When to take pepcid

How soon after starting Pepcid will my symptoms improve?

How quickly your symptoms improve after you start taking Pepcid (famotidine) will likely depend on why you’re taking the drug. If it’s to relieve heartburn, you should get some relief within a few minutes. If you’re taking Pepcid to treat an ulcer (sores in the stomach or small intestine), your ulcer will probably heal within a month, and your symptoms may improve even sooner. You may be able to stop taking Pepcid within two months, but follow your doctor’s instructions for when to take and stop taking Pepcid.
If you’re taking prescription Pepcid to treat gastroesophageal reflux disease (GERD), a condition in which stomach acid backs up into the esophagus (the tube connecting your mouth to your stomach), you may need to take Pepcid for six weeks or so, but you’ll probably start feeling better much sooner. If you’re also treating esophagitis (irritation and swelling in the esophagus), you may need to take Pepcid for 12 weeks or longer.
If you have a medical condition that causes your body to produce excess stomach acid, how long you need to take Pepcid and when your symptoms will improve may depend on the condition and how well your body responds to Pepcid.

Famotidine, Oral Tablet

The famotidine dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using famotidine to treat
  • your age
  • the form of famotidine you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: Famotidine

  • Form: oral tablet
  • Strengths: 20 mg, 40 mg

Brand: Pepcid

  • Form: oral tablet
  • Strengths: 20 mg, 40 mg

Dosage for duodenal ulcer

Adult dosage (ages 18 years and older)

  • Short-term dosage: 40 mg taken once per day at bedtime for up to eight weeks. Your doctor may divide your dose into 20 mg taken two times per day.
  • Long-term dosage: 20 mg taken once per day at bedtime.

Child dosage (ages 0–17 years, 40 kg or greater)

  • Short-term dosage: 40 mg taken once per day at bedtime for up to eight weeks. Your doctor may divide your dose into 20 mg taken two times per day.
  • Long-term dosage: 20 mg taken once per day at bedtime.
  • Dosage changes: Your doctor may adjust your dosage and length of treatment based on how well you respond to the drug.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

People with moderate or severe kidney disease: Your doctor may decrease your dose of this drug by half or they may have you take one dose every 48 hours instead of every day.

Dosage for gastric ulcer

Adult dosage (ages 18 years and older)

  • Short-term dosage: 40 mg taken once per day at bedtime for up to eight weeks.

Child dosage (ages 0–17 years, 40 kg or greater)

  • Short-term dosage: 40 mg taken once per day at bedtime for up to eight weeks.
  • Dosage changes: Your doctor may adjust your dosage and length of treatment based on how well you respond to the drug.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

People with moderate or severe kidney disease: Your doctor may decrease your dose of this drug by half. Or they may have you take one dose 48 hours instead of every day.

Dosage for gastroesophageal reflux disease

Adult dosage (ages 18 years and older)

  • Gastroesophageal reflux disease (GERD) symptoms: 20 mg taken two times per day for up to six weeks.
  • Esophagitis (irritated esophagus with sores) with GERD symptoms: 20 to 40 mg taken two times per day for up to 12 weeks.

Child dosage (ages 0–17 years, 40 kg or greater)

  • Gastroesophageal reflux disease (GERD) symptoms: 20 mg taken two times per day for up to six weeks.
  • Esophagitis (irritated esophagus with sores) with GERD symptoms: 20 to 40 mg taken two times per day for up to 12 weeks.
  • Dosage changes: Your doctor may adjust your dosage and length of treatment based on how well you respond to the drug.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

People with moderate or severe kidney disease: Your doctor may decrease your dose of this drug by half. Or they may have you take one dose every 48 hours instead of every day.

Dosage for pathological hypersecretory conditions

Adult dosage (ages 18 years and older)

  • Typical starting dose: 20 mg taken every 6 hours.
  • Dose increases: Your doctor may increase your dose based on your symptoms.
  • Maximum dose: People with severe disease may need 160 mg taken every 6 hours.

Child dosage (under 0–17 years)

This drug hasn’t been studied in children under 18 years of age for the treatment of this condition.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Special considerations

People with moderate or severe kidney disease: Avoid using famotidine tablets for treating pathological hypersecretory conditions. The doses required for treating this condition may be higher than the maximum doses recommended in people with kidney disease.

Medications for acid reflux, heartburn, and GERD (gastroesophageal reflux disease) come in three flavors: H2 blockers, proton pump inhibitors (PPIs), and antacids. They all work differently and are geared towards either prevention or quick relief. If you’re struggling with reflux and want to start treating the symptoms yourself, here’s what you need to know:

H2 blockers — start here

H2 blockers are short-term preventative medications that decrease stomach acid. They block histamine, one of the body’s inflammatory agents, from stimulating the stomach to produce acid.

How should I take an H2 blocker?

If you have mild reflux symptoms that occur less than two times a week, you can start with a low dose of one of the following H2 blockers: ranitidine (Zantac), famotidine (Pepcid), or cimetidine (Tagamet). All three work better when taken on an empty stomach, without food. And remember: H2 blockers are only good for short-term use.

Any treatment for acid reflux should be accompanied by diet and lifestyle changes. Aim for no late night eating, elevating your head in bed at night, getting enough sleep, and so on. If symptoms persist, you can increase the dose of these medications to twice a day for two weeks.

Once your acid reflux improves, stop the medication. It’s very important to know that almost all H2 blockers don’t work well after two to six weeks. The stomach adjusts and they become much less effective.

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Which H2 blocker is the best?

Ranitidine (Zantac). Compare to cimetidine (Tagamet), ranitidine is better at lowering acidity and relieving heartburn symptoms. With respect to famotidine (Pepcid), ranitidine has been shown in research to work faster. So, ranitidine appears to edge out the others here.

Proton pump inhibitors — when H2 blockers don’t help

If after a couple weeks of taking H2 blockers your acid reflux symptoms still aren’t letting up, stop them and try a proton pump inhibitor (PPI) once daily. These include omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium), all now available with a prescription or over the counter. If your symptoms are under control using a PPI, continue taking it for 8 weeks. If your symptoms are not controlled, this is where you’ll come see us, your primary care doctors.

Antacids — for quick relief

Yes, you can take antacids too.

H2 blockers and proton pump inhibitors work better than antacids, but if you need something for very quick relief, antacids are an option. Antacids don’t do anything to prevent GERD, but they can be used on demand for symptom relief.

Common antacids contain calcium carbonate (Tums, Rolaids) and/or magnesium (Mylanta, Maalox, milk of magnesia), and provide relief of heartburn within five minutes. However, they only work temporarily — for 30 to 60 minutes tops.

Dr O.

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  • Need a safe antacid for heartburn? FDA declares Pepcid, Nexium and others free of NDMA

    The bad news for heartburn sufferers, of course, is that Zantac and its ranitidine generics have, perhaps for years, contained a suspected carcinogen without the FDA knowing it. The good news is that the FDA has now declared a handful of branded antacid alternatives and their generics as safe for consumers.

    The FDA Wednesday said that preliminary tests of alternatives including Pepcid (famotidine), Tagamet (cimetidine), Nexium (esomeprazole), Prevacid (lansoprazole) and Prilosec (omeprazole) found no N-nitrosodimethylamine (NDMA), the suspected cancer-causing agent found in OTC ranitidine drugs including the popular Zantac.

    RELATED: Zantac maker Sanofi joins peers in recalling antacid

    The announcement came as the agency said more Zantac generic makers are voluntarily calling their meds. Dr. Reddy’s Laboratories confirmed that NDMA had been found in its ranitidine products, and Perrigo has joined the recall after testing its versions.

    The recent discovery of NDMA in Zantac and its generics came after the finding last year that the impurity was being created during the manufacturing of many high blood pressure drugs like losartan and valsartan.

    RELATED: Pfizer, GSK, others face negligence suits over Zantac carcinogen testing

    The online pharmacy Valisure, which tests all of the products it sells, notified the FDA earlier this year that it had found a similar manufacturing phenomenon was occurring in ranitidine drugs. Valisure filed a citizen petition seeking to have the FDA have drugmakers recall the suspected products, set an acceptable NDMA level and create tests for the suspected carcinogen.

    While the FDA has rejected Valisure’s testing methods, the agency has set standards and informed drugmakers how to test for NDMA in ranitidine. It announced Wednesday a new test using what it called “a more widely available technology than the first posted method.”

    Pepcid vs Zantac: Main Differences and Similarities

    Major pharmacies pulled Zantac from shelves. Read more about the recall here.

    Pepcid and Zantac are brand name medications used to treat duodenal and gastric ulcers among other digestive conditions. Both medications work in similar ways to block the action of histamine in the digestive system. As antihistamines, they ultimately reduce the production of acid. Despite their similarities, they also have some differences to review.

    Pepcid

    Pepcid is the brand name for famotidine. It works as an antihistamine to reduce the production of acid and prevent irritation. Pepcid is approved to treat conditions like GERD, stomach ulcers, esophagitis, and other digestive conditions. It can also treat occasional heartburn.

    Pepcid comes as a 10 mg, 20mg, and 40 mg oral tablet. The dose used depends on the condition being treated. However, it may be taken more than once per day for up to 6 weeks in some cases.

    Zantac

    Zantac is also known by its generic name ranitidine. It blocks acid production in the stomach by blocking histamine receptors. Zantac can be used to treat GERD, stomach ulcers, erosive esophagitis, and other digestive conditions.

    Zantac is available as an oral tablet in strengths of 75 mg, 150 mg, and 300 mg. It can be taken once or twice daily although dosage depends on your condition. Zantac, like other similar drugs, is not typically used long term.

    Pepcid vs Zantac Side by Side Comparison

    Pepcid and Zantac are two medications with several similarities and differences. Their features can be found in the comparison table below.

    Pepcid Zantac
    Prescribed For
    • Gastric hypersecretion
    • Duodenal ulcer
    • Gastric ulcer
    • Gastroesophageal reflux disease (GERD)
    • Heartburn
    • Zollinger-Ellison Syndrome
    • Gastric hypersecretion
    • Duodenal ulcer
    • Gastric ulcer
    • Gastroesophageal reflux disease (GERD)
    • Heartburn
    • Zollinger-Ellison Syndrome
    Drug Classification
    • Histamine (H2) Blocker
    • Histamine (H2) Blocker
    Manufacturer
    • Merck & Co
    • Mylan/Sanofi/Chattem
    Common Side Effects
    • Headache
    • Diarrhea
    • Dizziness
    • Constipation
    • Nausea
    • Vomiting
    • Dry mouth
    • Rash
    • Headache
    • Constipation
    • Abdominal pain
    • Nausea
    • Diarrhea
    • Vomiting
    • Rash
    • Fever
    Is there a generic?
    • Yes, famotidine
    • Yes, ranitidine
    Is it covered by insurance?
    • Varies according to your provider
    • Varies according to your provider
    Dosage Forms
    • Oral tablet
    • Oral powder for suspension
    • Oral tablet
    • Oral capsule
    • Oral powder for suspension
    • Oral solution
    • Oral syrup
    Average Cash Price
    • $19 for 60, 20 mg tablets
    • $390 for a supply of 60, 150 mg tablets
    SingleCare Discount Price
    • Pepcid Price
    • Zantac Price
    Drug Interactions
    • Atazanavir
    • Erlotinib
    • Ketoconazole
    • Itraconazole
    • Rilpivirine
    • Ledipasvir/sofosbuvir
    • Nilotinib
    • Tizanidine
    • Delavirdine
    • Fosamprenavir
    • Procainamide
    • Warfarin
    • Atazanavir
    • Delavirdine
    • Gefitinib
    • Erlotinib
    • Glipizide
    • Ketoconazole
    • Itraconazole
    • Midazolam
    • Triazolam
    Can I use while planning pregnancy, pregnant, or breastfeeding?
    • Pepcid is in Pregnancy Category B. It does not pose a risk for fetal harm. Consult a doctor regarding steps to take if planning pregnancy or breastfeeding.
    • Zantac is in Pregnancy Category B. It does not pose a risk for fetal harm. Consult a doctor regarding steps to take if planning pregnancy or breastfeeding.

    Summary

    Pepcid and Zantac are two drugs that are used in the treatment of gastric ulcers, duodenal ulcers, GERD, and Zollinger-Ellison syndrome. Both drugs work by blocking histamine receptors to reduce acid production in the stomach.

    Pepcid and Zantac can be purchased over the counter and taken as oral tablets. They have similar durations of action although dosing depends on the condition being treated. Both medications also have similar side effects like headache, diarrhea, dizziness, constipation and rash.

    Zantac and Pepcid interact with various medications it should be used with caution when taken other drugs.

    This information is meant to explain similarities and differences between two over-the-counter medications. Consult a physician or other healthcare provider to determine which medication may be best for you.

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