| Name | Pepcid (Famotidine) |
| Uses | Histamine H2-receptor antagonist used to reduce stomach acid production. In wellness settings, may be used to reduce the risk of gastric irritation caused by high-dose vitamin C or other acidic nutrients. May also be included in pre-medication protocols to reduce histamine-mediated reactions. |
| Route Of Administration | Intravenous (IV) |
| Frequency Of Use | Administered as needed before infusions with higher gastric irritation potential or during reactions. Routine weekly use is not recommended unless medically indicated. |
| Concentration(s) | Common concentration: 10 mg/mL. |
| Maximum Dosage (Day, Wk) (g/mL)/mL | Maximum dose per infusion: 20 mg. Maximum daily dose: 40 mg. Use the lowest effective dose for elective wellness patients. |
| Contraindications | Hypersensitivity to famotidine or other H2-receptor antagonists. Severe renal impairment (dose adjustment required). History of acute porphyria. Pregnancy and breastfeeding unless cleared by OB provider. |
| Possible Side Effects | Headache, dizziness, constipation, or diarrhea. Injection site irritation. Rare: allergic reaction (rash, itching, anaphylaxis). Prolonged use may alter stomach acid balance, affecting nutrient absorption. |
| Compatibility With Other Drugs | Compatible with normal saline and D5W. Should not be mixed directly with calcium-containing solutions. May be combined with certain vitamins and amino acids in comprehensive IV formulations, but compatibility must always be verified prior to mixing. |
| Allergies | True allergy to famotidine is rare. Reactions are more likely related to preservatives or stabilizers in compounded formulations. |
| Administration Time | Typical administration time: Slow IV push over 2 to 5 minutes. If added to a larger IV bag, may be infused over the duration of the entire treatment. |
| IV Dosing | For gastric protection: 10 mg to 20 mg IV given once prior to infusion. For histamine reaction mitigation: 20 mg IV as a one-time dose during reaction, if appropriate. |
| IM/Push | May be administered as a slow IV push. IM administration is possible but less preferred due to slower onset and patient discomfort. |
| What To Do If Adverse Reaction Occurs | 1. Stop the infusion immediately if reaction occurs after Pepcid administration. 2. Assess vital signs (blood pressure, heart rate, oxygen saturation). 3. For allergic reactions (rash, itching, shortness of breath), administer additional antihistamines and consider epinephrine if severe. 4. For dizziness or hypotension, place the patient in a supine position and consider fluid bolus if necessary. 5. If symptoms persist or worsen, arrange for emergency transfer to a higher level of care (call 911 if necessary). |