Famotidine

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In gastroenterology, famotidine is a competitive Histamine H2 antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion.[1] Indications include duodenal and gastric ulcer, Zollinger-Ellison syndrome, gastroesophageal reflux disease, and the self-treatment of minor "heartburn". It is used as a preanesthetic drug to reduce the risk of aspiration of acidic gastric contents during emergency surgery. [2]

History

Pepcid brand of famotidine was approved by the Food and Drug Administration in the United States. It is available as a generic, and also in over-the-counter forms.

Pharmacology

Administration

It is most commonly administered orally, as a tablet or suspension. An intravenous preparation is approved for hospitalized patients.

While it has a relatively short half-life, its toxicity is so low that it can be given once or twice a day, especially at bedtime when they can efficiently block nocturnal acid secretion without the challenge of food.

Distribution

Metabolism

Excretion

Toxicity

While no drug can be considered free of toxicity, there have been no reports of acute poisoning with famotidine in clinical practice. The oral and IV LD50 of famotidine have been reported to be greater than 3000 and 254–563 mg/kg, respectively, in both mice and rats.[3]

Side effects have been reported to include headache, dizziness, diarrhea and constipation.

Drug-drug interactions are less likely with famotidine than with the related drugs cimetidine and ranitidine. It "does not appear to inhibit the metabolism of drugs, including warfarin, theophylline, phenytoin, diazepam, or procainamide, by the hepatic cytochrome P-450 (microsomal) enzyme system. ... minimal effects of the drug on cytochrome P-450 enzymes have been suggested, and additional experience with long-term therapy and with relatively high dosages is necessary to determine the potential, if any, for clinically important effects." [4]

Clinical use

General medicine

Veterinary medicine

Famotidine is useful for gastrointestinal irritation in cats. It is most commonly administered as a tablet, always a challenge in cats. For human use, oral suspensions are approved, but before use in cats, the "inert ingredients" must be checked to ensure that the preparation does not contain xylitol or other sugar alcohols as sweeteners. These are toxic in cats, and cats, in any event, cannot taste sweetness.

The parenteral preparation may also be administered subcutaneously, which may well be less stressful, for home care, both to cat and human.

External links

The most up-to-date information about Famotidine and other drugs can be found at the following sites.


References

  1. Anonymous (2024), Famotidine (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Laurence L. Brunton (1996), Chapter 37. Agents for control of gastric acidity and control of peptic ulcers, in Joel G. Hardman et al., Goodman & Gilman's the pharmacological basis of therapeutics (9th ed.), New York: McGraw-Hill, ISBN 0-07-026266-7, at 906-907
  3. American Society of Health System Pharmacists, Toxicity, Monograph: famotidine, Medscape
  4. American Society of Health System Pharmacists, Drug interactions, Monograph: famotidine, Medscape