When administered absorbtsiya- incomplete; bioavailability is 40-45%, increased when taken with food, and is reduced by antacids background. Relationship to plasma proteins – 15-20%. Maximum plasma concentration achieved after oral administration at 1 -3 hours. It penetrates into the cerebrospinal fluid, the placenta and breast milk. The half-life (T1 / 2) – 2.5-3.5 hours. In patients with severe renal impairment (creatinine clearancetestosterone ethanate- less than 10 ml / min), the T1 / 2 increases to 20 hours (dose adjustment is required). 30-35% of the drug is metabolized in the liver. Famotidine is a weak bases and hydrophilic drug substance, which is practically not able to penetrate tissues (heart, bronchi, central nervous system, etc.) And to cause side effects typical histamine receptors I generation. Excreted by the kidneys by glomerular filtration and tubular secretion. 25-30% of an oral dose is found in the urine in unchanged form.
- Treatment and prevention of relapse of gastric ulcer and 12 duodenal ulcer.
- Treatment and prevention of symptomatic gastric ulcers and 12 duodenal ulcer .
- Erosive gastroduodenitis.
- Functional dyspepsia associated with increased gastric secretion.
- Reflux esophagitis.
- Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomatosis.
- Prevention of recurrence of bleeding from the upper gastrointestinal tract (.
- Prevention of aspiration of gastric juice during general anesthesia (Mendelson’s syndrome).CONTRAINDICATIONS
Hypersensitivity to famotidine and other ingredients.
Children’s age (for a given dosage form).
Hereditary disorders such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption.Precautions
Liver and / or kidney failure, cirrhosis with portosystemic encephalopathy testosterone ethanate, immunodeficiency, pregnancy, lactation.Pregnancy and lactation
The use of famotidine during pregnancy, especially during the first trimester and during lactation is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus and child.
Dosing and Administration
The inside is not liquid, squeezed small amounts of water.
In the acute gastric ulcer and 12 duodenal ulcer – 40 mg 1 time a day at bedtime or on. 20 mg 2 times a day. If necessary, the daily dose can be increased to 80-160 mg. The duration of treatment, 4-8 weeks.
For the prevention of relapse of peptic ulcer disease – 20 mg 1 time a day at bedtime.
When Zollinger-Ellison syndrome – the initial dose of 20-40 mg 4 times daily; if necessary, the daily dose can be increased to 240-480 mg. The treatment is continued as long as necessary (severe forms of the syndrome – 160 mg every 6 hours).
When reflux esophagitis initial dose – 20 mg 2 times / day to 6 weeks (if necessary -20-40 mg 2 times a day up to 12 weeks).
to prevent aspiration of gastric contents – 4C mg before surgery or the morning of surgery for 2 hours before the operation.
When the rest of the testimony is most commonly used dose of 20 mg 2 times / day or 20-40 mg 1 time a day at bedtime .
Patients with creatinine clearance (CC) of less than 10 ml / min for 20 mg at bedtime. The time interval between doses can be increased to 36-48 hours.
Side effect From the digestive system: dry mouth, decreased appetite, nausea, vomiting, abdominal pain, increased activity of “liver” transaminases, constipation, diarrhea, jaundice, hepatocellular, cholestatic or mixed hepatitis, acute pancreatitis. From the side of hematopoiesis: neutropenia, leukopenia, thrombocytopenia, hemolytic anemia, agranulocytosis, pancytopenia. Allergic reactions: urticaria, skin rash, itching, bronchospasm, angioedema, mnogomorfnaya erythema, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylactic shock. On the part of cardio vascular system: decrease in blood pressure (BP), bradycardia, atrio-ventricular testosterone ethanateblock, arrhythmia, vasculitis. nervous system: headache, asthenia, somnolence, insomnia, fatigue, anxiety, depression, anxiety, psychosis, dizziness, confusion, hallucinations, hyperthermia. From the senses: tinnitus. From the urogenital system: . chronic administration of high doses – reduced potency and libido From the musculoskeletal system: . arthralgia, myalgia Other: dry skin, alopecia, gynecomastia.
Overdose Symptoms: vomiting, motor excitation, tremors, decreased blood pressure, tachycardia, collapse. Treatment: orally shows induction of vomiting and / or gastric lavage. Symptomatic and supportive therapy: in convulsions – intravenous (i / v) diazepam; bradycardia – atropine; ventricular arrhythmia – lidocaine. Hemodialysis is effective.
Interaction with other drugs
increases the absorption of amoxicillin and clavulanic acid. Antacids and sucralfate delay absorption. It reduces absorption of itraconazole and ketoconazole. Drugs that suppress the bone marrow, increasing the risk of developing neutropenia.
symptoms of peptic ulcer disease 12 – duodenum may disappear within 1-2 weeks, therapy should be continued for as long as the scarring is not confirmed by endoscopy or examination may mask symptoms associated with carcinoma of the stomach, so before starting treatment to rule out malignancy. Shall be progressively abolished because of the risk of the syndrome of “rebound” at the abrupt cancellation.
With prolonged treatment in immunocompromised patients, as well as stress may be bacterial lesions of the stomach and then spread the infection. Blockers H 2 histamine receptors to be taken 2 hours after administration of ketoconazole or itraconazole avoid significant reduction of absorption. Counteracts the influence of pentagastrin and histamine on gastric acid-forming function, so for 24 hours preceding the test, use blockers of H 2 histamine receptors are not recommended.
Blockers of H 2 histamine receptors can suppress skin reaction to histamine, leading to false negative results (before the diagnostic skin tests to detect immediate allergic skin reaction such as the use of blockers of H 2 histamine receptors should stop).
During treatment should avoid eating foods, drinks and other drugs that can cause irritation of the gastric mucosa.
The effectiveness of the drug in inhibiting the nocturnal acid secretion in the stomach may be reduced as a result of smoking.
Patients with burns may require increased doses of the drug due to the increased ground clearance.
When you miss a dose, it should be taken as soon as possible; do not take the missed dose if it is time for your next dose; not double the dose. During the testosterone ethanate period of treatment must be careful when driving and occupation of other potentially hazardous activities that require high concentration and psychomotor speed reactions.