Pharmacokinetics and pharmacodynamics of famotidine and ranitidine in critically ill children.

Journal of clinical pharmacology

PubMedID: 24258773

Madani S, Kauffman R, Simpson P, Lehr VT, Lai ML, Sarniak A, Tolia V. Pharmacokinetics and pharmacodynamics of famotidine and ranitidine in critically ill children. J Clin Pharmacol. 2013;.
To characterize and compare acid suppression (pharmacodynamics) and pharmacokinetics of IV famotidine and ranitidine in critically ill children at risk for stress gastritis. Single-blind, randomized study in PICU patients 6 months to 18 years requiring mechanical ventilation with continuous gastric pH monitoring, randomized to IV famotidine 12?mg/m(2) or ranitidine 60?mg/m(2) when gastric pH?1?hour with serial blood sampling following first dose. Twenty-four children randomized to either famotidine (n?=?12) or ranitidine (n?=?12). Sixteen out of twenty-four completed both PK and PD study arms (7/12 famotidine; 4.7?±?3.4 years; 9/12 ranitidine; 6.6?±?4.7 years; p?=?0.38). Time to gastric pH 4.0 and total time pH above 4.0 similar with no difference in pH at 6 and 12?hours (p?>?0.2). No difference between drugs in clearance, volume of distribution and half-life (p?>?0.05). Ratio of AUC pH to AUC drug concentration 0-12?hours after first dose was significantly greater for famotidine (0.06849?±?0.01460 SD) than ranitidine (0.02453?±?0.01448; p?