Famotidine (PEPCID) - Renal dosing

Usual Dosing (Adults)

20mg po/IV q12h or 40mg qhs.

Renal Dosing

dialysis [>50 ml/min]: No changes

[0-49]: decrease dose by 50% (e.g. 10mg q12h or 20mg qhs) or extend interval to q36-48h (to limit potential CNS adverse effects).

Dosage Adjustments for Patients with Moderate or Severe Renal Insufficiency
In adult patients with moderate (creatinine clearance <50 mL/min) or severe (creatinine clearance <10 mL/min) renal insufficiency, the elimination half-life of famotidine is increased. For patients with severe renal insufficiency, it may exceed 20 hours, reaching approximately 24 hours in anuric patients. Since CNS adverse effects have been reported in patients with moderate and severe renal insufficiency, to avoid excess accumulation of the drug in patients with moderate or severe renal insufficiency, the dose of famotidine injection may be reduced to half the dose, or the dosing interval may be prolonged to 36 to 48 hours as indicated by the patient’s clinical response.

Based on the comparison of pharmacokinetic parameters for famotidine in adults and pediatric patients, dosage adjustment in pediatric patients with moderate or severe renal insufficiency should be considered.


dialysis Decrease dose by 50% (e.g. 10mg q12h or 20mg qhs) or extend interval to q36-48h. Give dosage after dialysis on dialysis days.


National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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