Is it appropriate to give a 31‑kg child 2 mL of famotidine suspension (40 mg/5 mL) twice daily?

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Famotidine Dosing for a 31-kg Child

No, 2 mL twice daily of famotidine suspension (40 mg/5 mL) is insufficient for a 31-kg child—this provides only 16 mg twice daily (32 mg/day total), which is below the recommended dose of 0.5 mg/kg twice daily (approximately 15.5 mg per dose, or 31 mg/day total). While the volume is close to appropriate, you should verify the exact dose needed and adjust accordingly.

Recommended Dosing

For a 31-kg child, the appropriate famotidine dose is 0.5 mg/kg twice daily, which equals approximately 15.5 mg per dose or 31 mg total daily. 1, 2

  • Using the 40 mg/5 mL suspension (8 mg/mL concentration), 2 mL provides 16 mg per dose 3
  • This gives 32 mg/day total, which is slightly above but acceptably close to the target of 31 mg/day 2
  • The 2 mL BID dosing is therefore clinically appropriate and represents standard pediatric dosing 1, 2

Dosing Algorithm for Children

For children over 1 year of age, use 0.5 mg/kg per dose every 8-12 hours (typically twice daily): 1, 4

  • Children >1 year: 0.5 mg/kg/dose every 12 hours 1, 4
  • Maximum single dose: 20 mg 3
  • Maximum daily dose: 40 mg 3

For infants <3 months: Use 0.5 mg/kg once daily due to immature renal function 4

For infants 3-12 months: Use 0.5 mg/kg every 12 hours 4

Clinical Efficacy Considerations

This dosing regimen (0.5 mg/kg BID) has demonstrated effectiveness in pediatric studies: 2

  • Heals gastroduodenal ulcers within 8 weeks in children 2
  • Maintains intragastric pH >4.0 for approximately 9 hours per dose 5
  • Oral bioavailability is approximately 50% in children, similar to adults 2

Important caveat: Prolonged IV use may lead to tachyphylaxis, with decreased duration of acid suppression after repeated doses 5

Administration Instructions

  • May be given with or without food 3
  • Can be administered with antacids if needed 3
  • For twice-daily dosing, give in morning and before bedtime 3

Monitoring and Safety

Famotidine is generally well-tolerated in children with minimal side effects: 2, 6

  • No significant adverse effects reported in pediatric trials 2, 6
  • Transient mild liver enzyme elevations may occur but are typically not drug-related 6
  • For children with renal impairment (CrCl <60 mL/min), reduce dosing frequency to once daily or every other day 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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