What is the recommended famotidine dosage for infants?

In this article:

• Famotidine infant dosage
• Dosing schedule
• Side effects
• Combining famotidine with other medications
• Lifestyle changes
• The bottom line

In this article

• Famotidine infant dosage
• Dosing schedule
• Side effects
• Combining famotidine with other medications
• Lifestyle changes
• The bottom line

Famotidine, commonly known by the brand name Pepcid, is a medication commonly used to treat heartburn, peptic ulcers, duodenal ulcers, gastroesophageal reflux disease (GERD), and pathological hypersecretory conditions (conditions where the stomach makes excess gastric acid), such as Zollinger-Ellison syndrome. Initially approved by the U.S. Food and Drug Administration (FDA) in 1986, famotidine is available by prescription and over-the-counter (OTC). Famotidine is part of a group of drugs called H2-blockers, or H2-receptor antagonists, and its mechanism of action is reducing stomach acid, causing acid suppression. Sometimes, infants or children are prescribed famotidine. If you are giving famotidine to your infant, you may want to know the dosage. The dosage depends on the reason for use as well as the infant’s age and weight. Continue reading to learn more about famotidine for infants.

Recommended famotidine infant dosage

Your infant’s healthcare provider will calculate the proper dosage based on the condition being treated, age, and weight. Always follow the healthcare provider’s instructions, as the dosage is individualized for your infant. Although various formulations of famotidine are available, infants are generally prescribed the oral liquid form. In some cases, such as in a hospital or clinic, your infant may receive famotidine by injection. However, this article will focus on the home use of famotidine for infants (up to 12 months old), which, in most cases, is with oral liquid. 

Famotidine infant dosage by weight
Use/age	Recommended dosage (liquid)
GERD for ages birth (neonates) to less than 3 months of age	The starting dosage is 0.5 milligrams (mg) per kilogram (kg) by mouth once daily. The healthcare provider may increase the dose to 1 mg per kg once daily if needed.
GERD for ages 3 months to less than 12 months	The starting dosage is 0.5 mg per kg twice a day. If needed, the healthcare provider may increase the dose to 1 mg per kg twice daily.
Erosive esophagitis due to GERD for ages birth to less than 3 months of age	The starting dosage is 0.5 mg per kg by mouth once daily. The healthcare provider may increase the dose to 1 mg per kg once daily if needed.
Erosive esophagitis due to GERD for ages 3 months to less than 12 months	The starting dosage is 0.5 mg per kg twice a day. If needed, the healthcare provider may increase the dose to 1 mg per kg twice daily.

Source: Famotidine (DailyMed), Pepcid (PDR)

Optimal dosing times for famotidine in pediatric care

Here are some tips for how to give your infant famotidine:

• Famotidine liquid is an oral suspension. Your pharmacist or certified pharmacy technician will mix the medicine for you. Before you measure each dose, shake the bottle (with the cap on) for five to ten seconds.
• Measure the dose with a medicine measuring device. Your pharmacy will usually provide you with the appropriate measuring device. Do not use household utensils such as kitchen spoons to measure medicine, as these tools are not accurate and could result in you giving your child too much or too little medicine. 
• If your infant takes famotidine once a day, you can administer it before bedtime unless otherwise directed by your child’s provider. If your infant takes famotidine twice a day, you can administer it in the morning and before bedtime. Famotidine can be taken with or without food. 
• Store the medicine at room temperature, away from direct light, heat, and moisture. Keep out of reach of children and pets. Throw away any unused suspension after 30 days.
• Follow the healthcare provider’s other instructions for dietary and lifestyle measures.

Side effects of famotidine in pediatric use

Agitation or fussiness is a common side effect of famotidine, with an incidence of about 14% of infants. Some infants will also experience gastrointestinal adverse effects like diarrhea or constipation. If your infant is taking famotidine and you think they may be experiencing a side effect, call the healthcare provider. 

Serious side effects, such as allergic reactions, are rare. If your infant has a rash, hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, get emergency medical help right away. 

Combining famotidine with other medications for GERD

Before your infant takes famotidine, be sure to tell the healthcare provider about all the medications they take, including:

• Prescription drugs
• OTC medicines
• Vitamins
• Dietary supplements

This will help the healthcare provider check for drug interactions and determine if famotidine is safe for your infant. While the prescribing information notes that famotidine suspension can be taken with antacids, antacids are generally not recommended for use in children under 12 years of age (except under the guidance of a healthcare provider). 

Proton pump inhibitors (PPIs), such as omeprazole, are another type of drug commonly used for GERD. However, because PPIs may increase the risk of certain types of infections in children, healthcare providers typically recommend using them only when there is a clear medical indication. 

GERD lifestyle changes for infants

Here are some general tips for helping infants with GERD symptoms. For individualized advice, ask your child’s healthcare provider.

• Keep your infant away from tobacco smoke. Smoke can worsen your baby’s reflux symptoms and cause other medical problems. Do not smoke in the home or car, and do not allow others to do so. 
• Breastfeed your infant, if possible. If GERD symptoms persist, you may want to try dietary changes such as eliminating cow’s milk, beef, and soy from your diet to see if that helps your baby’s symptoms.
• If you use formula, ask your infant’s healthcare provider if you should use a specific formula best suited to your infant’s needs, such as a hypoallergenic or corn-free formula. 
• Avoid overfeeding your infant. Let them stop a feeding when they seem satisfied or no longer interested. 
• If possible, keep your infant upright for 20 to 30 minutes after a feeding. Carrying the infant on your shoulder is a helpful position, as opposed to sitting, which can cause compression. 
• Put your infant on their back to sleep. Do not change your infant’s sleeping or crib position unless their healthcare provider recommends it. 
• Check with your baby’s healthcare provider before trying to thicken formula or breastmilk with cereal. It is not safe in every situation. 

The bottom line

Your infant’s healthcare provider will calculate the appropriate dosage of famotidine based on the condition, age, and weight. Always follow the dosing instructions given by the healthcare provider. Monitor your infant for side effects such as agitation, diarrhea, or constipation, and notify the healthcare provider if you have any questions or concerns.