.This form of famotidine is given by vein and is used to treat these conditions for a short time when you cannot take the medication by mouth. Your doctor should switch you to taking this medication by mouth when possible.

              HOW TO USE: This medication is injected into a vein as directed by your doctor. The dosage and length of treatment are based on your medical condition and response to treatment. In children, dosage may also be based on body weight.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before injecting each dose, clean the injection site with rubbing alcohol. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.Tell your doctor if your condition persists or worsens.

              SIDE EFFECTS: Headache, constipation, diarrhea, or pain/redness at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever, chills), mental/mood changes (e.g., restlessness, confusion, depression), hearing/seeing things that are not there (hallucinations).Get medical help right away if you have any very serious side effects, including: fast/slow/irregular heartbeat, severe dizziness, fainting, seizure.A very serious allergic reaction to this drug is unlikely, but get medical help right away if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using famotidine, tell your doctor or pharmacist if you are allergic to it; or to other H2 blockers (e.g., cimetidine, ranitidine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: immune system problems, kidney problems, liver problems, lung problems (e.g., asthma, chronic obstructive pulmonary disease-COPD), other stomach problems (e.g., tumors).Some symptoms may actually be signs of a more serious condition. Get medical help right away if you have: heartburn with lightheadedness/sweating/dizziness, chest/jaw/arm/shoulder pain (especially with shortness of breath, unusual sweating), unexplained weight loss.Older adults may be more sensitive to the side effects of this drug, especially mental/mood changes (such as confusion), seizure, or unusual tiredness.Famotidine should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products need stomach acid so that the body can absorb them properly. Famotidine decreases stomach acid, so it may change how well these products work. Some affected products include atazanavir, dasatinib, delavirdine, certain azole antifungals (such as itraconazole, ketoconazole), pazopanib, among others.Do not take this medication with other products that contain famotidine or other H2 blockers (cimetidine, nizatidine, ranitidine).

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.Lifestyle changes such as stress reduction programs, stopping smoking, limiting alcohol, and diet changes (such as avoiding caffeine and certain spices) may help this medication work better. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Laboratory and/or medical tests (e.g., endoscopy, kidney function tests) may be performed to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

              STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.