Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

The purpose of this study is to design push-pull osmotic pump (PPOP) tablets of famotidine using the expert system for the formulation design of osmotic pump of poor water-soluble drug which had been established by the authors. Firstly, the parameters which were requisite of the system input were obtained from literatures and experimental tests. Then the parameters were input into the system, and the program was run. The system displayed the designed formulations sequential. Finally, famotidine PPOP was prepared according to the designed formulations and the in vitro dissolution was carried out. It was found out that the target formulation of famotidine PPOP which could release for 24 hours was obtained in a very short period. Meanwhile, the practicability of the established expert system was proved.
Delayed-Action Preparations ; Drug Delivery Systems ; methods ; Excipients ; chemistry ; Expert Systems ; Famotidine ; administration & dosage ; chemistry ; Osmosis ; Solubility ; Tablets ; Water

H2-receptor antagonists, such as cimetidine, ranitidine and famotidine, are some of the most commonly prescribed medications for gastric acid-related disorders. These compounds are generally well-tolerated and anaphylactic reactions to them are rare. Here, we report two cases of H2-receptor antagonist-induced anaphylactic reactions: the first presented with sudden dyspnea, sneezing, urticaria, and swelling of the eyelids after ranitidine intake. The second presented with sudden severe urticaria, facial swelling, chest discomfort, dizziness, and hypotension. Possible cross-reactivity with other H2-receptor antagonists was assessed by oral challenge and skin tests. To date, only a few reports addressing cross-reactivity among H2-receptor antagonists have been published. We review the literature and summarize the data available on drug cross-reactivity in H2-receptor antagonist hypersensitivity.
Anaphylaxis ; Cimetidine ; Cross Reactions ; Dizziness ; Drug Hypersensitivity ; Dyspnea ; Eyelids ; Famotidine ; Histamine H2 Antagonists ; Hypersensitivity ; Hypotension ; Ranitidine ; Skin Tests ; Sneezing ; Thorax ; Urticaria

BACKGROUND/AIMS: The effects of Histamine-2 receptor antagonists and proton pump inhibitors on the gastrointestinal motility have not yet been sufficiently investigated. The aim of this study was to determine the effects of intravenous bolus administration of famotidine and omeprazole on the rate of gastric emptying using the continuous 13C breath test (BreathID system, Exalenz Bioscience Ltd, Israel). METHODS: Twelve healthy male volunteers participated in this randomized, 3-way crossover study. After fasting overnight, the subjects were randomly assigned to receive 20 mg of famotidine, 20 mg of omeprazole or 20 mL of saline alone by intravenous bolus injection before a test meal (200 kcal per 200 mL, containing 100 mg of 13C-acetate). Gastric emptying was monitored for 4 hours after the ingestion of test meal by the 13C-acetic acid breath test performed using the BreathID system. RESULTS: No significant differences in the calculated parameters, namely, the T1/2, Tlag, GEC, beta and kappa, were observed among the 3 test conditions. CONCLUSIONS: The study revealed that intravenous administration of gastric acid suppressant drugs had no significant influence on the rate of gastric emptying in comparison with that of saline alone as a placebo. Our results indicating the absence of any effect of either famotidine or omeprazole on accelerating the rate of gastric emptying suggest that both medications can be administered safely to patients suffering from hemorrhagic peptic ulcers who need to be kept nil by mouth from the viewpoint of possible acceleration of gastrointestinal motility in the clinical setting.
Acceleration ; Administration, Intravenous ; Breath Tests ; Cross-Over Studies ; Eating ; Famotidine ; Fasting ; Gastric Acid ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Male ; Meals ; Mouth ; Omeprazole ; Peptic Ulcer ; Proton Pump Inhibitors ; Proton Pumps ; Protons ; Stress, Psychological

Endoscopic mucosal resection (EMR) results in the formation of iatrogenic gastric ulcers and the optimal treatments for such ulcers are still unclear. We aimed to evaluate the efficacy of rebamipide in the management of EMR-induced ulcers by comparing it with an H2 receptor antagonist. After EMR, patients were randomly assigned into either rebamipide or famotidine groups. All patients received a one-week lansoprazole 30 mg q.d. therapy followed by three-week famotidine (20 mg b.i.d.) or rebamipide (100 mg t.i.d.) therapy. Four weeks after the treatments, ulcer sizes, stages, bleeding rates, and ulcer-related symptoms were compared using endoscopy and a questionnaire. A total of 63 patients were enrolled in this study. Finally, 51 patients were analyzed, 26 in rebamipide and 25 in famotidine group. Baseline characteristics were not significantly different between the two groups. Four weeks after EMR, the two groups were comparable in terms of ulcer reduction ratio (P=0.297), and ulcer stage (P=1.000). Moreover, no difference was observed with regard to ulcer-related symptoms, drug compliance, adverse drug event rates, and bleeding rates. Our data suggest that rebamipide is not inferior to famotidine in healing iatrogenic gastric ulcers, and could be a therapeutic option in the treatment of such ulcers.
Adult ; Aged ; Aged, 80 and over ; Alanine/*analogs & derivatives/therapeutic use ; Anti-Ulcer Agents/*therapeutic use ; Endoscopy, Gastrointestinal/*adverse effects ; Famotidine/*therapeutic use ; Histamine H2 Antagonists/*therapeutic use ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Pilot Projects ; Prospective Studies ; Quinolones/*therapeutic use ; Receptors, Histamine H2/metabolism ; Stomach Ulcer/*drug therapy/*etiology/pathology ; Wound Healing

OBJECTIVETo investigate the efficacy and safety of famotidine treatment for stress ulcers in neonates.

METHODSFifty-four neonates with stress ulcers from 2001 to 2006 were enrolled. Seven cases were confirmed with stress ulcers by gastroscopy. Famotidine was administered intravenously at a dosage of 0.5 mg/kg every other 12 hrs. After cessation of hematemesis and vomiting, famotidine was administered once a day for two days. Primary diseases and complications were concurrently treated. Clinical symptoms and gastric pH were assessed before and after famotidine treatment. Possible adverse effects of famotidine treatmentdouble ended arrowrelated were observed.

RESULTSAfter 24 hrs of famotidine treatment, hematemesis and vomiting ceased in 52 patients (96.3%). Clinical symptoms disappeared in all of the 54 patients 48 hrs after famotidine treatment. Gastric pH value increased 6, 12, 24, 36 and 48 hrs after famotidine treatment from 2.07+/-0.22 (before treatment) to 5.01-5.15 (P<0.01). All of the 54 patients were successfully treated. Famotidine treatment did not lead to abnormal respiration, heart rate and blood pressure. Loss of appetite, nausea, vomiting, diarrhea, constipation and rashes were not seen after famotidine treatment. There were significant differences in white cell count, platelet count and hepatic enzyme levels before and after famotidine treatment. An augmented side effect of the other drugs concurrently used due to famotidine treatment was not noted.

CONCLUSIONSFamotidide is effective and safe for the treatment of stress ulcers in neonates.

Anti-Ulcer Agents ; therapeutic use ; Famotidine ; adverse effects ; therapeutic use ; Female ; Gastric Acidity Determination ; Histamine H2 Antagonists ; therapeutic use ; Humans ; Infant, Newborn ; Male ; Stomach Ulcer ; drug therapy ; Stress, Psychological ; complications

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) currently serves as the minimally invasive treatment of choice for early gastric cancer and premalignant lesions of the stomach. There have been few studies addressing whether a proton pump inhibitor or a histamine 2-receptor antagonist is the most effective treatment for iatrogenic ulcers after EMR. We compared the effectiveness of pantoprazole and famotidine in treating iatrogenic ulcers and preventing bleeding after EMR without endoscopic submucosal dissection. METHODS: Between March 2006 and April 2007, we retrospectively analyzed the effect of famotidine (40 mg/day) and pantoprazole (40 mg/day) on the healing of iatrogenic ulcers and control of bleeding after EMR. RESULTS: During the study period, 126 patients underwent EMR. Eighty-one received famotidine, and 45 received pantoprazole. The mean duration of drug therapy was 44 days in each group. The stages of ulcers at 1 to 3 months after EMR were mostly scar stage, and there was no specific difference between the groups. Delayed bleeding was seen after EMR in one patient (1.2%) from the famotidine group and in one patient (2.2%) from the pantoprazole group. There were no other major complications after EMR. CONCLUSIONS: Famotidine was no different than pantoprazole in its effectiveness toward preventing delayed bleeding and promoting healing of iatrogenic ulcers after EMR.
2-Pyridinylmethylsulfinylbenzimidazoles ; Cicatrix ; Famotidine ; Hemorrhage ; Histamine ; Humans ; Proton Pumps ; Retrospective Studies ; Stomach ; Stomach Neoplasms ; Ulcer

Endoscopic submucosal dissection (ESD) has been reported to have a higher bleeding rate than conventional methods. However, there are few reports on whether a proton pump inhibitor or a histamine2-receptor antagonist is the more effective treatment for preventing bleeding after ESD. In a prospective trial, patients undergoing ESD due to gastric adenoma or adenocarcinoma were randomly assigned to pantoprazole or famotidine. Both drugs were given intravenously for the first 2 days, thereafter by mouth. Eighty-five in the pantoprazole group and 79 in the famotidine group were included for analysis. Primary outcome measure was the delayed bleeding rate. Clinical characteristics were not different between the two groups. The delayed bleeding rate was significantly lower in the pantoprazole group compared with the famotidine group (3.5% vs. 12.7%, p=0.031). On multivariate analysis, the preventive use of pantoprazole (relative hazard: 0.220, 95% CI: 0.051- 0.827, p=0.026) and the specimen size (> or =34 mm, relative hazard: 4.178, 95% CI: 1.229-14.197, p=0.022) were two independent factors predictive of delayed bleeding. There were no significant differences in en bloc and complete resection rate between the two groups. In conclusion, pantoprazole is more effective than famotidine for the prevention of delayed bleeding after ESD.
2-Pyridinylmethylsulfinylbenzimidazoles/*therapeutic use ; Aged ; Anti-Ulcer Agents/*therapeutic use ; Dissection ; Famotidine/*therapeutic use ; Female ; Gastric Mucosa/*surgery ; Gastrointestinal Hemorrhage/*prevention & control ; *Gastroscopy ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage/*prevention & control ; Prospective Studies ; Single-Blind Method ; Stomach Neoplasms/*surgery

AIMTo study the drug release mechanism of famotidine time-controlled release pellets and to explore the mechanism of "organic acid-induced type drug delivery system".

METHODSThe effects of dissociated and undissociated forms of succinic acid on the drug release behavior of famotidine time-controlled release pellets were studied from the following aspects: ion-exchange reaction, hydration, etc.

RESULTSThe dissociated succinic acid created new ionic circumstances by ion-exchange reaction with Eudragit RS100. Whereas undissociated succinic acid increased the flexibility of the film by distribution in the hydrophobic segment of Eudragit RS100. Effects of both forms of the succinic acid could improve the hydration of Eudragit RS film. As a result, the permeability of the film was improved evidently.

CONCLUSIONThe lag time of famotidine time-controlled release pellets is induced by the hydrophobicity of the film. After water dissolve the organic acid, the dissociated and undissociated forms of succinic acid interact with the film through different ways. These interactions can change the structure of the film. Therefore the permeability of the film will be improved markedly.

Acrylic Resins ; chemistry ; Anti-Ulcer Agents ; chemistry ; pharmacokinetics ; Delayed-Action Preparations ; chemistry ; pharmacokinetics ; Famotidine ; chemistry ; pharmacokinetics ; Ion Exchange ; Succinic Acid ; chemistry ; Time Factors ; Water ; chemistry