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Drug Info Maternal Matters

Is famotidine safe during pregnancy?

It’s not a first-line treatment, but can be used if lifestyle changes and antacids don’t work
Valerie Williams headshot
By | Aug. 29, 2024 Medically reviewed by Kimberly Bowman, MD

Key takeaways

  • Famotidine is an H2 blocker that treats and prevents acid reflux caused by indigestion. It is generally considered safe for use by pregnant women.

  • Although studies of the medication involving human subjects are inadequate, there are currently no known risks to the mother or fetus.

  • Alternatives to famotidine include antacids, such as Tums or Rolaids, and natural remedies, such as changing your eating and sleeping habits.

In this article:

Heartburn is incredibly common during pregnancy, especially in the second and third trimesters. If you find yourself dreading that churning, burning feeling before every meal, don’t fret. Pregnancy-safe treatments and remedies, such as famotidine (commonly known by its brand names Pepcid AC and Zantac 360), can help.

Famotidine belongs to a class of medications called histamine-2 receptor antagonists (H2 blockers for short). “Famotidine is a medication used to treat heartburn (acid reflux),” says Kecia Gaither, MD, double board-certified OB-GYN and maternal-fetal medicine, director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx. “It functions to reduce the amount of stomach acid that is produced.” It also treats upset stomach due to consuming certain foods or drinks, stomach ulcers, gastroesophageal reflux disease (GERD), and conditions causing too much stomach acid.

Can you take famotidine while pregnant?

Famotidine is considered safe to use for pregnant women to relieve heartburn and indigestion, according to the U.S. Food and Drug Administration (FDA). However, you should try lifestyle changes and antacids first.

Why? There are no adequate or well-controlled studies in pregnant women to definitively say it’s risk-free. However, the class of medication it falls under, H2-blockers, has not been found to cause an increased risk of perinatal mortality, premature delivery, low birth weight, or low Apgar scores. Any medication taken during pregnancy should be a joint decision with your healthcare provider, weighing the benefits and risks—which are low for this particular medication.

“Even though famotidine has not been tested in humans, experience and many retrospective studies have shown when used appropriately and in recommended dosages, it is safe in pregnancy,” says Los Angeles-based OB-GYN and urogynecologist Michael Tahery, MD. “Also, animal studies have not shown any fetal side effects in pregnant animals.”

What are the risks of taking famotidine while pregnant?

There is a lack of human data proving the safety of famotidine during pregnancy. Famotidine crosses the placenta. However, “the available research studies have not noted any increased risk of congenital disorders when taken during pregnancy,” confirms Dr. Gaither. It’s not known to cause any pregnancy complications.

Pregnant people taking other antacids should not take famotidine unless directed by their healthcare provider. Additionally, those with renal complications, an allergy to famotidine, people who are unable to swallow, and those with hematemesis (bloody stools) should not use famotidine, according to Dr. Gaither.

“Famotidine does get into breast milk,” notes Dr. Gaither. However, famotidine should be safe to use while breastfeeding as dosages of it have been administered to newborns in higher amounts than what is excreted in breast milk. Check with your healthcare provider before taking famotidine while nursing.

Famotidine dosage

“The usual dosage for famotidine is 20 mg, and the frequency is usually once a day,” advises Dr. Tahery. “However, the frequency is usually recommended by the treating physician.”

Famotidine side effects

The most common adverse effects while taking famotidine include:

  • Headaches
  • Dizziness
  • Constipation
  • Diarrhea

It is important to follow the dosage instructions and seek medical advice from your healthcare provider if you experience side effects that concern you.

What can I take instead of famotidine during pregnancy?

Pregnancy-safe alternatives to famotidine include:

Check with your healthcare provider before trying any over-the-counter (OTC) medications or supplements for heartburn relief during pregnancy.

Natural remedies for heartburn during pregnancy

“The first line of treatment is diet and behavioral changes,” says Dr. Tahery. According to the American College of Obstetricians and Gynecologists (ACOG), pregnant people should implement some lifestyle changes to prevent heartburn before using medications, such as:

  • Try not to overeat. Being overly full can contribute to indigestion and discomfort. Consume smaller meals more frequently and eat slowly to aid in digestion. “Eating small portions helps because of the small capacity of the stomach, and the slow-down of bowel movement helps alleviate reflux,” says Dr. Tahery.
  • Practice good posture. Dr. Tahery suggests sitting up straight while eating to allow for less compression of the stomach and more space for food.
  • Change your diet. Dr. Tahery advises limiting chocolate, tobacco, peppermint, carbonated beverages, spicy foods, fatty foods, caffeine, and anything acidic (such as citrus fruits). If you still experience heartburn, certain foods can help relieve it, such as yogurt, milk, bananas, honey, or a teaspoon of baking soda mixed with water.
  • Try chewing gum to create more saliva, which may help break down foods for easier digestion.
  • Consider ginger. Dr. Gaither recommends ginger root. Ginger can do double duty by helping to relieve pregnancy-related heartburn and ward off nausea, which is a common symptom in the first trimester of pregnancy.
  • Leave adequate time between your final meal of the day and going to sleep—at least three to four hours, if possible.
  • Elevate the head of your bed to help prevent a build-up of stomach acid in the esophagus while you sleep.

Be sure to stay in close communication with your healthcare provider, particularly during pregnancy, and discuss your symptoms with them before trying any new therapies, even if they are natural remedies.

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