Famotidine

About Famotidine

Famotidine blocks histamine H2 receptors on the stomach’s acid-producing cells, reducing acid output. Prescription tablets are labeled for adults and children weighing at least 40 kg with an active duodenal or gastric ulcer, reflux disease without erosions, or erosive esophagitis, and for adults to lower the risk of a duodenal ulcer returning and for conditions with too much acid, such as Zollinger-Ellison syndrome. The suspension has the adult uses and is labeled for peptic ulcer disease and reflux disease in children 1 and older and for reflux disease in babies under 1, dosed by weight. Adults with an ulcer usually take 40 mg once a day at bedtime for up to eight weeks; reflux disease is treated with 20 mg twice a day for up to six weeks, and erosive esophagitis with 20 or 40 mg twice a day for up to twelve weeks. The dose is lowered with moderate or severe kidney impairment (creatinine clearance under 60 mL/min).

There is no boxed warning. Famotidine must not be taken after a serious allergic reaction, such as anaphylaxis, to it or another H2 blocker. Confusion, delirium, hallucinations, seizures and lethargy have been reported in older adults and in people with moderate or severe kidney impairment, and a prolonged QT interval, a change in heart rhythm, has been reported with moderate or severe kidney impairment; because blood levels run higher when the kidneys are impaired, the label lowers the dose. Relief of symptoms does not rule out stomach cancer. Headache, dizziness, constipation and diarrhea are the most common side effects.

Over-the-counter famotidine (Pepcid AC 10 and 20 mg and generics) relieves heartburn from acid indigestion and sour stomach, or prevents it when taken before trigger foods, in adults and children 12 and older; its labels allow no more than 2 tablets in 24 hours, say not to combine it with other acid reducers, and say to ask a doctor if it is needed for more than 14 days. Pepcid Complete adds calcium carbonate and magnesium hydroxide in a chewable tablet. The FDA lists the original Pepcid prescription tablets and suspension as discontinued; tablets labeled Pepcid today are approved as a generic. The pharmacy mixes the suspension with water, and any left after 30 days is thrown away. An injection is used in hospitals.

Taking Famotidine

How to take it

Take prescription famotidine as directed, usually once a day at bedtime or twice a day (morning and bedtime), with or without food. Shake the suspension for 5 to 10 seconds and measure each dose with an oral syringe. To prevent heartburn, swallow an over-the-counter tablet with a glass of water 15 to 60 minutes (10 mg) or 10 to 60 minutes (20 mg) before the food or drink that brings it on, and take no more than 2 tablets in 24 hours.

If you miss a dose

Take a missed prescription dose as soon as you remember, unless it is almost time for the next dose; then skip it. Do not take a double dose. Over-the-counter tablets are taken as needed.

Storage

At room temperature in the original, tightly closed container, away from heat and moisture, out of reach of children. Do not let the suspension freeze, and throw away any left 30 days after the pharmacy mixed it.

Interactions to know about

Avoid tizanidine, which can cause low blood pressure, a slow heartbeat or excessive drowsiness with famotidine. It is not recommended with dasatinib, delavirdine, cefditoren or fosamprenavir, which need stomach acid to be absorbed, and it can weaken other such drugs. The over-the-counter labels say not to use it with other acid reducers.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Famotidine differs from pharmacy to pharmacy

Prescription famotidine tablets are generics from many makers, so quotes for the same strength differ mainly by each pharmacy’s fee and markup and by whether famotidine is on its flat-price generic list.

The suspension is a separate product that the pharmacy mixes, so it is quoted per bottle, separately from the tablets. Famotidine 10 and 20 mg tablets are also sold over the counter, outside a prescription quote; the 40 mg tablet and the suspension are prescription only.

Ways to pay less for Famotidine without insurance

• Ask for generic tablets, and ask whether famotidine is on the pharmacy’s flat-price generic list.
• If you take it long term, ask for a ninety-day supply once your dose is settled.
• If a suspension was prescribed and you can swallow tablets, ask the prescriber whether tablets would suit you.
• Ask the prescriber whether an over-the-counter strength fits your treatment, and never combine it with prescription famotidine or another acid reducer.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Famotidine

1. 1.Is my dose right for my kidney function?
2. 2.Can I take it with tizanidine or my other medicines?
3. 3.How do I measure a dose of the suspension, and how long can I keep it?
4. 4.Is the over-the-counter tablet the same medicine as my prescription, and can I take both?

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