[fahMOHtihdeen Pregnancy Category B

Apo-Famotidine M, Gen-Famotidine M, Novo-Famotidine M, Nu-Famoti-dine M, Pepcid, Pepcid AC Acid Controller, Pepcid IV [Rx] (Pepcid AC is OTC)

Classification: Histamine H2 receptor antagonist

See also Histamine H2 Antagonists. Action/Kinetics: Competitive inhibitor of histamine H2 receptors leading to inhibition of gastric acid secretion. Peak plasma levels: 1-3 hr. tv2: 2.5-35 hr. Onset: 1 hr. Duration:

10—12 hr. Does not inhibit the cytochrome P-450 system in the liver; thus, drug interactions due to inhibition of liver metabolism are not expected to occur. From 25% to 30% of a PO dose is eliminated through the kidney unchanged; from 65% to 70% of an IV dose is excreted through the kidney unchanged. Uses: Rx: Treatment of active duodenal ulcers. Maintenance therapy for duodenal ulcer, at reduced dosage, after active ulcer has healed. Pathologic hypersecretory conditions such as Zollinger-Ellison syndrome or multiple endocrine adenomas. GERD, including erosive esophagitis. Treatment of benign gastric ulcer. Non-FDA Approved Uses: Prevent aspiration pneumonitis, for prophylaxis of stress ulcers, prevent acute upper GI bleeding, as part of multidrug therapy to eradicate Helicobacter pylori.

OTC: Relief of and prevention of the symptoms of heartburn, acid indigestion, and sour stomach. Contraindications: Cirrhosis of the liver, impaired renal or hepatic function, lactation.

Special Concerns: Safety and efficacy in children have not been established.

Side Effects: Oral: Dry mouth. GI: Constipation, diarrhea, N&V, anorexia, abdominal discomfort. CNS: Dizziness, headache, paresthesias, depression, anxiety, confusion, hallucinations, insomnia, fatigue, sleepiness, agitation, grand mal seizure, psychic disturbances. Skin: Rash, acne, pruritus, alopecia, urticaria, dry skin, flushing. CV: Palpitations. Musculoskeletal: Arthralgia, asthenia, musculoskeletal pain. Hematologic: Thrombocytopenia. Other: Fever, orbital edema, conjunctival injection, bronchospasm, tinnitus, taste disorders, decreased libido, impotence, pain at injection site (transient). Drug Interactions Antacids / i Absorption of famoti-dine from the GI tract

Diazepam / l Absorption of diazepam from the GI tract How Supplied: Injection: 10 mg/mL; Powder for reconstitution: 40 mg/5 mL; Tablet: 10 mg, 20 mg, 40 mg

Dosage-

• Oral Suspension, Tablets

Duodenal ulcer, acute therapy.

■ Adults: 40 mg once daily at bedtime or 20 mg b.i.d. Most ulcers heal within 4 weeks and it is rarely necessary to use the full dosage for 6—8 weeks.

Duodenal ulcer, maintenance therapy.

Adults: 20 mg once daily at bedtime.

Benign gastric ulcers, acute therapy.

Adults: 40 mg at bedtime.

Hypersecretory conditions. Adults, individualized, initial: 20

mg q 6 hr; then, adjust dose to response, although doses of up to 160 mg q 6 hr may be required for severe cases.

Gastroesophageal reflux disease. Adults: 20 mg b.i.d. for 6 weeks. For esophagitis with erosions and ulcerations, give 20 or 40 mg b.i.d. for up to 12 weeks.

Prophylaxis of upper GI bleeding. Adults: 20 mg b.i.d.

Prophylaxis of stress ulcers. Adults: 40 mg/day.

Relief of and prevention of heartburn, acid indigestion, and sour stomach (OTC).

Adults and children over 12 years of age, for relief: 10 mg (1 tablet) with water. For prevention: 10 mg

1 hr before eating a meal that may cause symptoms. Maximum dose: 20 mg/24 hr. Not to be used continuously for more than 2 weeks unless medically prescribed.

• IM, IV, IV Infusion Hospitalized clients with hypersec-

retory conditions, duodenal ulcers, gastric ulcers; clients unable to take PO medication.

Before anesthesia to prevent aspiration of gastric acid.

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