Pepcid

Pep·cid (ppsd)

A trademark for the drug famotidine.

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Pepcid,

trademark for an H₂ receptor antagonist used as antiulcer medication (famotidine).

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famotidine

Apo-Famotidine (CA), Gen-Famotidine (CA), Mylanta AR, Novo-Famotidine (CA), Nu-Famotidine (CA), Pepcid, Pepcid AC, Ulcidine (CA), Ultra Heartburn Relief (UK)

Pharmacologic class: Histamine₂-receptor antagonist

Therapeutic class: Antiulcer drug

Pregnancy risk category B

Action

Blocks action of histamine at histamine₂-receptor sites in gastric parietal cells, inhibiting gastric acid secretion and stabilizing pepsin

Availability

Gelcaps: 10 mg

Oral suspension: 40 mg/5 ml

Solution for injection: 10 mg/ml, 20 mg/50 ml of normal saline solution

Tablets: 10 mg, 20 mg, 40 mg

Tablets (chewable): 10 mg

Tablets (orally disintegrating): 20 mg, 40 mg

⊘Indications and dosages

➣ Active duodenal ulcers and benign gastric ulcers

Adults: 40 mg P.O. once daily at bedtime or 20 mg P.O. b.i.d. for up to 8 weeks

➣ Prophylaxis of duodenal ulcers

Adults: 20 mg P.O. once daily at bedtime

➣ Gastroesophageal reflux disease

Adults: 20 mg P.O. b.i.d. for up to 6 weeks. Maximum dosage is 40 mg b.i.d. for up to 12 weeks.

Children ages 1 to 16: 1 mg/kg P.O. daily in two divided doses, to a maximum of 40 mg b.i.d.

➣ Gastric hypersecretory conditions (such as Zollinger-Ellison syndrome)

Adults: Initially, 20 mg P.O. q 6 hours, increased as needed to 160 mg q 6 hours

➣ Hospitalized patients with pathologic hypersecretory conditions or ulcers; patients who can't take oral drugs

Adults: 20 mg I.V. q 12 hours

➣ Prevention or treatment of heartburn, acid indigestion, and sour stomach (Pepcid AC only)

Adults: For prevention, 10 mg P.O. 1 hour before eating, or 10-mg chewable tablet 15 minutes before eating, to a maximum of 20 mg/24 hours for up to 2 weeks. For symptomatic treatment, 10 mg P.O. once or twice daily.

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug or other histamine₂-receptor antagonists
• Alcohol intolerance (some oral liquid products)

Precautions

Use cautiously in:
• renal impairment
• elderly patients
• pregnant or breastfeeding patients.

Administration

• Be aware that drug usually is given in one daily dose to patients with renal insufficiency.
• Give P.O. form with foods or liquids.
• Dilute I.V. form with 10 ml dextrose 5% in water or normal saline solution (100 ml) for I.V. piggyback administration.
• Deliver by I.V. push over 2 minutes or intermittent infusion over 30 minutes.
• Know that drug may cause transient irritation at I.V. site.

Route	Onset	Peak	Duration
P.O.	Within 1 hr	1-4 hr	6-12 hr
I.V.	Rapid	0.5-3 hr	8-15 hr

Adverse reactions

CNS: dizziness, headache, paresthesia, asthenia

CV: palpitations

GI: nausea, diarrhea, constipation, dry mouth, anorexia

EENT: orbital edema, conjunctival redness, tinnitus

Musculoskeletal: musculoskeletal pain

Skin: flushing, acne, dry skin

Other: altered taste, fever, pain at injection site, hypersensitivity reactions

Interactions

Drug-food. Caffeine-containing foods: increased gastric irritation

Drug-herbs. Yerba maté: decreased famotidine clearance

Drug-behaviors. Alcohol use, smoking: increased gastric irritation

Patient monitoring

• Assess patient for GI signs and symptoms.
• Monitor blood urea nitrogen and creatinine levels in patients with renal impairment.

Patient teaching

• Tell patient that drug is most effective when taken at bedtime.
• Inform patient that pain relief may not begin until several days after therapy starts.
• Caution patient to avoid alcohol, caffeine, and smoking because they may increase gastric irritation.
• Tell female patient to inform prescriber if she is pregnant or breastfeeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the foods, herbs, and behaviors mentioned above.

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Pepcid®

Famotidine, see there