Neonatal Drug Therapy Manual

Famotidine

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Pepcid
Classification: 
Histamine H2 Receptor Antagonist
Original Date: 
February 2012
Revised Date: 
April 2015
Indications: 
  • Treatment and prevention of stress ulcers and gastro-intestinal hemorrhage
  • Treatment of esophagitis
Administration: 
  • IV direct: over at least 2 minutes
  • IV intermittent infusion: over 15 - 30 minutes
  • PO
Dosage: 
  • Neonates
    • IV: 0.5 mg/kg/dose once daily
    • PO: 0.5 mg/kg/dose once daily
  • Infants (corrected GA > 42 weeks and PNA > 4 weeks)
    • IV: 0.25 - 0.5 mg/kg/dose once daily
    • PO: 0.5 mg/kg/dose once daily
  • Infants > 3 months to 1 year
    • IV: 0.25 - 0.5 mg/kg/dose once daily
    • PO: 0.5 mg/kg/dose twice daily

Dosage adjustment required in renal impairment.  Refer to available references or clinical pharmacist for dosage adjustment.

Side Effects: 
  • CVS: bradycardia, tachycardia, AV block, palpitations, hypertension, angioedema
  • Dermatologic: rash
  • Hematologic:: thrombocytopenia
  • Hepatic: increase in liver enzymes
  • Renal: BUN and serum creatinine elevated
Parameters to Monitor: 
  • HR and BP
  • BUN and serum creatinine
  • Liver function tests

 

Reconstitution and Stability: 
  • Famotidine 10 mg/mL
    • Take 1 mL (10 mg) and add to 19 mL D5W
    • Final concentration: 0.5 mg/mL
Compatibility: 

- Solutions Compatible: dextrose solutions up to D10W,  0.9% NaCl

- Y-site Compatible: acyclovir, ampicillin, cefazolin, cefotaxime, cefuroxime, dexamethasone, gentamicin, heparin, insulin, midazolam, morphine, potassium chloride, sodium bicarbonate, TPN (amino acids- dextrose), vancomycin

- Incompatible: azithromycin, piperacillin-tazobactam, SMOF

References: 

- Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 20th Edition. Hudson: Lexi-Comp Inc; 2013

- Wu, Yan-Yong.  Efficacy and safety of famotidine for the treatment of stress ulcers in neonates.  Chinese Journal of Contempory Pediatrics; 2008-05

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