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famotidine
Pepcid, Pepcid ACOTC, Pepcidine‡

Pregnancy Risk Category B

How supplied
Tablets:
10 mg, 20 mg, 40 mg
Powder for oral suspension:
40 mg/5 ml after reconstitution
Injection:
10 mg/ml
Premixed injection:
20 mg/50 ml in normal saline

Action
Competitively inhibits action of H2 at receptor sites of the parietal cells, decreasing gastric acid secretion.

Indications & dosage
Duodenal ulcer (short-term treatment)--

Adults:
for acute therapy, 40 mg P.O. once daily h.s. or 20 mg P.O. b.i.d. For maintenance therapy, 20 mg P.O. once daily h.s.
Benign gastric ulcer (short-term treatment)--

Adults:
40 mg P.O. daily h.s. for 8 weeks.
Pathologic hypersecretory conditions (such as Zollinger-Ellison syndrome)--

Adults:
20 mg P.O. q 6 hours, up to 160 mg q 6 hours.
Hospitalized patients with intractable ulcerations or hypersecretory conditions or who can't take oral drug--

Adults:
20 mg I.V. q 12 hours.
Gastroesophageal reflux disease (GERD)--

Adults:
20 mg P.O. b.i.d. for up to 6 weeks. For esophagitis caused by GERD, 20 to 40 mg b.i.d. for up to 12 weeks.
Prevention or treatment of heartburn--

Adults:
10 mg (Pepcid AC only) P.O. 1 hour before meals (prevention) or 10 mg (Pepcid AC only) P.O. with water when symptoms occur. Maximum daily dose is 20 mg. Drug shouldn't be taken daily for more than 2 weeks.
Adjust-a-dose:
For patients with severe renal insufficiency and creatinine clearance below 10 ml/minute, 20 mg I.V. or P.O. h.s., or prolong dosing interval to q 36 to 48 hours.

Adverse reactions
CNS:
headache, dizziness, vertigo, malaise, paresthesia.
CV:
palpitations, flushing.
EENT:
tinnitus, orbital edema.
GI:
diarrhea, constipation, anorexia, taste perversion, dry mouth.
GU:
increased BUN and creatinine levels.
Hepatic:
elevated hepatic enzyme levels.
Musculoskeletal:
bone and muscle pain.
Skin:
acne, dry skin.
Other:
transient irritation at I.V. site, fever.

Interactions
None significant.

Effects on diagnostic tests
Drug may antagonize pentagastrin during gastric acid secretion tests. In skin tests using allergen extracts, drug may cause false-negative results.

Contraindications
Contraindicated in patients with hypersensitivity to drug.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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