ACID REDUCER (famotidine)

There are 0 contraindications.

There are 5 severe contraindications. Adequate patient monitoring is recommended for safer drug use.

Severe List
Chronic kidney disease stage 3A (moderate) GFR 45-59 ml/min
Chronic kidney disease stage 3B (moderate) GFR 30-44 ml/min
Chronic kidney disease stage 4 (severe) GFR 15-29 ml/min
Chronic kidney disease stage 5 (failure) GFr<15 ml/min
Gastric cancer

There are 1 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Kidney disease with likely reduction in glomerular filtration rate (GFr)

There are 25 severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare

Abnormal hepatic function tests Agranulocytosis Anaphylaxis Anemia Angioedema Atrioventricular block Bronchospastic pulmonary disease Cardiac arrhythmia Dyspnea Hepatitis Hypotension Increased alanine transaminase Increased aspartate transaminase Interstitial pneumonitis Leukopenia Obstructive hyperbilirubinemia Pancytopenia Psychiatric disorder Rhabdomyolysis Seizure disorder Skin rash Stevens-johnson syndrome Thrombocytopenic disorder Toxic epidermal necrolysis Urticaria

There are 32 less severe adverse reactions.

More Frequent	Less Frequent
Constipation Diarrhea Dizziness Headache disorder	None.

Rare/Very Rare
Acne vulgaris Acute abdominal pain Acute cognitive impairment Agitation Allergic conjunctivitis Alopecia Anorexia Anticholinergic toxicity Arthralgia Cramps Delirium Drowsy Dry skin Dysgeusia Facial edema Fatigue Fever Flushing General weakness Hallucinations Insomnia Lethargy Nausea Paresthesia Pruritus of skin Tinnitus Vomiting Xerostomia

Reproduction studies in rats and rabbits using oral famotidine dosages up to 2 (approximately 2500 times the maximum human dosage) and 0.5 g/kg daily, respectively, or IV dosages up to 0.2 (approximately 250 times the maximum human dosage) and 0.1

g/kg daily, respectively, have not revealed evidence of harm to the fetus. Oral dosages of 2 g/kg daily inhibited weight gain in pregnant rats, and those of 0.5 and/or 2 g/kg daily on days 7-17 of gestation decreased fetal weight and delayed sternal ossification in the offspring.

Decreased food intake and decreased weight gain also occurred in offspring of rats receiving these dosages from days 10-28 post partum. Death and locomotor dysfunction were observed in pregnant rats receiving IV famotidine dosages of 100 or 200 mg/kg daily. IV dosages of 100 or 200 mg/kg daily in rats have decreased pup body weight during the post-weaning period.

Although no direct fetotoxic effects have been observed, sporadic abortions and decreases in fetal weight occurred secondary to substantial decreases in food intake in pregnant rabbits receiving oral dosages of 200 mg/kg (250 times the usual human dosage) or more daily. Decreased number of sacrocaudal vertebrae and delayed ossification have occurred in rabbits receiving oral famotidine dosages of 0.5 g/kg daily.

There are no adequate and controlled studies to date using famotidine in pregnant women, and the drug should be used during pregnancy only when clearly needed. Women who are pregnant or nursing should seek the advice of a health professional before using famotidine for self-medication.

Famotidine is distributed into milk in humans and in animals. The drug has produced transient growth depression in the offspring of lactating rats receiving dosages at least 600 times the usual human dosage. Because of the potential for serious adverse reactions to famotidine in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman.

Precaution Exists
Precaution exists. (No data or inconclusive human data.) Use of this drug by breast feeding mothers should be evaluated carefully.

Drug Name	Excretion Potential	Effect on Infant	Notes
Famotidine	Excreted.This drug is known to be excreted in human breast milk.	It is not known whether this drug has an adverse effect on the nursing infant. (No data or inconclusive human data)	Limited data suggest low amounts excreted, with no resulting effect on infant

No enhanced Geriatric Use information available for this drug.

Precaution Exists
Geriatric management or monitoring precaution exists.

Drug Name	Narrative	REN	HEP	CARDIO	NEURO	PULM	ENDO
Famotidine	Neuro/Psych-Avoid in older adults with or at high risk of delirium because of inducing or worsening delirium. Avoid in elderly with dementia or cognitive impairment. Renal-Dose adjustment may be required for CrCL<50 mL/min. to minimize CNS effects (e.g., mental status changes).	Y	N	N	Y	N	N