From the Guidelines
The pediatric dose of Famotidine (Pepcid) is 1 mg/kg/d, divided in 2 doses, for children 1-16 years old. This dose is based on the guidance provided by the American Academy of Pediatrics, as outlined in the study published in Pediatrics in 2013 1. The study provides a table outlining the doses of various medications, including Famotidine, for the treatment of gastroesophageal reflux disease (GERD) in children. Key points to consider when administering Famotidine to children include:
- The medication should be given in 2 divided doses
- The dose is based on the child's weight, with a dose of 1 mg/kg/d
- The medication is available in a cherry-banana-mint–flavored oral suspension, making it easier to administer to children
- The dose may need to be adjusted based on the child's response to treatment and any side effects that may occur, as noted in the study 1. It is essential to consult with a healthcare provider to determine the best course of treatment for each individual child, as they can provide guidance on the appropriate dose and administration of Famotidine based on the child's specific needs and medical history.
From the FDA Drug Label
The use of Famotidine 20 mg and 40 mg tablets is not recommended for use in pediatric patients weighing less than 40 kg because the lowest available strength (20 mg) exceeds the recommended dose for these patients For pediatric patients weighing less than 40 kg, consider another famotidine formulation (e.g., oral suspension, lower dose tablet)
The pediatric dose of Famotidine is not explicitly stated in the provided drug labels for patients weighing less than 40 kg. However, it is recommended to use another formulation, such as an oral suspension or a lower dose tablet, for these patients.
- Pediatric patients weighing 40 kg or greater: The recommended dosage is shown in Table 1 of the drug label 2.
- Pediatric patients weighing less than 40 kg: Consider an alternative formulation, such as an oral suspension or a lower dose tablet.
From the Research
Pediatric Dose of Famotidine
The pediatric dose of Famotidine (Pepcid) can be determined based on the available evidence.
- The study 3 suggests that a possibly efficacious famotidine dose for infants is 0.5 mg/kg, with the frequency adjusted for age.
- The study 4 characterizes the pharmacokinetics of famotidine in infants and suggests that the dose should be adjusted based on age, with infants <3 months of age requiring a different dosing regimen than infants >3 months of age.
- The study 4 also reports that a short course of famotidine therapy in infants appears generally well tolerated, with approximate dose-proportionality and no accumulation on multiple dosing.
Dosage Considerations
When considering the dosage of famotidine for pediatric patients, the following points should be taken into account:
- The dosage may require individualization based on response, as some patients may require a higher dose of 1.0 mg/kg 3.
- The development of renal function, which is the primary route of elimination for famotidine, plays a significant role in determining the pharmacokinetics of the drug in infants 4.
- The study 4 suggests that infants <3 months of age have decreased plasma and renal clearance of famotidine compared to infants >3 months of age, which should be taken into account when determining the dosage.