famotidine Nursing Considerations & Management

 Drug Name

Generic Name : famotidine

Brand Name: Apo-Famotidine (CAN), Novo-Famotidine (CAN), Pepcid, Pepcid AC, Pepcid AC Maximum Strength, Pepcid RPD, ratio-Famotidine (CAN)

Classification:  Histamine 2 (H2) receptor antagonist

Pregnancy Category B

Dosage & Route
ADULTS
  • Acute treatment of active duodenal ulcer: 40 mg PO or IV hs or 20 mg bid PO or IV. Therapy at full dosage should generally be discontinued after 6–8 wk.
  • Maintenance therapy for duodenal ulcer: 20 mg PO at bedtime.
  • Benign gastric ulcer: 40 mg PO daily at bedtime.
  • Hypersecretory syndrome: 20 mg q 6 hr PO initially. Doses up to 160 mg q 6 hr have been administered. 20 mg IV q 12 hr in patients unable to take oral drugs.
  • GERD: 20 mg bid PO for up to 6 wk. For patients with esophagitis, the dose is 20–40 mg bid PO for up to 12 wk.
  •  Heartburn, acid indigestion: 10 mg PO for relief; 10 mg PO 1 hr before eating for prevention. Do not exceed 20 mg/24 hr.
PEDIATRIC PATIENTS 1–16 YR
  • Peptic ulcer: 0.5 mg/kg/day PO hs or divided in two doses up to 40 mg/day; 0.25 mg/kg q 12 hr IV up to 40 mg/day if unable to take orally or for pathological hypersecretory conditions.
  • GERD with or without esophagitis: 1 mg/kg/day PO divided in two doses up to 40 mg bid.
GERIATRIC PATIENTS OR PATIENTS WITH RENAL IMPAIRMENT
  • Reduce dosage to 20 mg PO at bedtime or 40 mg PO q 36–48 hr.
Therapeutic actions
  • Famotidine competitively blocks histamine H2-receptors thus reducing basal, nocturnal and stimulated gastric acid secretion. Pepsin secretion is reduced resulting in decreased peptic activity. It effectively heals duodenal and gastric ulcers and prevents recurrence.
Indications
  • Short-term treatment and maintenance of duodenal ulcer
  • Short-term treatment of benign gastric ulcer
  • Treatment of pathologic hypersecretory conditions (eg, Zollinger-Ellison syndrome)
  • Short-term treatment of GERD, esophagitis due to GERD
  • OTC: Relief of symptoms of heartburn, acid indigestion, sour stomach
Adverse effects
  • Headache, dizziness, constipation, diarrhoea, nausea, rash, GI discomfort, fatigue, gynaecomastia, impotence.
Contraindications
  • Hypersensitivity; lactation.
Nursing considerations
Assessment
  • History: Allergy to famotidine; renal failure; lactation, pregnancy, hepatic impairment
  • Physical: Skin lesions; liver evaluation, abdominal examination, normal output; renal function tests, serum bilirubin
Interventions
  • If using one dose a day, administer drug at bedtime.
  • Decrease doses with renal failure.
  • Arrange for administration of concurrent antacid therapy to relieve pain.
  • Reserve IV use for hospitalized patients not able to take oral medications; switch to oral medication as soon as possible.
Teaching points
  • Take this drug at bedtime (or in the morning and at bedtime). Therapy may continue for 4–6 weeks or longer. Place rapidly disintegrating tablet on tongue and swallow with or without water.
  • Take antacid exactly as prescribed, being careful of the times of administration.
  • Have regular medical follow-up while on this drug to evaluate your response.
  • Take over-the-counter drug 1 hour before eating to prevent indigestion. Do not take more than two per day.
  • You may experience these side effects: Constipation or diarrhea; loss of libido or impotence (reversible); headache (adjust lights, temperature, noise levels).
  • Report sore throat, fever, unusual bruising or bleeding, severe headache, muscle or joint pain.