Famotidine 20mg - 28 Tablets

Famotidine is an H2 blocker (histamine H2-receptor antagonist): it stops histamine from telling the stomach to make acid. It is the medicine many people knew as Pepcid, and it has become the usual choice when a proton pump inhibitor isn't suitable or when acid breaks through at night. Famotidine 20mg tablets treat acid reflux and reflux oesophagitis, heal stomach and duodenal ulcers and stop them coming back, and are used by specialists for Zollinger-Ellison syndrome.

It works faster than a PPI (within an hour) but less powerfully, and because it is cleared by the kidneys rather than the liver it has far fewer interactions with other medicines. Prescription-only in the UK, supplied through our Acid Reflux & Heartburn online clinic after a short consultation reviewed by a UK prescriber. Pack of 28 film-coated tablets; the manufacturer may vary.

Famotidine is the most potent of the H2 blockers: 20mg suppresses acid for 10 to 12 hours, roughly eight times the effect of an equivalent dose of ranitidine, which was withdrawn in the UK in 2020. Unlike a PPI it doesn't need a protective coating, so there is nothing to worry about if the tablet is cut or crushed.

Famotidine is licensed for:

• Reflux oesophagitis and GORD: 20mg twice a day (40mg twice a day if the oesophagus is eroded) for six to twelve weeks, then 20mg twice a day to prevent recurrence.
• Duodenal ulcer: 40mg at bedtime for four to eight weeks, then 20mg at bedtime to prevent relapse.
• Benign stomach ulcer: 40mg at bedtime for four to eight weeks, once a GP has ruled out anything more serious.
• Zollinger-Ellison syndrome: higher, specialist-adjusted doses.

In practice it is also prescribed as a bedtime add-on for people whose daytime PPI leaves them with night-time heartburn, and as the main acid suppressant for people who can't take a PPI because of interactions (clopidogrel, for example), low magnesium or side effects. If you have never been treated for reflux before, a PPI such as esomeprazole 20mg is usually the first choice; the prescriber will tell you if famotidine suits you better.

Famotidine eases the burning behind the breastbone after meals, acid rising into the throat when you lie down, a sour taste in the mouth, belching and a bloated, uncomfortable stomach, and the gnawing hunger-like pain of an ulcer that wakes you in the early hours. Because it starts working within an hour, it suits symptoms with an obvious pattern, such as heartburn every night, as well as regular courses. It will not instantly neutralise acid the way an antacid does, but relief lasts far longer.

A pack of 28 tablets is two weeks at twice a day or four weeks at bedtime only. Our prescriber approves one pack per order; reorder as needed, and after three months of continuous use please review your symptoms with your GP.

Famotidine is for adults. It can't be taken by anyone who has reacted to famotidine or another H2 blocker (ranitidine, cimetidine, nizatidine). The dose is halved in moderate to severe kidney disease, so the consultation asks about your kidneys. It is not prescribed through this clinic in pregnancy, when planning a pregnancy or while breastfeeding, as the manufacturer advises against both.

It has few drug interactions, which is one of its advantages, but it reduces the absorption of medicines that need stomach acid: take ketoconazole, itraconazole or the HIV medicine atazanavir at least two hours before famotidine, and keep antacids one to two hours apart. It should not be combined with probenecid, which raises famotidine levels. Anyone with difficulty swallowing, unexplained weight loss, repeated vomiting, blood in vomit or black stools, anaemia, or new symptoms over 55 needs a GP assessment first, because acid suppressants can mask a stomach cancer.

Famotidine is well tolerated. The common side effects (up to 1 in 10 people) are headache, dizziness, constipation and diarrhoea; dry mouth, nausea, loss of appetite, tiredness and skin rash are uncommon. Confusion has been reported in elderly people and those with kidney impairment, usually at higher doses, and settles when the medicine is stopped. Rarely, liver enzyme changes, low blood counts or allergic reactions occur. Unlike proton pump inhibitors it is not associated with low magnesium, fractures or vitamin B12 deficiency, although very long courses should still be reviewed. Stop and seek urgent help for swelling of the face or throat, difficulty breathing or a severe rash, and report suspected side effects through the MHRA Yellow Card scheme.

Omeprazole and esomeprazole are proton pump inhibitors: slower to start (two to three days) but stronger, switching off acid production almost completely, so they are the first choice for erosive oesophagitis and for reflux that happens most days. Famotidine works within an hour and for 10 to 12 hours, suppresses acid by about 70%, and is kinder on interactions and on long-term bone and magnesium effects. It is the better option for intermittent or night-time symptoms, for people on clopidogrel or with low magnesium, and for those who had side effects from a PPI. Some people take both, a PPI in the morning and famotidine at night, under a prescriber's direction. The prescriber reviewing your consultation will choose based on your history.

Start from the Acid Reflux & Heartburn clinic page and complete the consultation first; you are not asked to choose a medicine until the questions are done. A UK-registered prescriber then reviews your answers and either approves the treatment you requested, suggests a more suitable one, or declines and refunds you with an explanation. Every prescription is checked by our pharmacist before dispatch. Stock My Medicine is a GPhC-registered UK pharmacy; orders go by Royal Mail Tracked, usually within three to five working days. Unsure whether this clinic is right for you? Talk to our pharmacist first.