Duodenal Ulcer (Active)
Adults: PO 40 mg at bedtime or 20 mg twice daily for 4 to 8 wk.
Maintenance: 20 mg at bedtime.
Children (1 to 16 yr of age): PO 0.5 mg/kg/day at bedtime or divided twice daily (max, 40 mg/day).
Benign Gastric Ulcer (Acute)
Adults: PO 40 mg at bedtime.
Symptoms of GERD: PO 20 mg twice daily for up to 6 wk.
Esophagitis, including erosions and ulcerations: 20 or 40 mg twice daily for up to 12 wk.
Children (younger than 3 mo of age): PO 0.5 mg/kg once daily for up to 8 wk.
Children (3 mo to younger than 1 yr of age): PO 0.5 mg/kg twice daily for up to 8 wk.
Children (1 to 16 yr of age): PO 1 mg/kg/day divided twice daily (max, 40 mg twice daily).
Pathologic Hypersecretory Conditions
Adults: PO Start at 20 mg every 6 h; adjust to individual patient needs and continue as long as clinically indicated; doses up to 160 mg every 6 h have been used.
Moderately or Severely Impaired Renal Function (CrCl less than 50 mL/min) May need to reduce dose 50%, or increase dosing interval to 36 to 46 h.
For Hospitalized Patients with Pathologic Hypersecretory Conditions, Intractable Ulcers, or Patients Unable to Take Orally Parenteral use in GERD not established.
Adults and children 16 yr of age and older: IV 20 mg every 12 h.
Children (1 to 16 yr of age): IV 0.25 mg/kg (injected over a period of no less than 2 min or as 15-min infusion) every 12 h (max 40 mg/day).
Heartburn, Acid Indigestion, Sour Stomach (OTC only)
Adults and Children 12 yr of age and older:
Acute: 1 tablet.
Prevention: 1 tablet 10 to 60 min before eating or drinking.
Max: 2 tablets/24 h.
Competitively blocks histamine at H2 receptors, particularly those in gastric parietal cells, leading to inhibition of gastric acid secretion.
Hypersensitivity to other H2 antagonists.
CV: Arrhythmia; AV block; palpitation.
CNS: Headache (5%); dizziness (1%); generalized tonic-clonic seizures, psychic disturbances, asthenia, fatigue.
DERM: Toxic epidermal necrolysis (very rare); acne, alopecia, dry skin, flushing, pruritus, rash, urticaria.
EENT: Conjunctival injection, taste disorder, tinnitus.
GI: Diarrhea (2%); constipation (1%); abdominal discomfort, anorexia, dry mouth, nausea, vomiting.
GU: Gynecomastia (rare).
HEMA/LYMPH: Agranulocytosis; leukopenia; pancytopenia; thrombocytopenia (rare).
HEPA: Abnormal liver enzymes; cholestatic jaundice.
HYPERSEN: Anaphylaxis, angioedema, fever, orbital or face edema.
MUSC: Arthralgia; musculoskeletal pain, including cramps.
Effects of ketoconazole may be decreased.
Histamine H (2) antagonist
Excreted in breast milk.
IV use in children younger than 1 yr of age not adequately studied.
Consult health care provider for children younger than 12 years of age.
Rare cases of anaphylaxis have occurred.
Renal Function Impairment:
CrCl less than 50 mL/min:
Longer intervals between doses or lower doses may be needed.
Multidose injection contains benzyl alcohol.
Symptomatic response to famotidine does not preclude gastric malignancy.
OTC chewable Pepcid AC contains phenylalanine 1.4 mg per tablet.
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