Hypersecretion and ailments associated with hypersecretion are prevalent among a high number of individuals in the US. Various conditions such as gastric ulcers, gastroesophageal reflux disease and duodenal ulcers are increasingly reported in hospitals and healthcare facilities. Famotidine is one among the different medications used in treating or managing the above conditions, apart from use in treating Zollinger-Ellison syndrome. The following sections offer a detailed look in to the mechanism of action of the medication, benefits, and possible side effects of famotidine, which will help patients and caregivers to take suitable preventive or remedial measures.

Overview of famotidine

Belonging to the category of histamine H2 receptor antagonist, Famotidine inhibits gastric acid secretion thereby helping manage conditions that are attributed to hypersecretion. It is a frequently prescribed medication for multiple gastrointestinal conditions in adults as well as children. The highlight of the medication is the high selectively of inhibitory action, that helps improve its efficacy. Consequently, the medication has the distinction of being labelled as highly potent, with more than 20 times potency that other medications used for curbing gastric acid secretion.

The medication is available as oral prescription tablets, as liquid suspension, as intravenous injections and is also available in OTC strengths and formulations. In addition to its use in treating or managing the conditions mentioned above, it is also commonly used off label for other conditions.

Overview of conditions treated with Famotidine

GERD, acronym for gastroesophageal reflux disease is the result of gastric acid backing up into the esophagus, that triggers the burning feeling in the throat and the chest. This is also one of the reasons for burping, frequently experienced by individuals with gastrointestinal conditions, apart from the sour taste. Apart from the above, this secretion results in potential damage to the esophagus lining, and the tissue cells. The formation of painful sores in the duodenal area and the stomach lining are all attributed to excessive gastric acid secretion. The other condition is Zollinger Ellison syndrome, wherein, the patient needs to put up with excessive stomach acid secretion.

Mechanism of action of the histamine H2 receptor antagonist

The outcomes of Famotidine are attributed to the selective inhibitory action on H2 receptors, which result in the blocking of action of histamine. The organic nitrogenous compound histamine is responsible for physiological functions in the guts and as a result is known to stimulate gastric acid secretion in the parietal cells. This secretion occurs due to various stimuli and actions, including the action of histamine on H2 receptors that activate proton pumps. The result is an increase in the release of gastric acid. Famotidine regulates the secretion of gastric acid by selectively inhibiting the H2 receptors, thereby preventing histamine from completing the actions that result in gastric acid secretion.

Ideal dosage of famotidine

The actual ideal dosage of famotidine is determined based on various factors, such as the age of the patient, the gender the condition being treated, other existing conditions and medications in use. It also depends on the actual form of the medication being prescribed, and the schedule or frequency of intake/injection. Generally, patients are started off on a lower dosage that is gradually increased to higher strengths, depending on the response and the desired or expected outcome of treatment. This section is intended to serve as a broad reference of the dosage; the actual dosage can only be assessed by the specialist. It is also necessary to remember that many side effects of medications are attributed to incorrect dosage and schedule.

For duodenal ulcer, the ideal dosage for adults is 40 mg daily, for a period of two months. This may also be staggered into two different doses. In the event that it is recommended as a single dose, it is usually taken at night. When the medication is prescribed for chronic conditions, wherein it needs to be taken for a long time or when it is prescribed as a maintenance dose, the strength is 20 mg daily, taken at night. For children below the age of 17, diagnosed with duodenal ulcer, the dosage is the same as adults, mentioned above.

Dosage for patients with gastric ulcer are similar to that of patients with duodenal ulcer. However, the dosage for patients with GERD are different. For instance, the medication is prescribed to be taken in dosages of 20 mg, twice daily for a period of one and a half months. Higher dosages are recommended for patients with GERD who suffer from irritate esophagus; wherein the dosage is increased to 40 mg twice daily for an extended period of three months. This usually applies to both adults and children diagnosed with the above conditions.

Senior citizens are usually prescribed lower strengths and dosage, as the kidneys may not be able to process the medication efficiently, and as desired. As a result of this, elderly patients may experience stronger or persistent side effects; to eliminate the possibility of such effects, the dosage is usually reduced appropriately. The same applies for individuals diagnosed with renal impairments and other kidney related conditions.

Commonly reported side effects of famotidine

All medications including gastric acid medications come with the possibility of undesirable effects. The actual effects may be experienced differently by different users of the same medication. Depending on the strength of the medication, the dosage schedule, the condition being treated, other existing conditions, age, gender and the health of the individual, the side effects may be felt in different ways. Some may need to put up with strong effects that may last long, while some may only experience mild effects that resolve quickly. It is also necessary to bear in mind that some users of medications may not experience any kind of side effects.  Here is a look at some of the commonly reported unwanted effects of famotidine. This list is neither complete, nor exhaustive in nature and is only intended to serve as a broad outline of the possible undesirable outcomes. Effects experienced by adults are slightly different from the effects experienced by children, and remedial or preventive measures need to be decided accordingly.

Adults are more likely to experience headache, bouts of constipation and dizzy feelings. On a contrary note, there is also the possibility of adults ending up with diarrhea. Children are likely to cry without any specific reason or even under normal circumstances. The child is more likely to be agitated with a certain degree of restlessness observed. Most effects that are mild in nature are likely to resolve naturally without the need for medical attention. When the effects persist beyond a week or two, it may be necessary to seek medical assistance.

Effects that are considered as serious in nature

Certain effects are to be considered as serios in nature and individuals are to seek medical intervention at the earliest to prevent the situation from going out of hand. There are certain tell-tale symptoms of serious effects of medication and this needs to be a general rule of thumb for most, if not all medications. For instance, if there is a sudden change in heart beat rate and rhythm, the individual is to seek medical attention. Similarly, if the individual experiences dizzy feelings that are intense and persistent in nature, it may require assessment. Faint feelings, shortness of breath are also other conditions that need to be quickly evaluated in the event of persistence.

It is necessary to avoid ignoring certain symptoms that may be usually considered as normal. For instance, muscle problems tend to be disregarded as trivial in nature. However, if the muscle problem is severe and is linked to some effect or sequence of action, the underlying cause needs to be tackled quickly. Symptoms such as pain in the muscles that are not attributed to any trauma or work are to be assessed. Similarly, if the individual experiences some form of overall weakness or fatigue that is not attributed to any specific condition, it needs to be checked at the earliest.

Other unwanted outcomes of famotidine

Other effects that are commonly linked to famotidine include fever, and neurological conditions. Symptoms linked to neurological fallouts of the medication include agitated feelings, episodes of depression, feelings of anxiety, difficulty falling asleep, and possible seizure episodes. In addition to the above, the patients are likely to also experience an impact on sexual desire, with lowered libido. There is also the possibility of patients experiencing liver complications that may be felt through abnormal weakness and a reduction in dietary intake. Other symptoms of liver issues or effects on the liver include discoloration of urine and possible pain the abdomen. Additionally, the color of the skin or the eyes may also change as a result of liver related complications – wherein a yellowish color is observed.  Other effects of the medication include impact on the skin, such as formation of blisters on the skin and outbreak of rashes. The patient may also end up with mouth ulcers and sores.

Drug interactions of famotidine

In addition to the above side effects of famotidine there is also the possibility of drug interactions of the medication. This is not uncommon in nature, and all medications are known to have some kind of interaction with other substances and medications This includes other prescription medications, OTC formulations, herbal remedies, supplements and alternative therapeutic ingredients. Interactions of two different medications or substances typically result in an increase in possible side effects of either of the two substances, a decrease in efficacy of one of the two medications, and possible excessive or more than desired outcomes in either of the two medications. It is necessary to keep the treating specialist informed of all medications and formulations being taken, as this will help in determination of how to avoid side effects. Depending on the importance or relative criticality of the two substances, one may be either discontinued, temporarily stopped, or the dosage may be altered or staggered to prevent overlap and interactions. It is also necessary to learn that certain medications of the category of combination medications, are known to contain multiple compounds or ingredients, and a medication that has a similar composition will result in increased outcome or more than desired outcomes. It is necessary to be aware of the composition of medications and ensure that overlap is avoided.

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