Famotidine

Famotidine, sold under the brand name Pepcid among others, is a histamine H₂ receptor antagonist medication that decreases stomach acid production. It is used to treat peptic ulcer disease, gastroesophageal reflux disease, and Zollinger–Ellison syndrome. It is taken by mouth or by injection into a vein. It begins working within an hour.

Common side effects include headache, abdominal pain, diarrhea or constipation, and dizziness. Serious side effects may include pneumonia and seizures. Use in pregnancy appears safe but has not been well studied, while use during breastfeeding is not recommended.

Famotidine was patented in 1979 and came into medical use in 1985. It is available as a generic medication. In 2023, it was the 33rd most commonly prescribed medication in the United States, with more than 16 million prescriptions.

Famotidine has a delayed onset of action, beginning after 90 minutes. However, famotidine has a duration of effect of at least 540 minutes (9.0 h). At its peak effect, 210 minutes (3.5 h) after administration, famotidine reduces acid secretion by 7.3 mmol per 30 minutes.

The most common side effects associated with famotidine use include headache, dizziness, and constipation or diarrhea.

Famotidine may contribute to QT prolongation, particularly when used with other QT-elongating drugs, or in people with poor kidney function.

Activation of H₂ receptors located on parietal cells stimulates proton pumps to secrete acid into the stomach lumen. Famotidine, an H₂ antagonist, blocks the action of histamine on the parietal cells, ultimately reducing acid secretion into the stomach.

Unlike cimetidine, the first H₂ antagonist, famotidine has a minimal effect on the cytochrome P450 enzyme system and does not appear to interact with as many drugs as other medications in its class. Some exceptions include antiretrovirals such as atazanavir, chemotherapeutics such as doxorubicin, and antifungal medications such as itraconazole.