From the Guidelines
The recommended dose of famotidine for pediatric patients is 1 mg/kg/d, divided in 2 doses. This dosage is based on the guidance provided in the study published in Pediatrics in 2013 1. The study outlines the doses of various medications, including famotidine, for the treatment of gastroesophageal reflux disease (GERD) in children.
Key Points to Consider
- The dose of 1 mg/kg/d, divided in 2 doses, is indicated for children aged 1-16 years 1.
- Famotidine is available in a cherry-banana-mint–flavored oral suspension, which may be more palatable for pediatric patients.
- It is essential to note that histamine-2 (H2) blockers like famotidine have limitations, including the potential for rapid tachyphylaxis development within 6 weeks of initiation of treatment, limiting their potential for long-term use 1.
- H2RAs are also less effective than proton pump inhibitors (PPIs) in symptom relief and healing rates of erosive esophagitis, although they are still a valuable treatment option for GERD in children 1.
From the FDA Drug Label
- 1 Recommended Dosage Table 1 shows the recommended dosage of Famotidine 20 mg and 40 mg tablets in adults and pediatric patients weighing 40 kg or greater with normal renal function. 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 Use another famotidine formulation for pediatric patients weighing less than 40 kg Famotidine Tablets in Adults and Pediatric Patients 40kg and Greater with Normal Renal Function Indication Recommended Dosage Recommended Duration Active duodenal ulcer (DU) 40mg once daily; or 20mg twice daily a Up to 8 weeks b,c Active gastric ulcer 40mg once daily Up to 8 weeks Symptomatic non-erosive GERD 20mg twice daily Up to 6 weeks c Erosive esophagitis diagnosed by endoscopy 20mg twice daily; or 40mg twice daily a Up to 12 weeks Pathological hypersecretory conditions d Starting dosage: 20mg every 6 hours; adjust dosage to individual patient needs Maximum dosage 160mg every 6 hours As clinically indicated Reduction of the risk of DU recurrence d 20mg once daily 1 year c or as clinically indicated
The dose of famotidine is:
- 20mg twice daily or 40mg once daily for active duodenal ulcer
- 40mg once daily for active gastric ulcer
- 20mg twice daily for symptomatic non-erosive GERD
- 20mg twice daily or 40mg twice daily for erosive esophagitis diagnosed by endoscopy
- 20mg every 6 hours, with a maximum dosage of 160mg every 6 hours, for pathological hypersecretory conditions
- 20mg once daily for reduction of the risk of DU recurrence 2
From the Research
Dose of Famotidine
The dose of famotidine varies depending on the condition being treated.
- For the treatment of gastro-oesophageal reflux disease, a dose of 20 mg given twice daily has been used 3.
- For the healing of gastric ulcers and duodenal ulcers, doses of 20 mg twice daily or 40 mg at bedtime have been effective 4, 5.
- For the prevention of duodenal ulcer recurrence, a single 20 mg dose of famotidine at night has been used 4.
- For the treatment of Zollinger-Ellison syndrome, individualized doses with a mean of 0.33 g/day have been used 5.
- For the treatment of gastroesophageal reflux disease (GERD), b.i.d. dosing has been necessary for achieving adequate results 6.
Tolerability and Safety
Famotidine has been found to be well tolerated, with an excellent safety profile 7.
- It does not notably bind to cytochrome P-450 or gastric alcohol dehydrogenase and therefore has not been associated with clinically significant drug interactions.
- It is generally well tolerated in patients with cardiovascular, renal, or hepatic dysfunction or with Zollinger-Ellison syndrome who have tolerated doses up to 800 mg daily 7.