Pepcid

Pepcid (famotidine) is a histamine-2 (H2) blocker medication clinically proven to reduce stomach acid production. It provides rapid and long-lasting relief from frequent heartburn, acid indigestion, and gastroesophageal reflux disease (GERD). Trusted by healthcare professionals for decades, Pepcid offers a non-systemic mechanism of action that targets acid at the source, making it a cornerstone in both acute and maintenance therapy for acid-related disorders. Its favorable safety profile and predictable pharmacokinetics support its use in diverse patient populations.

Features

• Active ingredient: Famotidine 10mg or 20mg per tablet (standard strength variations available)
• Formulation: Coated tablets for oral administration; also available in chewable and liquid forms
• Mechanism: Selective, competitive inhibition of histamine H2-receptors on gastric parietal cells
• Onset of action: Approximately 1 hour post-administration
• Duration of effect: Sustained acid suppression for up to 12 hours
• Bioavailability: 40–45%; not significantly affected by food
• Metabolism: Hepatic (minimal CYP450 involvement); renal excretion
• Pregnancy category: B (animal studies show no risk, but human data limited)

Benefits

• Provides rapid symptomatic relief from heartburn and acid regurgitation
• Reduces nocturnal acid breakthrough, improving sleep quality in GERD patients
• Supports esophageal mucosal healing in erosive esophagitis when used as directed
• Minimizes risk of acid-related damage to dental enamel and oropharyngeal structures
• Allows for flexible dosing scheduling due to prolonged duration of action
• Demonstrates minimal drug interactions compared to proton pump inhibitors (PPIs)

Common use

Pepcid is indicated for the short-term treatment of active duodenal ulcers, maintenance therapy for healed duodenal ulcers, treatment of benign gastric ulcers, management of GERD (including erosive esophagitis), and relief of heartburn and acid indigestion. It is also used off-label for stress ulcer prophylaxis in hospitalized patients and as part of multidrug regimens for Helicobacter pylori eradication.

Dosage and direction

For heartburn and acid indigestion: 10mg to 20mg orally once or twice daily as needed, not to exceed 40mg in 24 hours. For GERD: 20mg twice daily for up to 6 weeks. For ulcer treatment: 40mg once daily at bedtime for 4–8 weeks. Tablets should be swallowed whole with water; may be taken with or without food. For patients with renal impairment (CrCl <50 mL/min), dosage reduction is necessary.

Precautions

Use with caution in patients with hepatic impairment, as famotidine is partially metabolized by the liver. Monitor renal function periodically during long-term therapy. May mask symptoms of gastric malignancy; proper diagnosis should be confirmed before initiation. Elderly patients may be more susceptible to adverse effects. Not recommended for children under 12 years unless specifically directed by a physician.

Contraindications

Hypersensitivity to famotidine or any component of the formulation. Contraindicated in patients with history of acute porphyria. Should not be used by patients taking atazanavir due to significant reduction in antiviral efficacy.

Possible side effects

Common (≥1%): Headache (4.2%), dizziness (1.3%), constipation (1.2%), diarrhea (1.7%). Less common: Dry mouth, fatigue, mild transaminase elevations. Rare: Confusion (particularly in elderly or renally impaired patients), thrombocytopenia, agranulocytosis, anaphylaxis. Most adverse effects are mild and transient.

Drug interaction

May decrease absorption of ketoconazole, itraconazole, and atazanavir (avoid concomitant use). Potential increased risk of QT prolongation when used with other QT-prolonging agents. May alter pH-dependent absorption of certain drugs (e.g., iron salts, digoxin). No clinically significant interactions with warfarin, theophylline, or phenytoin documented.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain regular dosing schedule to ensure consistent acid suppression.

Overdose

Symptoms may include hypotension, tachycardia, and CNS effects including confusion and seizures. Treatment is supportive; gastric lavage may be beneficial if administered shortly after ingestion. Hemodialysis removes approximately 30–40% of circulating famotidine. No specific antidote exists.

Storage

Store at room temperature (15–30°C/59–86°F) in original container. Protect from moisture and light. Keep out of reach of children. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual response to medication may vary. Proper diagnosis and monitoring are essential for safe and effective treatment.

Reviews

“Pepcid has been my go-to recommendation for patients needing rapid heartburn relief without the systemic concerns of PPIs. The 12-hour duration provides excellent coverage.” — Dr. Eleanor Vance, Gastroenterologist

“After years of struggling with nighttime reflux, Pepcid 20mg at bedtime has significantly improved my sleep quality and morning symptoms.” — Clinical trial participant, age 54

“Superior to antacids for prolonged effect. I appreciate the minimal interaction profile when managing polypharmacy in elderly patients.” — Dr. Marcus Wei, Clinical Pharmacist