파모티딘
Famotidine
3-[({2-[(diaminomethylidene)amino]-1,3-thiazol-4-yl}methyl)sulfanyl]-N'-sulfamoylpropanimidamide
다른 이름: Pepcid AC · Pepcid RPD · famotidinum · L-643341 · MK-208 · YM-11170 · Famotidina
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| To reduce gastric acid production | 0.1-0.2 mg/kg | PO, SC, IM, IV | q12h | — | 🌎 NA |
| To reduce gastric acid production | 0.5 mg/kg | PO, SC, IM, IV | q12-24h | — | 🌎 NA |
| For esophagitis | 0.5-1 mg/kg | PO | q12h | — | 🌎 NA |
| For acute reflex esophagitis | 0.55-1.1 mg/kg | PO | q24h (or q12h if severe) | 2-3 weeks | 🌎 NA |
| Adjunctive treatment (prevent/treat gastric ulcers) of mast cell tumors | 0.5 mg/kg | Not specified | q24h | — | 🌎 NA |
| Adjunctive treatment of GI effects associated with chronic kidney disease | 0.5 mg/kg | PO | q24h | — | 🌎 NA |
| All uses (ulcers, gastritis, oesophagitis, hypersecretory conditions) | 0.5-1.0 mg/kg | PO | q12-24h | — | 🌍 EU |
- Adjunctive treatment of GI effects associated with chronic kidney disease: Effective evidence grade: 3
- All uses (ulcers, gastritis, oesophagitis, hypersecretory conditions): Effect on gastric pH diminishes with time when given daily.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| To reduce gastric acid production | 0.2 mg/kg | PO, SC, IM, IV | q24h | — | 🌎 NA |
| To reduce gastric acid production | 0.5 mg/kg | PO, SC, IM, IV | q12-24h | — | 🌎 NA |
| For esophagitis | 0.5 mg/kg | PO | q12h | — | 🌎 NA |
| For acute reflex esophagitis | 0.55-1.1 mg/kg | PO | q24h (or q12h if severe) | 2-3 weeks | 🌎 NA |
| Adjunctive treatment of GI effects associated with chronic progressive renal disease | 1 mg/kg | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of GI effects associated with chronic progressive renal disease | 0.5-1 mg/kg | PO | q12-24h | — | 🌎 NA |
| All uses (ulcers, gastritis, oesophagitis, hypersecretory conditions) | 0.5-1.0 mg/kg | PO | q12-24h | — | 🌍 EU |
- To reduce gastric acid production: See warning about IV use in cats
- All uses (ulcers, gastritis, oesophagitis, hypersecretory conditions): Effect on gastric pH diminishes with time when given daily.
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Rabbits: For stress induced ulcer prevention once critically ill animal has stabilized | 1 mg/kg | IV | q24h | — | 🌎 NA |
페렛
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| For stress induced ulcers | 0.25-0.5 mg/kg | PO, IV | q24h | — | 🌎 NA |
| In combination with antibiotics for Helicobacter treatment | 0.25-0.5 mg/kg | PO, IV | q24h | — | 🌎 NA |
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| As an adjunct in ulcer treatment | 0.23 mg/kg or 0.35 mg/kg | IV | q8h (for 0.23 mg/kg) or q12h (for 0.35 mg/kg) | — | 🌎 NA |
| As an adjunct in ulcer treatment | 1.88 mg/kg or 2.8 mg/kg | PO | q8h (for 1.88 mg/kg) or q12h (for 2.8 mg/kg) | — | 🌎 NA |
- As an adjunct in ulcer treatment: ARCI UCGFS Class 5 Drug
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
파모티딘은 강력하고 지속 시간이 긴 히스타민 H2 수용체 길항제로, 수의학에서 위산 분비를 억제하고 위/십이지장 궤양, 위염 및 식도염을 치료하거나 예방하는 데 널리 사용됩니다.
시메티딘과 비교할 때 파모티딘은 훨씬 강력하고 투여 빈도가 적으며, 가장 중요한 점은 간의 사이토크롬 P450 효소계를 억제하지 않아 흔한 약물 상호작용이 거의 없다는 것입니다.
임상 요점: 경미한 위산 억제나 일상적인 예방에는 효과적이지만, 활동성 궤양 치료, 운동 유발성 위염 예방 또는 중증 식도염 관리에는 오메프라졸과 같은 양성자 펌프 억제제(PPI)가 일반적으로 더 우수하다고 간주됩니다. 또한, 개와 고양이에서 3~14일 동안 지속적으로 사용하면 약리학적 내성(속성내성, Tachyphylaxis)이 발생하기 쉬워 시간이 지남에 따라 위산 억제 효능이 감소합니다.
작용 기전
Famotidine acts as a competitive, reversible antagonist at the H2 receptors located on the basolateral membrane of gastric parietal cells.
By blocking histamine binding, it prevents the activation of adenylate cyclase → decreases intracellular cAMP levels → reduces the activation of the H+/K+-ATPase proton pump. This effectively blunts both basal gastric acid secretion and secretion stimulated by food, pentagastrin, or insulin. By decreasing the total volume of gastric juice produced, H2-blockers also indirectly decrease the amount of pepsin secreted. It does not alter gastric emptying time, biliary secretion, or lower esophageal sphincter pressure.
안전성·주의사항
금기사항
- Known hypersensitivity to H2 blockers
- Known hypersensitivity to famotidine or other H2 receptor antagonists
부작용
- Bradycardia (if infused too rapidly IV)
- GI effects (anorexia, vomiting, diarrhea)
- Headache
- Dry mouth or skin
- Intravascular hemolysis (rare, anecdotally reported in cats given IV)
- Transient increase in serum gastrin (returns to baseline by 14 days)
- Generally has a very good safety profile with fewer side effects than cimetidine
주의
Use cautiously in geriatric patients and those with significantly impaired hepatic or renal function; consider dosage reduction in patients with significant renal dysfunction. Famotidine may have negative inotropic effects and some cardioarrhythmogenic properties; use with caution in patients with cardiac disease. When administering IV to cats, infuse slowly (over 5 minutes) to minimize the rare risk of intravascular hemolysis.
약물 상호작용
Famotidine raises gastric pH, which may decrease the absorption of these agents. Administer the azole one hour prior to famotidine.
Famotidine may decrease the absorption of these cephalosporins. Taking with food may alleviate this effect.
Famotidine may decrease the absorption of oral iron. Administer iron at least one hour prior to famotidine.
모니터링
- Clinical efficacy (decrease in symptomatology, endoscopic examination, resolution of blood in feces)
- Adverse effects
- Clinical signs of GI ulceration or bleeding (vomiting, melena, anorexia)
- Gastric pH (if clinically indicated and feasible)
약동학
반감기
흡수
Incompletely absorbed after oral administration with minimal first-pass metabolism. Systemic bioavailability is ~40-50% in humans. Bioavailability is low in horses (13%).
분포
Concentrates in the liver, pancreas, kidney, and submandibular gland (in rats). Only ~15-20% is bound to plasma proteins. Does not cross the blood-brain barrier or placenta in rats. Distributed into milk. Volume of distribution in horses is 4.28 L/kg.
대사
Primarily metabolized in the liver.
배설
Excreted in the urine. After oral dosing, ~1/3 is excreted unchanged; after IV dosing, ~2/3 is excreted unchanged.
과다투여
Famotidine has a wide margin of safety. The minimum acute lethal dose in dogs is reported to be >2 grams/kg for oral doses and approximately 300 mg/kg for intravenous doses.
IV doses in dogs ranging from 5-200 mg/kg caused vomiting, restlessness, mucous membrane pallor, and redness of the mouth and ears. Higher doses caused hypotension, tachycardia, and collapse.
Most overdoses require only monitoring. In massive oral overdoses, gut-emptying protocols should be considered and supportive therapy initiated when warranted.
제품
제형
- Oral tablets (plain, film-coated, chewable, orally disintegrating)
- Powder for oral suspension
- Injection
- 20 mg tablets
- 40 mg tablets
인용의약품
- Famotidine Oral Tablets (plain, film-coated, chewable & orally disintegrating) & Gelcaps: 10 mg, 20 mg, & 40 mg (Pepcid®, Pepcid AC®, generic)
- Famotidine Powder for Oral Suspension: 8 mg/mL when reconstituted (Pepcid®)
- Famotidine Injection: 10 mg/mL in vials; 20 mg/50 mL premixed containers (generic)
- 20 mg tablets
- 40 mg tablets
규제 현황
Human authorized product used off-label under the cascade. Cimetidine is the only H2 antagonist with veterinary authorization.
Human authorized product used off-label under the cascade (POM).
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Tablets should be stored in well-closed, light-resistant containers at room temperature. Powder for oral suspension should be stored <40°C; after reconstitution, it is stable for 30 days when stored <30°C (do not freeze). Injection should be stored in the refrigerator (2-8°C).
보호자 정보
- 투여 방법: 수의사의 처방에 따라 정확하게 투여하십시오. 위산 차단 효과를 극대화하려면 보통 공복(식사 30~60분 전)에 투여하는 것이 가장 좋습니다.
- 일관성: 투여를 건너뛰지 마십시오. 복용을 놓치면 위산 역류나 궤양의 임상 증상이 재발할 수 있습니다.
- 액상 제제: 조제된 경구용 현탁액을 사용하는 경우, 매 사용 전 잘 흔들어 주고 냉장고에 보관하십시오. 30일이 지난 남은 약은 폐기하십시오.
- 상호작용: 반려동물이 복용 중인 다른 약물이나 영양제가 있다면 수의사에게 알리십시오. 경구용 철분제나 특정 항진균제를 복용하는 경우 파모티딘과 최소 1시간 간격을 두고 투여해야 합니다.
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