Pepcid (famotidine) is a histamine-2 (H2) blocker medication that provides clinically proven, long-lasting relief from gastric acid-related conditions. As a competitive inhibitor of histamine at H2 receptors of gastric parietal cells, it significantly reduces both the volume and concentration of stomach acid. This mechanism offers a targeted therapeutic approach for managing symptoms of gastroesophageal reflux disease (GERD), peptic ulcer disease, and conditions involving pathological hypersecretion. Trusted by healthcare professionals for decades, Pepcid delivers predictable, dose-dependent acid suppression with a well-established safety profile.

Features

• Active ingredient: Famotidine (20 mg per tablet in standard strength)
• Drug class: Histamine H2-receptor antagonist
• Onset of action: Approximately 1 hour after oral administration
• Duration of effect: 10–12 hours of acid suppression per dose
• Formulations: Oral tablets, chewable tablets, and oral suspension
• Bioavailability: 40–45% (oral administration, reduced by food)
• Protein binding: 15–20%
• Metabolism: Hepatic (minimal, via CYP450 system)
• Elimination half-life: 2.5–3.5 hours
• Excretion: Primarily renal (65–70% unchanged)

Benefits

• Provides rapid and sustained relief from heartburn, acid indigestion, and sour stomach
• Reduces nighttime acid breakthrough, supporting uninterrupted sleep
• Promotes healing of erosive esophagitis and duodenal ulcers when used as directed
• Minimizes acid-related damage to esophageal mucosa in GERD patients
• Offers predictable acid suppression without tolerance development during short-term use
• Available in multiple formulations for personalized dosing and administration preferences

Common use

Pepcid is indicated for the short-term treatment of active duodenal ulcers, maintenance therapy for healed duodenal ulcers, treatment of active benign gastric ulcers, and management of GERD including erosive esophagitis. It is also used for the treatment of pathological hypersecretory conditions (such as Zollinger-Ellison syndrome) and as part of combination therapy for Helicobacter pylori eradication. Over-the-counter formulations are approved for the prevention and relief of heartburn, acid indigestion, and sour stomach.

Dosage and direction

For active duodenal ulcer: 40 mg once daily at bedtime or 20 mg twice daily for 4–8 weeks. For maintenance of healed duodenal ulcer: 20 mg once daily at bedtime. For GERD: 20 mg twice daily for 6–12 weeks. For erosive esophagitis: 20 mg twice daily or 40 mg twice daily for up to 12 weeks. For OTC use: Adults and children 12 years and older take 10 mg (one tablet) with water as needed, not to exceed 20 mg in 24 hours. Tablets may be swallowed whole or chewed. For optimal effect, take 15–60 minutes before consuming food or beverages that may cause heartburn. Do not use for more than 14 days continuously without medical supervision.

Precautions

Use with caution in patients with renal impairment (dosage adjustment required for CrCl <50 mL/min). Monitor renal function periodically during prolonged therapy. Elderly patients may be more sensitive to effects and require dosage adjustments. Long-term therapy may lead to vitamin B12 deficiency due to reduced acid-mediated absorption. There is potential for cross-sensitivity with other H2 antagonists. Use during pregnancy only if clearly needed (Category B). Famotidine is excreted in breast milk—consider alternative feeding options during therapy. Not recommended for children under 12 years without medical supervision.

Contraindications

Hypersensitivity to famotidine or any component of the formulation. Patients with history of acute porphyria. Concomitant use with atazanavir due to significant reduction in atazanavir absorption and efficacy. Severe renal impairment without appropriate dosage adjustment. Not for use in patients with suspected gastric malignancy without proper diagnostic evaluation.

Possible side effects

Common (≥1%): Headache (4.7%), dizziness (1.3%), constipation (1.2%), diarrhea (1.7%). Less common: Dry mouth, fatigue, nausea, abdominal discomfort. Rare but serious: Mental confusion (particularly in elderly or renally impaired patients), arrhythmias, hepatitis, pancreatitis, blood dyscrasias (thrombocytopenia, agranulocytosis), anaphylaxis, bronchospasm. Most adverse effects are mild and transient, resolving with continued therapy or discontinuation.

Drug interaction

May reduce absorption of drugs requiring acidic environment: ketoconazole, itraconazole, atazanavir (contraindicated), iron salts, cyanocobalamin. Potential increased concentration of pH-dependent drugs. May alter absorption of delavirdine. Minimal CYP450 interactions due to low metabolism via this system. Possible additive effects with other acid-reducing agents. Monitor prothrombin time when used with warfarin (though interaction less likely than with cimetidine).

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for the missed one. For twice-daily regimens, if remembered within 4 hours of scheduled time, take immediately. If remembered later, skip and resume normal schedule. For once-daily regimens, take as soon as remembered unless within 8 hours of next dose.

Overdose

Symptoms may include hypotension, tachycardia, muscle tremors, vomiting, and restlessness. Treatment is supportive and symptomatic. Gastric lavage may be beneficial if performed soon after ingestion. Hemodialysis removes approximately 65% of circulating drug over 4 hours and should be considered in severe cases. Monitor vital signs and provide appropriate cardiovascular support. No specific antidote exists.

Storage

Store at room temperature (15–30°C or 59–86°F) in original container. Protect from moisture and light. Keep tightly closed. Do not store in bathroom medicine cabinet due to humidity fluctuations. Keep out of reach of children and pets. Do not use if tablets show signs of discoloration or deterioration. Discard unused medication after expiration date.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Individual response to medication may vary. Consult a healthcare professional before starting, stopping, or changing any medication regimen. Do not use this information to self-diagnose or self-treat. Proper diagnosis and treatment planning require comprehensive medical evaluation by a qualified healthcare provider.

Reviews

Clinical studies demonstrate famotidine’s efficacy with 72-90% of patients experiencing complete relief of nighttime heartburn symptoms at 20 mg dose. Endoscopic healing rates of 83% for duodenal ulcers after 8 weeks of therapy. Patient satisfaction surveys indicate 87% preference for famotidine over antacids for sustained relief. Medical literature supports its position as a well-tolerated option in acid suppression therapy with minimal drug interactions compared to other H2 antagonists.