FAMOTIDINE
Place in Therapy
Famotidine is a Histamine-2-Receptor-Antagonist 2 (H2RA). Famotidine is an effective management method for gastric esophageal reflux disease1,2,3, 4. In terms of the gastric acid suppressants, there is supported evidence that famotidine is not as effective in preventing/treating GERD when compared to PPIs5. When compared to antacids, there is evidence to support a greater global/overall efficacy for famotidine, however in terms of onset to relief, antacids provide faster relief 1, 2,4, 5. The difference between famotidine and other H2RAs is seen in duration and onset. In terms of efficacy, there is no difference between H2RAs 4, 2.
The use of famotidine is mainly recommended for mild GERD (<3 episodes/week)2,3,4. Therapy greater than 6 weeks may not provide additional benefit2. Famotidine has shown to be efficacious in prophylactic treatment of GERD taken 1 hour before meals1. Due to famotidine’s longer action of onset, there is evidence that for persistent GERD, twice daily use has shown greater efficacy than antacids1, 5. Famotidine has even shown some efficacy at higher divided doses in healing esophagitis, but are not as effective as PPIs6. These higher doses are not recommended over-the-counter doses and moderate to severe GERD should be referred to physicians2.
Famotidine is not recommended if children under the age of 16 due to a lack of efficacy in this population2.
Famotidine also has less anticholinergic side effects when compared to Ranitidine and may be a safer option for the elderly population.
References
1. Ciccone, Decktor, et. al. Efficacy and tolerability of famotidine in preventing heartburn and related symptoms of upper gastrointestinal discomfort. Am J of Therapeutics 1995 (2);314-319.
2. Co D, Patient Self Care Canadian Pharmacists Association (2010). Second Edition Chapter 33: Dyspepsia and GERD
p.298-307 (Print).
3. Kenneth R, Devalut, et al. Updated guidelines for the diagnosis and treatment of
gastroesophageal reflux disease. Am J of Gastroenterology 2005 (100); 190-200.
4. Tran T, Lowry A, et al. Meta-analysis: the efficacy of over-the-counter gastro-oesophageal reflux disease therapies. Alimentary
Pharmacology & Therapeutics 2006 (25); 143-153.
5. Simon T, Berlin R, et al. Self-directed treatment of intermittent heartburn: a randomized, multicenter, double-blind, placebo-controlled evaluation of antacid and low doses of an H2-receptor antagonist (famotidine). Am J of Therapeutics 1995 (2);304-313.
6. Berlin R, Bradstreet D, et al. Famotidine relieves symptoms of gastroesophageal reflux disease and heals erosions and ulcerations.
Archives of Internal Medicine 1991 (153); 2394-2408.
The use of famotidine is mainly recommended for mild GERD (<3 episodes/week)2,3,4. Therapy greater than 6 weeks may not provide additional benefit2. Famotidine has shown to be efficacious in prophylactic treatment of GERD taken 1 hour before meals1. Due to famotidine’s longer action of onset, there is evidence that for persistent GERD, twice daily use has shown greater efficacy than antacids1, 5. Famotidine has even shown some efficacy at higher divided doses in healing esophagitis, but are not as effective as PPIs6. These higher doses are not recommended over-the-counter doses and moderate to severe GERD should be referred to physicians2.
Famotidine is not recommended if children under the age of 16 due to a lack of efficacy in this population2.
Famotidine also has less anticholinergic side effects when compared to Ranitidine and may be a safer option for the elderly population.
References
1. Ciccone, Decktor, et. al. Efficacy and tolerability of famotidine in preventing heartburn and related symptoms of upper gastrointestinal discomfort. Am J of Therapeutics 1995 (2);314-319.
2. Co D, Patient Self Care Canadian Pharmacists Association (2010). Second Edition Chapter 33: Dyspepsia and GERD
p.298-307 (Print).
3. Kenneth R, Devalut, et al. Updated guidelines for the diagnosis and treatment of
gastroesophageal reflux disease. Am J of Gastroenterology 2005 (100); 190-200.
4. Tran T, Lowry A, et al. Meta-analysis: the efficacy of over-the-counter gastro-oesophageal reflux disease therapies. Alimentary
Pharmacology & Therapeutics 2006 (25); 143-153.
5. Simon T, Berlin R, et al. Self-directed treatment of intermittent heartburn: a randomized, multicenter, double-blind, placebo-controlled evaluation of antacid and low doses of an H2-receptor antagonist (famotidine). Am J of Therapeutics 1995 (2);304-313.
6. Berlin R, Bradstreet D, et al. Famotidine relieves symptoms of gastroesophageal reflux disease and heals erosions and ulcerations.
Archives of Internal Medicine 1991 (153); 2394-2408.