From the Guidelines
Pepcid (famotidine) 20mg twice daily can be used for itching, particularly when the itching is related to histamine release such as in hives or allergic reactions, but it is not the first-line treatment for generalized pruritus of unknown origin (GPUO) or cholestatic pruritus. This medication is an H2 antihistamine that works by blocking histamine receptors in the stomach but also has some effect on skin histamine receptors. For itching, you can take one 20mg tablet in the morning and one in the evening. The medication typically starts working within an hour, though it may take a few days of regular use to see maximum benefit for chronic itching. Some key points to consider when using Pepcid for itching include:
- Side effects are generally mild but may include headache, constipation, or diarrhea.
- While Pepcid can help with itching, it's essential to identify and address the underlying cause.
- If your itching is severe, persists beyond a week of treatment, or is accompanied by a rash, difficulty breathing, or other concerning symptoms, consult a healthcare provider.
- For better relief of allergy-related itching, Pepcid often works best when combined with a traditional H1 antihistamine like cetirizine (Zyrtec) or diphenhydramine (Benadryl) 1.
- In cases of cholestatic pruritus, other treatments such as bezafibrate or rifampicin may be more effective, as recommended by the EASL clinical practice guidelines 1.
- In GPUO, consider nonsedative antihistamines (H1 antagonists) such as fexofenadine 180 mg or loratadine 10 mg, or mildly sedative agents such as cetirizine 10 mg orally, as recommended by the British Association of Dermatologists' guidelines 1.
From the FDA Drug Label
Famotidine Tablets in Adults and Pediatric Patients 40kg and Greater with Normal Renal Function Indication Recommended Dosage Recommended Duration ... Symptomatic non-erosive GERD 20mg twice daily Up to 6 weeks
2.3 Administration Instructions • Take Famotidine once daily before bedtime or twice daily in the morning and before bedtime, as recommended.
The recommended dosage of 20mg twice daily is indicated for Symptomatic non-erosive GERD, but there is no direct information about using Famotidine for itching. Itching is not listed as an indication for Famotidine use in the provided drug label 2.
From the Research
Dosage and Administration
- The dosage of 20mg Pepcid (famotidine) BID (twice a day) is mentioned in the study 3 as part of a combination therapy with cetirizine for the treatment of COVID-19 patients.
Efficacy for Itching
- Famotidine has been shown to reduce pruritus (itching) associated with acute urticaria in a study 4.
- The study 4 found that famotidine was comparable to diphenhydramine in efficacy for reducing pruritus, but with less sedation.
Safety and Side Effects
- Famotidine is generally considered safe and well-tolerated, with minimal side effects, as seen in the study 4 where it did not cause sedation.
- However, it is essential to note that the study 3 used a combination of cetirizine and famotidine, and the safety and efficacy of this combination for itching are not directly addressed in the provided studies.
- Other studies, such as 5, discuss the effects of antihistamines on cognition, psychomotor performance, mood, and sedation, but do not directly relate to the use of famotidine for itching.