Famotidine

PEPCID

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Pronunciation: fa-MOE-ti-deen

Famotidine ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Famotidine ballicule

Famotidine PEPCID mascot mnemonic cartoon — Visual mnemonic: Famotidine mascot
**“Pepsi Family tidings”**

What it isH2 receptor antagonist; GERD and ulcer disease.

Why this oneUnlike cimetidine, it has essentially no CYP inhibition, making it the H2 blocker for polypharmacy and on-demand use.

What limits itTolerance erodes scheduled acid suppression within weeks. Reduce in renal impairment; accumulation can cause confusion or QT effects.

Famotidine molecular structure (skeletal formula) — Molecular structure: Famotidine

FDA-approved for

GERD/ulcers (1986)

Off-label

adjunct in anaphylaxis and urticaria
stress ulcer prophylaxis

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Active duodenal ulcer	Adults & peds ≥40 kg	40 mg QD or 20 mg BID	40 mg QD or 20 mg BID
Active gastric ulcer	Adults & peds ≥40 kg	40 mg QD	40 mg QD
Symptomatic nonerosive GERD	Adults & peds ≥40 kg	20 mg BID	20 mg BID
Erosive esophagitis	Adults & peds ≥40 kg	20 mg BID or 40 mg BID	20 mg BID or 40 mg BID
Pathological hypersecretory conditions	Adults	20 mg q6h	adjust to patient needs	160 mg q6h
Reduction of risk of DU recurrence	Adults	20 mg QD	20 mg QD

Renal Reduce dosage for moderate–severe impairment (CrCl <60); no adjustment for mild (CrCl ≥60)

Hepatic Undefined

Instructions

Take once daily before bedtime or twice daily (morning and before bedtime)
May be taken with or without food; may be given with antacids
For pediatric patients <40 kg, use another formulation (oral suspension or lower-dose tablet)

Available strengths

tab 10, 20, 40 mg
susp 40 mg/5 mL
inj 0.4, 10 mg/mL
chew tab 20 mg
sol 40 mg/5 mL

Contraindications

Serious hypersensitivity (e.g., anaphylaxis) to famotidine or other H2-receptor antagonists

Cautions

CNS adverse reactions (confusion, delirium, seizures) in elderly and moderate/severe renal impairment — reduce dose
Absence of GI symptoms does not preclude gastric malignancy — evaluate before/after treatment

Adverse reactions

Headache
Dizziness
Constipation
Diarrhea

Pregnancy Insufficient data to establish drug-associated risk; animal studies showed no adverse developmental effects

Lactation Limited data; present in human milk with no reported effects on breastfed infant

Cost

Famotidine (PEPCID)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $	CostPlus
10 mg	tab	30 qd	$2.84/mo	offered
20 mg	tab	30 qd	$0.87/mo	offered
40 mg	tab	30 qd	$1.45/mo	offered
40 mg/5 mL	susp	per unit	$0.13/mL	not offered
0.4 mg/mL	inj	per unit		not offered
10 mg/mL	inj	per unit	$0.30/mL	not offered

Generic entry2001

NO BOXED WARNINGS

Principal riskDose adjustment needed in renal impairment

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryB

Defining liabilityLong-term infection, magnesium/B12 and bone risks; selected agents have clinically important CYP interactions.

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Memory aids: interaction avatars

Box: minimal PK interactions

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