Famotidine

General characteristics. Structure:

Active agent: famotidine — 20 mg or 40 mg.

Excipients: magnesium stearate, potato starch, polyvinylpirrolidone low-molecular medical, microcrystallic cellulose, lactose. Cover: a gidroksipropilmetiltsellyuloza, titanium dioxide, quinolinic yellow (tablets on 20 mg), the twin 80, aerosil.

Pharmacological properties:

Pharmacodynamics. Blocker of H2-histamine receptors of the III generation. Suppresses basal and stimulated a histamine, gastrin and acetylcholine products of hydrochloric acid. Reduces activity of pepsin. Strengthens protective mechanisms of a mucous membrane of a stomach and promotes healing of its damages connected with influence of hydrochloric acid (including to the termination of gastrointestinal bleedings and scarring of stressful ulcers) by increase in formation of gastric slime, the maintenance in it of glycoproteins, stimulation of secretion of a hydrocarbonate a mucous membrane of a stomach, endogenous synthesis in it of prostaglandins and speeds of regeneration. Significantly does not change gastrin level in plasma. Poorly inhibits oksidazny system of P450 cytochrome in a liver. After intake action begins in 1 hour, reaches a maximum within 3 hours. Duration of effect of drug at a single dose depends on a dose and makes from 12 to 24 hours.

Pharmacokinetics. After intake it is quickly absorbed from a GIT. After intake the maximum concentration in a blood plasma is reached within 1-3,5 hours. Bioavailability — 40-45%, increases at reception with food and decreases against the background of reception of antacids. Communication with proteins of plasma — 15-20%. 30-35% of famotidine are metabolized in a liver (with formation of S-oxide). Elimination, generally happens through kidneys: 27-40% of drug are removed with urine in not changed look. The elimination half-life — 2,5-4 hours, at patients with clearance of creatinine lower than 30 ml/min. increases till 10-12 o'clock. At patients with a heavy renal failure (the clearance of creatinine is lower than 10 ml/min.) it increases till 20 o'clock. Gets through a placental barrier and it is allocated with breast milk.

Indications to use:

Peptic ulcer of a 12-perstny gut and stomach in an aggravation phase, prevention of a recurrence. Treatment and prevention of the symptomatic stomach ulcers and a 12-perstny gut (connected with reception of non-steroidal anti-inflammatory drugs, stressful, postoperative ulcers).
Erosive gastroduodenit. The functional dyspepsia associated with the increased secretory function of a stomach. Reflux esophagitis. Zollingera-Ellison's syndrome. Prevention of a recurrence of bleedings from upper parts of a GIT.
The prevention of aspiration of a gastric juice at the general anesthesia (Mendelssohn's syndrome).

Route of administration and doses:

At a peptic ulcer of a stomach and a 12-perstny gut in an aggravation phase, symptomatic ulcers, an erosive gastroduodenit usually appoint 20 mg 2 times a day or on 40 mg of 1 times a day to night. If necessary the daily dose can be increased to 80-160 mg. A course of treatment — 4-8 weeks. At the dyspepsia connected with the increased secretory function of a stomach appoint 20 mg 1-2 times a day. For the purpose of prevention of a recurrence of a peptic ulcer appoint 20 mg of 1 times a day before going to bed.
At a reflux esophagitis — 20-40 mg two times a day within 6-12 weeks. At Zollingera-Ellison's syndrome the dose of drug and duration of a course of treatment are established individually. The initial dose usually makes 20 mg each 6 hours and can be increased to 160 mg each 6 hours. For prevention of aspiration of a gastric juice at the general anesthesia appoint 40 mg in the evening and/or in the morning before operation. Tablets of Famotidine should be swallowed without chewing, washing down with enough water. At a renal failure if the clearance of creatinine makes less than 30 ml/min. or the content of creatinine in blood serum more than 3 mg / 100 ml, it is necessary to reduce a daily dose of drug to 20 mg.

Features of use:

Before an initiation of treatment it is necessary to exclude a possibility of existence of a malignant disease of a gullet, stomach or duodenum. Famotidine, as well as all H2-gistaminoblokatory, is undesirable to cancel sharply (a syndrome of "ricochet"). At prolonged treatment at the weakened patients, in the conditions of a stress, bacterial damages of a stomach with the subsequent spread of an infection are possible.

With CARE apply at patients at an abnormal liver function. Blockers H2-gistaminoretseptorov can counteract influence of Pentagastrinum and histamine on acid-forming function of a stomach therefore within 24 hours preceding the test it is not recommended to apply blockers H2-gistaminoretseptorov. Blockers H2-gistaminoretseptorov can suppress skin reaction to a histamine, resulting thus in false-negative results (before conducting diagnostic skin tests for identification of allergic skin reaction of immediate type use of blockers H2-gistaminoretseptorov is recommended to be stopped). During treatment it is necessary to avoid the use of food stuffs, drinks and other medicines which can cause irritation of a mucous membrane of a stomach.

Side effects:

- From the alimentary system: are possible — dryness in a mouth, nausea, vomiting, abdominal pains, it is rare — appetite loss, increase in activity of "hepatic" transaminases; development of hepatitis, acute pancreatitis is in some cases possible.
- From a nervous system: headache, dizziness; cases of development of hallucinations, confusion of consciousness, an illegibility of visual perception are described.
- From cardiovascular system: very seldom — a lowering of arterial pressure, bradycardia.
- Allergic reactions: skin rash, itch, acute anaphylaxis.
- From bodies of a hemopoiesis: seldom — a leukopenia, thrombocytopenia; in isolated cases — an agranulocytosis, a pancytopenia, a hypoplasia, a marrow aplasia.
- From reproductive system: at long reception of high doses — a giperprolaktinemiya, a gynecomastia, an amenorrhea, decrease in a libido, impotence.
- Other: seldom — fever, an arthralgia, a mialgiya.

Interaction with other medicines:

Owing to increase рН stomach contents at a concomitant use absorption of a ketokonazol can decrease. At simultaneous use with antiacid means, sukralfaty there is a decrease in intensity of absorption of famotidine therefore the break between reception of these drugs has to make not less than 1-2 hours. Increases absorption of amoxicillin and clavulanic acid.
The medicines oppressing marrow increase risk of development of a neutropenia.

Contraindications:

Pregnancy, the lactation period, liver failure, children's age, hypersensitivity to drug components.

With CARE — cirrhosis with portosistemny encephalopathy in the anamnesis, a renal failure.

Overdose:

Symptoms: aggravation of side effects is possible.
Treatment: gastric lavage, symptomatic therapy, hemodialysis.

Storage conditions:

List B. In the dry, protected from light place, at a temperature not above 25 °C. To store in the places unavailable to children.

Issue conditions:

According to the recipe

Packaging:

On 10 tablets in a blister strip packaging.
On 10, 20, 30, 40, 50, 60, 100, 120, 180 tablets in a container polymeric or a bottle from glass melt.
One container (bottle) or 1,2, 3,4, 5,6,8,10, 12, 18 blister strip packagings together with the application instruction in a pack from a cardboard. On 5, 10 or 20 containers (bottles) or on 30, 40, 60, 80 and 100 blister strip packagings together with the corresponding number of application instructions in a box from a cardboard (for hospitals).