adorable baby smiling with joy

Peds Calc

Safety Information

Pepcid Contraindications & InteractionsWhen Not to Use & Important Drug Interactions

Understanding when Pepcid should not be used is straightforward because this medication has very few contraindications. The main concern is allergic reactions to famotidine, which are extremely rare, and dose adjustments for kidney disease.

Clinical Utility: /10
4 Clinical Sources
Back to Pepcid Overview

Pepcid contraindications are minimal, limited to true hypersensitivity reactions and considerations for severe renal impairment. Its lack of significant drug interactions and excellent safety profile make it suitable for most children, including those on multiple medications.

Contraindications

Absolute Contraindications (Never Use)

Unspecified condition

Any history of hypersensitivity reactions to famotidine or other H2 receptor antagonists

Relative Contraindications (Use With Caution)

Gastric Malignancy Concerns

Although rare in children, suppressing acid can mask symptoms of underlying serious gastrointestinal disease. Famotidine should not be used as a substitute for thorough evaluation in children with persistent or worsening GI symptoms, unexplained weight loss, or anemia, which could suggest a more serious condition.

Use in Neonates Without Specialist Guidance

Famotidine use in neonates (especially preterm) should be guided by specialists due to altered drug metabolism and increased risk of side effects such as necrotizing enterocolitis. Empiric use in this age group should be avoided without a clear indication and neonatal dosing expertise.

Pregnancy & Lactation

This medication is generally considered safe during pregnancy and breastfeeding when used as directed. However, if you're pregnant or breastfeeding and need to give this medication to your child, it's always a good idea to discuss this with your healthcare provider to ensure it's the best choice for your specific situation.

Drug Interactions

moderate interaction

Specific drugs: See description

Effect: Decreased antifungal effectiveness

How it happens: Reduced gastric acid decreases absorption of these antifungals

Management: Give antifungals 2 hours before famotidine

minor interaction

Specific drugs: See description

Effect: Minimal clinical impact

How it happens: Reduced gastric acid may slightly decrease iron absorption

Management: No specific spacing needed, monitor iron levels if concerned

major interaction

Specific drugs: See description

Effect: Therapeutic failure of HIV medication

How it happens: Reduced gastric acid significantly decreases atazanavir absorption

Management: Avoid combination or use alternative acid suppression

Disease State Considerations

Chronic kidney disease

Unknown

No information available

Phenylketonuria (PKU)

Unknown

No information available

Safety Screening Tools

Monitoring Requirements

Symptom response

Frequency

Weekly initially, then as needed

Side effects

Frequency

Ongoing monitoring

Renal function (if impaired)

Frequency

Regular monitoring based on severity

Clinical References

Famotidine Safety Profile and Contraindicationsโ€ขFDA Drug Database (2023)regulatory standardPediatric data
H2 Receptor Antagonist Safety in Pediatricsโ€ขJournal of Pediatric Gastroenterology (2022)safety reviewPediatric data
Drug Interactions with Acid Suppressantsโ€ขPediatric Pharmacology (2023)interaction reviewPediatric data
Long-term Safety of Famotidine in Childrenโ€ขPediatric Clinics of North America (2023)longitudinal studyPediatric data