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Famotidine
See also Histamine H 2 receptor antagonists
General information
Famotidine is a histamine H 2 receptor antagonist. It does not affect drug metabolism and it has been claimed to be free of the antiandrogenic effect of cimetidine; however in one woman who accidentally took double doses of the drug for some months it did cause hyperprolactinemia and breast engorgement [ ]. In other ways it bears a very close resemblance to cimetidine; for example, headache and confusion with intravenous use are reported, as are thrombocytopenia and pancytopenia [ ].
The effects of famotidine 20 mg bd and omeprazole 20 mg/day for 8 weeks have been compared in the treatment of reflux esophagitis in a randomized trial in 56 patients [ ]. Omeprazole was more effective in healing esophagitis and providing symptom relief. Adverse events, which were rare, were similar in the two groups, and consisted of nausea, palpitation, abdominal pain, and mild abnormalities of liver function tests.
Drug studies
Comparative studies
Famotidine 20 mg/day (n = 66) and rebamipide 300 mg/day (n = 63) for 4 weeks have been compared in 129 patients with gastric hemorrhage or erosions associated with non-steroidal anti-inflammatory drugs (NSAIDs) [ ]. They continued to take the NSAIDs throughout the study. There was a significant improvement in gastric lesions with famotidine, but no change with rebamipide. Ten patients taking famotidine had adverse drug reactions, including increased alanine transaminase activity (n = 10) and increased blood urea nitrogen concentrations (n = 2). Of those taking rebamipide 10 had an adverse drug reaction, including increased aspartate transaminase activity (n = 2) increased blood urea nitrogen (n = 2) and an increased white blood cell count (n = 2). There were no serious adverse reactions.
Endoscopic mucosal resection of gastric tumors often results in iatrogenic ulcers. In 82 patients who took either famotidine 40 mg/day or omeprazole 20 mg/day after endoscopic mucosal resection there was no difference in ulcer stage or reduction ratio at 28 days [ ]. However, a subgroup analysis suggested benefit with omeprazole in those who underwent endoscopic submucosal dissection. There were no adverse events in either group.
Organs and systems
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