Famotidine tablets p / o 40mg, No. 20

• Treatment and prevention of relapses of gastric ulcer and duodenal ulcer,

• reflux esophagitis,

• Zollinger-Ellison syndrome,

• diseases and conditions accompanied by increased secretion of gastric juice,

• prevention of erosive and ulcerative lesions of the gastrointestinal tract while taking NSAIDs;

• bleeding from the upper gastrointestinal tract (for intravenous administration, as part of complex treatment).

Individual, depending on the indications.

Inside for the purpose of treatment, 10-20 mg is used 2 times / day or 40 mg 1 time / day.

If necessary, the daily dose can be increased to 80-160 mg. For the purpose of prophylaxis - 20 mg 1 time / day before bedtime.

When administered intravenously, a single dose is 20 mg, the interval between injections is 12 hours.

With CC less than 30 ml / min or with a serum creatinine concentration of more than 3 mg / dL, it is recommended to reduce the dose to 20 mg / day.

famotidine

• Pregnancy,

• lactation period,

• hypersensitivity to famotidine.

pharmachologic effect

III generation histamine H2 receptor blocker. Suppresses the production of hydrochloric acid, both basal and stimulated by histamine, gastrin and, to a lesser extent, acetylcholine. Simultaneously with a decrease in the production of hydrochloric acid and an increase in pH, the activity of pepsin decreases. The duration of action with a single dose depends on the dose and ranges from 12 to 24 hours.

Pharmacokinetics

After oral administration, it is rapidly, but incompletely, absorbed from the gastrointestinal tract. Cmax in blood plasma is achieved after 2 hours. Bioavailability is 40-45% and changes slightly in the presence of food. T1 / 2 from plasma is about 3 hours and increases in patients with impaired renal function. Protein binding is 15-20%. A small part of the active substance is metabolized in the liver to form famotidine S-oxide. Most of it is excreted unchanged in the urine.

Side effect

From the digestive system: possible lack of appetite, dry mouth, taste disorders, nausea, vomiting, bloating, diarrhea or constipation; in some cases - the development of cholestatic jaundice, an increase in the level of transaminases in the blood plasma. From the side of the central nervous system: headache, increased fatigue, tinnitus, transient mental disorders are possible. From the side of the cardiovascular system: rarely - arrhythmias. From the hematopoietic system: very rarely - agranulocytosis, pancytopenia, leukopenia, thrombocytopenia. From the musculoskeletal system: possible muscle pain, joint pain. Allergic reactions: itching, bronchospasm, fever are possible. Dermatological reactions: possible alopecia, acne vulgaris, dry skin. Local reactions: irritation at the injection site.

Application during pregnancy and lactation

Contraindicated for use during pregnancy and lactation. Famotidine is excreted in breast milk.

Application for violations of liver function

Use with caution in patients with impaired liver function.

Application for impaired renal function

Use with caution in patients with impaired renal function.

Application in children

Clinical experience with famotidine in children is limited.

special instructions

Use with caution in patients with impaired renal and hepatic function. Before starting treatment, it is necessary to exclude the possibility of a malignant disease of the esophagus, stomach or duodenum. Does not alter the activity of liver microsomal enzymes. It is necessary to observe the interval between taking antacids and famotidine at least 1-2 hours. Clinical experience with the use of famotidine in children is limited.

Drug interactions

With simultaneous use with anticoagulants, the possibility of an increase in prothrombin time and the development of bleeding is not excluded. With simultaneous use with antacids containing magnesium hydroxide and aluminum hydroxide, it is possible to reduce the absorption of famotidine. With simultaneous use with itraconazole, a decrease in the concentration of itraconazole in blood plasma and a decrease in its effectiveness is possible. With simultaneous use with nifedipine, a case of a decrease in cardiac output and cardiac output is described, apparently due to an increase in the negative inotropic effect of nifedipine. With simultaneous use with norfloxacin, the concentration of norfloxacin in the blood plasma decreases; with probenecid - the concentration of famotidine in the blood plasma increases.With simultaneous use, a case of an increase in the concentration of phenytoin in blood plasma with the risk of developing a toxic effect has been described. With simultaneous use, the bioavailability of cefpodoxime decreases, apparently due to a decrease in its solubility in the contents of the stomach with an increase in the pH of gastric juice under the influence of famotidine. With simultaneous use with cyclosporine, a slight increase in the concentration of cyclosporine in the blood plasma is possible.