Key takeaways
Famotidine is an H2 receptor blocker that is FDA approved to treat conditions such as occasional heartburn, duodenal ulcers, GERD, and Zollinger-Ellison syndrome.
How often and when you take famotidine depends on your medical condition.
For occasional heartburn, it’s best to take famotidine 30 to 60 minutes before a meal. Two daily doses are common for other conditions—one in the morning and one at night. If you take famotidine once daily, taking it before bed can maximize symptom control.
Famotidine is an over-the-counter (OTC) heartburn medication. Sold under the brand names Pepcid AC, Pepcid Complete, and Zantac 360, it belongs to a class of drugs called histamine-2 (H2) receptor blockers, which work by reducing the amount of acid that your stomach produces. If you have a condition that can cause severe acid reflux—such as gastroesophageal reflux disease (GERD), hiatal hernia, or Zollinger-Ellison syndrome—your provider might prescribe a stronger dose. How often and when you should take famotidine depends on why you’re taking the medication. It’s usually taken in the morning before eating, but for some people, taking it before bed helps control symptoms.
When is the best time to take famotidine?
The best time to take famotidine varies by the condition you’re taking it to treat. If you are taking prescription-strength famotidine, your provider will give instructions on when to take the medication.
To treat occasional heartburn, “the recommendation is to take famotidine 30 to 60 minutes before a meal. It is best to take it before breakfast,” says Babak Firoozi, MD, a board-certified gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA. This allows the medication to reduce stomach acid production before your stomach releases acid to digest your first meal of the day.
To treat stomach ulcers and GERD, most people take two doses a day—one in the morning and one at bedtime.
Famotidine can be taken at any time of the day whenever you experience occasional heartburn symptoms.
Why take famotidine at night?
If you’re taking just one dose of famotidine a day, it’s often recommended that you take it before your evening meal or before bed. Why? Gastrointestinal reflux is more likely to occur at night, with up to 79% of people with GERD experiencing nighttime symptoms. When unmanaged, this can lead to nighttime wakings from heartburn and indigestion.
How long does famotidine take to work?
Famotidine comes in different forms and strengths, including:
- Oral suspension
- Oral tablets (10 mg, 20 mg, and 40 mg)
- Intravenous solution
The oral forms of the medication start working to reduce stomach acid secretion within one hour and reach their peak effect in about 1 to 3 hours. The intravenous form reaches peak effect within 30 minutes of administration. “The duration of action of this medication can last for up to 12 hours, making it effective for both acute and preventive treatment,” says Sazan Sylejmani Pharm.D., the owner and manager of Westmont Pharmacy.
What should not be taken with famotidine?
Certain meds require an acidic stomach environment to be properly absorbed, and taking famotidine simultaneously with them can reduce their effectiveness. Medications that may interact with famotidine include:
- Rescriptor (delavirdine)
- Ceftin (cefuroxime)
- Nerlynx (neratinib)
- Sprycel (dasatinib)
- Actonel (risedronate)
- Votrient (pazopanib)
It’s also best to avoid taking famotidine concurrently with Zanaflex (tizanidine), a skeletal muscle relaxant. Famotidine mildly inhibits the drug metabolism enzyme CYP1A2, causing a significant increase in the blood levels of tizanidine which can result in unwanted side effects such as dizziness or drowsiness.
Some supplements also interact with famotidine. For example, famotidine can impair the proper absorption of magnesium, causing lower-than-normal levels of magnesium in the blood. Discuss any supplements or medications you are taking with a healthcare professional before you start taking famotidine to avoid drug interactions.
Side effects of famotidine
The most common side effect of famotidine in adults is headaches. Famotidine can also cause other mild side effects, including:
- Diarrhea
- Constipation
- Dizziness
- Muscle aches
In rare cases, more serious side effects may occur, such as hives, skin rashes, and difficulty swallowing or breathing. These may indicate an allergic reaction to the medication. If you experience these symptoms, discontinue the medication and seek medical attention right away.
Over-the-counter famotidine is only recommended for 14 days of use. After this period, if you notice your heartburn persists or worsens, discontinue the medication and seek medical advice from a healthcare provider. Also, notify your provider if your heartburn is accompanied by chest pain, unexplained weight loss, early satiety, persistent stomach pain, or dizziness.
Sources
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- H2 blockers, StatPearls (2023)
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- Sleep and GERD, International Foundation for Gastrointestinal Disorders
- Comparison of the early effects of vonoprazan, lansoprazole, and famotidine on intragastric pH: a three-way crossover study, Journal of Clinical Biochemical and Nutrition (2018)
- Famotidine induced hypomagnesemia leading to hypocalcemia, Oxford Medical Case Reports (2020)
- What is famotidine?, Pepcid
- Functional food in relation to gastroesophageal reflux disease (GERD), Nutrients (2023)
- Famotidine, StatPearls (2024)