From the FDA Drug Label
The types of adverse reactions in overdosage of Famotidine are similar to the adverse reactions encountered with use of recommended dosages [see Adverse Reactions (6.1)]. In the event of overdosage, treatment should be symptomatic and supportive. Unabsored material should be removed from the gastrointestinal tract, the patient should be monitored, and supportive therapy should be employed. Due to low binding to plasma proteins, famotidine is eliminated by hemodialysis. There is limited experience on the usefulness of hemodialysis as a treatment for Famotidine overdosage.
In the event of a famotidine overdose, treatment should be:
- Symptomatic: managing the symptoms as they appear
- Supportive: providing care to prevent further complications Key considerations include:
- Removing unabsorbed material from the gastrointestinal tract
- Monitoring the patient
- Employing supportive therapy
- Possibly using hemodialysis for elimination, although experience with this treatment is limited 1
From the Research
Famotidine overdose is generally considered to have low toxicity, with most cases resulting in minimal symptoms even at doses many times the recommended amount. If someone has taken too much famotidine, they should seek medical attention immediately by calling poison control or going to an emergency room. Symptoms of overdose may include headache, dizziness, abdominal pain, nausea, vomiting, and rarely, cardiac arrhythmias. Treatment is primarily supportive care, including monitoring vital signs, providing intravenous fluids if needed, and treating symptoms as they arise. There is no specific antidote for famotidine overdose. Activated charcoal may be administered if the overdose was recent (within 1-2 hours).
Key Considerations
- Famotidine is an H2 receptor antagonist that reduces stomach acid production by blocking histamine's action on the parietal cells in the stomach 2.
- Its relatively safe profile in overdose is due to its specific mechanism of action and limited effects on other body systems, but medical evaluation is still essential to rule out complications, especially in individuals with pre-existing health conditions.
- The study by 2 provides insight into the pharmacodynamic and pharmacokinetic properties of famotidine, highlighting its potency and efficacy in treating peptic ulcer disease and Zollinger-Ellison syndrome.
Management
- Supportive care is the primary treatment approach for famotidine overdose, focusing on monitoring vital signs, providing intravenous fluids if needed, and treating symptoms as they arise.
- Activated charcoal may be considered if the overdose was recent, but its effectiveness in this context is not well-established.
- It is essential to note that the evidence provided does not directly address the management of famotidine overdose, but the general principles of supportive care and monitoring can be applied based on the drug's mechanism of action and pharmacokinetic properties.
Important Notes
- The study by 3 is not relevant to the management of famotidine overdose, as it discusses bullous emphysema and its pathophysiology.
- In real-life clinical practice, it is crucial to prioritize the patient's safety and well-being, even if the evidence is limited or indirect, and to seek medical attention immediately if an overdose is suspected.