What is the dosage of famotidine (Famotidine) for gastroesophageal reflux disease (GERD)?

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Last updated: April 29, 2025View editorial policy

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From the Guidelines

The recommended dosage of famotidine for acid reflux is 20 mg taken twice daily, as evidenced by the FAMOUS trial 1. This dosage has been shown to be effective in reducing the incidence of peptic ulcer, hematomas, intracranial hemorrhage, and bleeding that requires surgery, especially in patients taking low-dose aspirin. Key points to consider when prescribing famotidine for acid reflux include:

  • The medication should be taken consistently at the same time each day for best results
  • Treatment duration varies based on symptom severity, but typically ranges from 2-8 weeks for active treatment
  • Some patients may require maintenance therapy to control symptoms
  • Famotidine can be taken with or without food, but it's essential to follow the specific instructions provided by the healthcare provider
  • Side effects are generally mild but may include headache, constipation, or diarrhea, as noted in the study 1. It's also important to note that famotidine does not interfere with the antiplatelet activity of clopidogrel, unlike some PPIs, making it a suitable alternative for patients requiring dual-antiplatelet therapy 1.

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 Symptomatic non-erosive GERD 20mg twice daily Up to 6 weeks Erosive esophagitis diagnosed by endoscopy 20mg twice daily; or 40mg twice daily a Up to 12 weeks

The recommended dosage of famotidine for acid reflux is:

  • 20mg twice daily for symptomatic non-erosive GERD, up to 6 weeks
  • 20mg twice daily or 40mg twice daily for erosive esophagitis diagnosed by endoscopy, up to 12 weeks 2

From the Research

Dosage of Famotidine for Acid Reflux

  • The provided studies do not directly mention the dosage of famotidine for acid reflux.
  • However, studies 3, 4, 5, 6, 7 discuss the treatment of gastroesophageal reflux disease (GERD) using proton-pump inhibitors (PPIs) and histamine(2) receptor antagonists.
  • Study 3 mentions that patients taking PPI therapy twice daily still have nocturnal acid breakthrough, and the addition of a histamine(2) receptor antagonist at bedtime may decrease this occurrence.
  • Study 7 compares the efficacy of different PPI dosing regimens for the treatment of GERD, but does not provide information on famotidine dosage.
  • Since famotidine is a histamine(2) receptor antagonist, its dosage for acid reflux may be related to the dosage of other histamine(2) receptor antagonists, such as ranitidine, which is mentioned in study 3.
  • However, without direct evidence, it is not possible to determine the exact dosage of famotidine for acid reflux.

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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