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Published on: April 17, 2021

Famotidine disposition in children and adolescents with chronic renal insufficiency

Holly D Maples1, Laura P James, Cindy D Stowe

  • 1University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Journal of Clinical Pharmacology
|January 11, 2003
PubMed

Insights

Pediatric famotidine pharmacokinetics change significantly with chronic renal insufficiency. Dosing adjustments based on glomerular filtration rate (GFR) are recommended for children with kidney impairment.

Area of Science:

  • Pharmacology
  • Nephrology
  • Pediatrics

Background:

  • Chronic renal insufficiency (CRI) affects drug pharmacokinetics in children.
  • Famotidine is a common H2 receptor antagonist used in pediatric patients.
  • Understanding famotidine's behavior in pediatric renal impairment is crucial for safe and effective dosing.

Purpose of the Study:

  • To evaluate the pharmacokinetics of intravenous famotidine in pediatric patients with varying degrees of chronic renal insufficiency.
  • To determine the relationship between famotidine clearance and renal function (creatinine clearance).

Main Methods:

  • 18 pediatric patients (1-18 years) with stable CRI received intravenous famotidine (0.5 mg/kg, max 20 mg).
  • Patients were stratified into mild, moderate, and severe renal insufficiency groups based on calculated creatinine clearance (Clcr).
  • Pharmacokinetic parameters including elimination rate (Kel), half-life (t1/2), area under the curve (AUC), and plasma clearance (Clp) were analyzed.

Main Results:

  • Significant differences in Kel, t1/2, AUC, and Clp were observed across renal insufficiency groups (p < 0.01).
  • Famotidine renal clearance (Clr) differed significantly between mild and severe groups (p < 0.05).
  • A strong linear correlation was found between Clcr and Clp (p < 0.0001; R2 = 0.70), with nonrenal clearance (Clnr) comprising a larger percentage of Clp in severe insufficiency.

Conclusions:

  • Pediatric famotidine pharmacokinetics are significantly altered by chronic renal insufficiency.
  • Dosing recommendations for famotidine in children with renal impairment should be guided by glomerular filtration rate (GFR), specifically creatinine clearance (Clcr).

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