Famotidine Acre

General characteristics. Structure:

Active ingredient: 20 mg of famotidine.

Excipients: lactose, potato starch, silicon dioxide colloid, magnesium stearate, talc. Structure of an obolochki:gipromelloz, polyethyleneglycol (macrogoal), titanium dioxide, glycerin, talc, titanium dioxide, lactose.

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 concentration of gastrin in plasma. Poorly inhibits oksidazny system of P 450 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 digestive tract. 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:

- a peptic ulcer of a 12-perstny gut and a 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 (NPVP), stressful, postoperative ulcers); 
- the functional dyspepsia associated with the increased secretory function of a stomach; 
- reflux esophagitis, erosive esophagitis; 
- Zollingera-Ellison's syndrome; 
- erosive gastroduodenit; 
- 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:

Inside. 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 2 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. 

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:

Symptoms of a peptic ulcer 12 - a perstny gut can disappear within 1-2 weeks, therapy should be continued until scarring is not confirmed with data of an endoscopic or X-ray analysis Can mask the symptoms connected with a stomach carcinoma therefore before an initiation of treatment it is necessary to exclude existence of a malignant new growth. Cancel gradually because of risk of development of a syndrome of "ricochet" at sharp cancellation.

At prolonged treatment at the weakened patients, and also at a stress bacterial damages of a stomach with the subsequent spread of an infection are possible.

H2 blockers - histamine receptors should be accepted in 2 h after reception of an itrakonazol or a ketokonazol in order to avoid considerable reduction of their absorption.

Counteracts influence of Pentagastrinum and histamine on acid-forming function of a stomach therefore during 24 h preceding the test it is not recommended to apply H2 blockers - histamine receptors.

Suppresses 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 of H2 - histamine receptors is recommended to be stopped).

During treatment it is necessary to avoid the use of food stuffs, drinks, etc. Hp which can cause irritation of a mucous membrane of a stomach.

Efficiency of drug in inhibition of night secretion of acid in a stomach can decrease as a result of smoking.

Increase in a dose of drug owing to the increased clearance can be required by patients with burns.

For in/in famotidine solution uses for injections before use it is necessary to dilute with solution 0.9% NaCl solution; in/in infusion - 5% dextrose solution.

In case of the admission of a dose, it needs to be accepted as soon as possible; not to accept if there came time of reception of the following dose; not to double a dose. Divorced solutions for injections are stable during 48 h at the room temperature. At discoloration or existence of a deposit solution should not be applied. In the absence of improvements consultation of the doctor is necessary.

Side effects:

From the alimentary system: dryness in a mouth, nausea, vomiting, abdominal pains, appetite loss, increase in activity of "hepatic" transaminases, hepatitis, acute pancreatitis. 

From a nervous system: headache, dizziness; cases of development of hallucinations, confusion of consciousness, an illegibility of visual perception are described.

From cardiovascular system: lowering of arterial pressure, atrioventricular block, bradycardia, arrhythmia, vasculitis. 

Allergic reactions: urticaria, itch, bronchospasm, Quincke's disease, toxic epidermal necrolysis, acute anaphylaxis. 

From bodies of a krovetvoreniya:leykopeniye, neutropenia, thrombocytopenia, agranulocytosis, pancytopenia, hypoplasia, marrow aplasia. 

From reproductive system: at long reception of high doses - a giperprolaktinemiya, a gynecomastia, an amenorrhea, decrease in a libido, impotence. 

From sense bodys: accommodation paresis, a ring in ears. 

Others: seldom - fever, an arthralgia, a mialgiya.

Interaction with other medicines:

Increases absorption of amoxicillin and clavulanic acid.

Let's combine from 0:18 and 0.9% NaCl solution, 4 and 5% solution of a dextrose, 4.2% Natrii hydrocarbonas solution.

Antacids and сукральфат slow down absorption.

Reduces absorption of an itrakonazol and ketokonazol.

The HP oppressing marrow increase risk of development of a neutropenia

Contraindications:

Hypersensitivity.

With care. A liver and/or renal failure, cirrhosis with portosistemny encephalopathy (in the anamnesis), an immunodeficiency, children's age, pregnancy, the lactation period.

Overdose:

Symptoms: vomiting, motive excitement, tremor, decrease in the ABP, tachycardia, collapse.

Treatment: at oral administration induction of vomiting or/and a gastric lavage is shown. Symptomatic and maintenance therapy: at spasms - in/in diazepam; bradycardia - atropine; ventricular arrhythmias - lidocaine. The hemodialysis is effective.

Storage conditions:

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

Issue conditions:

According to the recipe

Packaging:

Tablets, film coated, 20 mg. On 10 tablets in a blister strip packaging. 2 blister strip packagings together with the application instruction in a pack from a cardboard.