Famotidina en el tratamiento de pacientes hospitalizados con COVID-19. Revisión sistemática y metaanálisis / Famotidine in the treatment of hospitalized patients with COVID-19. Systematic review and meta-analysis

Introducción: El síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2), de alta morbimortalidad, carece a la fecha de preparar esta revisión, de una terapia específica altamente eficaz. Famotidina se ha postulado como una opción terapéutica viable, basado en trabajos de cohorte retrospectiva y modelos computacionales guiados por inteligencia artificial. Objetivo: Recopilar la mejor evidencia científica disponible para determinar la efectividad y eficacia de famotidina en el tratamiento de pacientes hospitalizados con COVID-19, para reducir el riesgo de progresión de la enfermedad, intubación, muerte y tiempo de estancia hospitalaria. Material y Métodos: Se realizó una búsqueda en PubMed, EBSCO, Scopus, Web of Science y Cochrane Central, de artículos originales que reporten las variables de interés asociadas al uso de famotidina en pacientes hospitalizados con COVID- 19. Los investigadores independientemente evaluaron y seleccionaron los estudios, se extrajeron los datos expuestos para las asociaciones de interés y se procesaron con el software Revman 5.3. Resultados: En la búsqueda se obtuvo un total de 126 artículos potenciales para la revisión, de los cuales 14 fueron seleccionados para el análisis. En el metaanálisis se incluyeron un total de 47.044 pacientes, de los cuales 6.647 fueron los usuarios de famotidina. El riesgo de intubación se vio reducido en el grupo no expuesto a famotidina, aunque sin significancia estadística, (RR 1,43 IC95% 0,42-4,83), en cuanto a la mortalidad no se evidenció reducción significativa en el grupo de famotidina (RR 0,95 IC 95% 0,70-1,29). Se observó reducción en el tiempo de estancia hospitalaria (DM -1,60 -2,89, -0,31) y finalmente se mostró que no hay presencia de asociación entre el uso de famotidina y el desenlace compuesto de reducción del riesgo de ingreso a UCI, intubación y muerte (RR 1,03 IC 95% 0,46-2,34). Conclusión: Famotidina no presenta efectividad ni eficacia en la reducción de riesgo de intubación o ingreso a UCI ni de mortalidad en pacientes hospitalizados por COVID-19. La eficacia en la reducción de la estancia hospitalaria no es consistente y se necesitan más ensayos clínicos con buena calidad metodológica para definirla.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with high morbidity and mortality, lacks, at the time of preparing this review, a highly effective specific therapy. Famotidine has been postulated as a viable therapeutic option, based on retrospective cohort investigations and computational models guided by artificial intelligence. Aim: The objective of this study was to compile the best scientific evidence available to determine the effectiveness and efficacy of famotidine in the treatment of hospitalized patients with COVID-19, to reduce the risk of disease progression, intubation, death, and time to hospital stay. Methods: A search was carried out in PubMed, EBSCO, Scopus, Web of Science, and Central Cochrane, for original articles that report the variables of interest associated with the use of famotidine in hospitalized patients with COVID-19. The investigators independently evaluated and selected the studies, the exposed data for the associations of interest were extracted and processed with Revman 5.3 software. Results: The search yielded a total of 126 potential articles for the review, of which 14 were selected for analysis. A total of 47,044 patients were included in the meta-analysis of which 6,647 were famotidine users. The risk of intubation was reduced in the group not exposed to famotidine, although without statistical significance (RR 1.43 IC95% 0.42 - 4.83), regarding mortality there was no significant reduction in the famotidine group (RR 0.95 IC 95 % 0.70-1.29). A reduction in the length of hospital stay was observed (MD -1.60 -2.89, -0.31) and finally it was shown that there is no association between the use of famotidine and the composite outcome of reduced risk of ICU admission, intubation and death. (RR 1.03 95% CI 0.46-2.34). Conclusion: Famotidine does not show effectiveness or efficacy in reducing the risk of intubation or ICU admission or mortality in patients hospitalized for COVID-19. The efficacy in reducing hospital stay is not consistent and more clinical trials with good methodological quality are needed to define it.

In Vitro In Vivo Evaluation Of Niosomal Formulation Of Famotidine

Objective: The present study was aimed on formulation and evaluation of famotidine loaded niosomal formulation for in vitro and in vivo pharmacokinetic behaviour. Formulating it as niosomal formulation might be quite advantageous for prolonging the duration of pharmacological action and improved bioavailability. Methods: In the present study niosomal formulations were prepared by using most documented thin film hydration technique by using various grades of surfactants (span 20, 40, 60, 80) in varying ratios with cholesterol, negative charge inducer di cetyl phosphate (DCP) and drug famotidine. Suitable preformulation studies were conducted like identification of drug, excipient and drug compatibility study. The optimized drug loaded niosomes were characterized for size and morphology, polydispersity index, zeta potential, drug entrapment, in vitro release, in vivo study and stability study. Results: The results showed that the vesicles formed were spherical in shape, size ranging between 160.1 nm to 718.7 nm with zeta potential values indicating good stability and formulation containing span 60 (NMS7) showed the highest entrapment efficiency (73.234%). All the formulations showed prolonged release profile for more than 24 h with release kinetics better suited to zero order release pattern. In vivo study conducted on rabbits predicted a fourfold increase in pharmacokinetic parameter (area under curve)AUC and pharmacological action for more than 24 h as compared to free drug famotidine which showed its action only upto 12 h. Conclusion: Thus the famotidine loaded niosomal formulation may be considered as a very promising drug delivery system which could be successfully employed for prolonging the drug release and overcoming the drawbacks of conventional drug delivery systems.

Therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on lipid peroxide,malondialdehyde and somatostatin levels / 中国医师进修杂志

Objective To explore the therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on the levels of lipid peroxide (LPO),malondialdehyde (MDA) and somatostatin (SS).Methods One hundred and fifty patients with peptic ulcer who were treated in Cixi Cilin Hospital from January 2018 to May 2019 were randomly divided into famotidine group and combined treatment group,with 75 cases in each group.Famotidine group was treated with famotidine,while bismuth potassium citrate combined with famotidine was used in combined treatment group.H+-K+-ATP ase activity,gastric acid-base value and gastric acid secretion function were detected in two groups.The levels of tumor necrosis factor-ot (TNF-α),interleukin-7 (IL-7),hypersensitive C-reactive protein (hs-CRP) were detected by ELISA,T lymphocyte subsets were detected by flow cytometry,and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry.The levels of LPO,MDA and SS were measured,and the therapeutic effect,ulcer healing and adverse reactions were compared between two groups.Results After treatment,the activity of H+-K+-ATP ase in the combined treatment group was lower than that in the famotidine group [(2.54 ± 0.41) μmol/min vs.(2.87 ± 0.50) μmol/min],the acid-base value in stomach was higher than that in the famotidine group (5.56 ± 1.19 vs.4.77 ± 0.89),and there were significant differences (P ＜ 0.05).After treatment,the levels of maximum gastric acid excretion after pentagastrin stimulation (MAO),peak gastric acid output (PAO),basal acid output (BAO),TNF-α,IL-17,hs-CRP,CD8+,LPO and MDA in combined treatment group were lower than those in famotidine group [(8.22 ± 1.76) mmol/h vs.(10.53 ± 2.21) mmol/h,(11.88 ± 2.51)mmol/h vs.(14.79 ± 2.76) mmol/h,(4.11 ± 1.32) mmol/h vs.(5.54 ± 1.49) mmol/h,(4.76 ± 1.52) ng/L vs.(6.91 ± 1.61) ng/L,(18.37 ± 3.25) ng/L vs.(22.83 ± 3.62) ng/L,(6.41 ± 1.81) mg/L vs.(8.67 ± 2.15) mg/L,0.287 6 ± 0.030 5 vs.0.325 5 ± 0.032 4,(0.06 ± 0.02) U/mg vs.(0.09 ± 0.03) U/mg,(10.19 ± 1.86) μmol/L vs.(13.25 ± 2.03) μmol/L],while the levels of CD3+,CD4+,SS were higher than those in the famotidine group [0.523 6 ± 0.040 9 vs.0.476 3 ± 0.039 5,0.356 6 ± 0.035 2 vs.0.315 8 ± 0.033 9,(14.59 ± 2.67)ng/L vs.(10.36 ± 2.31) ng/L],and there were significant differences (P＜0.05).The total effective rate and ulcer healing rate in combined treatment group were higher than those in famotidine group [93.33％ (70/75) vs.80.00％ (60/75),94.67％ (71/75) vs.82.67％ (62/75)] (P＜ 0.05).The incidence of adverse reactions in combined treatment group was slightly higher than that in famotidine group [16.00％(12/75)vs.13.33％ (10/75)],but there was no significant difference between the two groups (P＞0.05).Conclusions Bismuth potassium citrate combined with famotidine in the treatment of peptic ulcer patients can improve gastric acid secretion function,regulate gastric acid-base value,inhibit inflammatory response,improve immune function,and reduce oxidative stress injury.

Therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on lipid peroxide,malondialdehyde and somatostatin levels / 中国医师进修杂志

Objective@#To explore the therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on the levels of lipid peroxide (LPO), malondialdehyde (MDA) and somatostatin (SS).@*Methods@#One hundred and fifty patients with peptic ulcer who were treated in Cixi Cilin Hospital from January 2018 to May 2019 were randomly divided into famotidine group and combined treatment group, with 75 cases in each group. Famotidine group was treated with famotidine, while bismuth potassium citrate combined with famotidine was used in combined treatment group. H+-K+-ATP ase activity, gastric acid-base value and gastric acid secretion function were detected in two groups. The levels of tumor necrosis factor-α (TNF-α), interleukin-7 (IL-7), hypersensitive C-reactive protein (hs-CRP) were detected by ELISA, T lymphocyte subsets were detected by flow cytometry, and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry. The levels of LPO, MDA and SS were measured, and the therapeutic effect, ulcer healing and adverse reactions were compared between two groups.@*Results@#After treatment, the activity of H+-K+-ATP ase in the combined treatment group was lower than that in the famotidine group [(2.54 ± 0.41) μmol/min vs. (2.87 ± 0.50) μmol/min], the acid-base value in stomach was higher than that in the famotidine group(5.56 ± 1.19 vs. 4.77 ± 0.89), and there were significant differences (P<0.05). After treatment, the levels of maximum gastric acid excretion after pentagastrin stimulation (MAO), peak gastric acid output (PAO), basal acid output (BAO), TNF-α, IL-17, hs-CRP, CD8+, LPO and MDA in combined treatment group were lower than those in famotidine group [(8.22 ± 1.76) mmol/h vs. (10.53 ± 2.21) mmol/h, (11.88 ± 2.51)mmol/h vs. (14.79 ± 2.76) mmol/h, (4.11 ± 1.32) mmol/h vs. (5.54 ± 1.49) mmol/h, (4.76 ± 1.52) ng/L vs.(6.91 ± 1.61) ng/L, (18.37 ± 3.25) ng/L vs. (22.83 ± 3.62) ng/L, (6.41 ± 1.81) mg/L vs. (8.67 ± 2.15) mg/L, 0.287 6 ± 0.030 5 vs. 0.325 5 ± 0.032 4, (0.06 ± 0.02) U/mg vs. (0.09 ± 0.03) U/mg, (10.19 ± 1.86) μmol/L vs. (13.25 ± 2.03) μmol/L], while the levels of CD3+, CD4+, SS were higher than those in the famotidine group [0.523 6 ± 0.040 9 vs. 0.476 3 ± 0.039 5, 0.356 6 ± 0.035 2 vs. 0.315 8 ± 0.033 9, (14.59 ± 2.67) ng/L vs. (10.36 ± 2.31) ng/L], and there were significant differences (P<0.05). The total effective rate and ulcer healing rate in combined treatment group were higher than those in famotidine group [93.33%(70/75) vs. 80.00%(60/75), 94.67%(71/75) vs. 82.67%(62/75)] (P<0.05). The incidence of adverse reactions in combined treatment group was slightly higher than that in famotidine group [16.00%(12/75) vs. 13.33%(10/75)], but there was no significant difference between the two groups (P>0.05).@*Conclusions@#Bismuth potassium citrate combined with famotidine in the treatment of peptic ulcer patients can improve gastric acid secretion function, regulate gastric acid-base value, inhibit inflammatory response, improve immune function, and reduce oxidative stress injury.

Formulation And Evaluation Of Famotidine Fast Dissolving Tablets Using Synthetic Superdisintegrants

Objective: The main aim of the present research work was to formulate fast dissolving tablets of famotidine by direct compression method and to evaluate the effect of synthetic super disintegrating agent on drug release pattern. Methods: The fast dissolving tablets were prepared by using crospovidone, croscarmellose sodium, sodium starch glycolate as superdisintegrants (2, 4 and 6 %w/w), mannitol 20 % and microcrystalline cellulose (44, 46 and 48 % w/w) as a directly compressible vehicle. All the prepared tablets were evaluated for hardness, friability, drug content uniformity, weight variation, disintegrating time, wetting time and in vitro drug release studies. Results: All the prepared fast dissolving tablets formulations were within the Pharmacopoeial standards limits. Based on in vitro drug release studies (>90 % within 30 min), the optimised formulations were optimised tested for the short term stability (at 40 ˚C/75% RH for 3 mo) and drug excipient interaction (fourier transform infrared spectroscopy). Conclusion: Hence, formulation prepared with 6 % w/w of crosspovidine and 44 % w/w of microcrystalline cellulose as emerged as the overall best formulation (>90 % within 30 min) compared to marketed product (>70 % within 30 min). Short-term stability studies on the formulations indicated that there are no significant changes in drug content and in vitro drug release (p<0.05).

Improving Solubility of Famotidine by Cocrystal Synthesis with Nicotinic Acid / 中国药学杂志

OBJECTIVE: This study was focused on obtaining and characterizing cocrystal of famotidine to improve its solubility. METHODS: A new cocrystal of famotidine with nicotinic acid(FAM-NIC) was obtained by solution evaporation. And the FAM-NIC cocrystal was characterized by single crystal X-ray diffraction, powder X-ray diffraction (PXRD), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and Fourier transform infrared spectroscopy (FTIR). In addition, the solubility and stability of cocrystal were studied. RESULTS: The asymmetric unit of FAM-NIC consisted of one molecule of famotidine, nicotinic acid, and water, and they were connected through hydrogen bonds. FAM-NIC had unique thermal, spectroscopic, X-ray diffraction, and solubility properties that differed from famotidine. Dissolution studies of the cocrystal showed a 4.2-fold increase of famotidine solubility, and FAM-NIC didn′t change the stability of famotidine in artificial gastric juice, at high humidity, at high temperature, and under illumination. CONCLUSION: The new cocrystal of famotidine with nicotinic acid obviously enhanced the solubility of famotidine.And the RESULTS can be useful for improving solubility of drugs by cocrystal synthesis.

Clinical therapy of Zisheng decoction recipe for chronic atrophic gastritis with intestinal metaplasia / 中国中药杂志

To explore the therapeutic effect and security of Zisheng decoction recipein treatment of the chronic atrophic gastritis (CAG) with intestinal metaplasia(IM). A total of 147 eligible cases were randomly divided into the traditional Chinese medicine group, Western medicine group and the combined group,47 cases in each group. Zisheng decoction recipe, famotidine, as well as Zisheng decoction recipe + famotidine were respectively given in the above three groups, with a treatment course of 30 d. The symptoms of traditional Chinese medicine, pathological score of gastric mucosa and the negative rate of Helicobacter pylori before and after treatment were observed in each group.The changes in pepsinogen Ⅰ (PGⅠ), pepsinogen Ⅱ (PGⅡ), gastrin-17 (GAS-17) and endothelin-1 (ET-1)were also detected to compare the efficient and safety indexes in the three groups. The combined group was better than the traditional Chinese medicine groupand the Western medicine group in total effective rate (P<0.05), pathological score of gastric mucosa and the negative rate of Helicobacter pylori, and serum indexes improvement (P<0.05). The improvement in TCM symptom score was more obvious in traditional Chinese medicine group and combined group than the Western medicine group (P<0.05). In the comparison ofincidence of complications,heart, liver and renal dysfunction, the traditional Chinese medicine group (2 case,4.8%)< the combined group (7 case,15.2%) <the Western medicine group (20 case,41.3%) (P<0.05). In the comparison of the blood and urine routine: the traditional Chinese medicine group (7 case,16.7%)< the combined group (14 case,30.4%) < the Western medicine group (24 case,52.2%) (P<0.05).The results showed that there was no significant difference in total effective rate between Zisheng decoction recipe and Western medicine in the treatment of CAG with IM, indicating Zisheng decoction recipe was effective; meanwhile, it had higher safety than famotidine. Zisheng decoction recipe combined with famotidine showed synergistic effect in the treatment of CAG with IM, can reverse the pathological changes of gastric mucosa in a certain extent, and the effect was better than that of Zisheng decoction recipe alone and famotidine alone.

Analysis of the effect of omeprazole and famotidine in the treatment of reflux esophagitis / 中国基层医药

Objective To investigate the effects of omeprazole and famotidine in the treatment of reflux esophagitis.Methods 75 patients with reflux esophagitis were selected as the research subjects,they were randomly divided into three groups according to the digital table,25 cases in each group.One group was treated with omeprazole,treatment group received oral famotidine,another group was given omeprazole combined with famotidine.The treatment effect of the three groups was observed.The improved situation of endoscopic examination,the quality of life and related symptoms before and after treatment were observed.Results The total effective rate of the combined group was 96.00％,which was higher than that of the other two groups,which of the omeprazole group was higher than that of the famotidine group (x21 =4.16,x22 =14.28,all P ＜ 0.05).After treatment,the symptom score of the combined treatment group was the lowest,heartburn [(0.49 ± 0.15) points] (t1 =3.20,t2 =11.21),acid reflux [(0.59 ±0.34) points] (t1 =2.93,t2 =9.10),chest pain[(0.66 ±0.24) points] (t1 =3.28,t2 =9.36),then was the omeprazole group.The quality of life score of the combined group was (85.62 ± 3.03) points,which was higher than that of the other two groups,which of,the famotidine group was the lowest (t1 =6.36,t2 =16.85,all P ＜ 0.05).Conclusion Omeprazole combined with famotidine in the treatment of reflux esophagitis has better clinical effect.

Famotidine-induced reversal of meperidine-related serotonin syndrome: a case report / 대한마취과학회지

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.

Famotidine-induced reversal of meperidine-related serotonin syndrome: a case report / 대한마취과학회지

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.

Anxiolytic and Antiulcer Activity of Leaves of Andrographys Paniculata in Experimental Model.

The Petroleum ether and Chloroform extract of Andrographis paniculata leaves was investigated for its potential to protect gastric mucosa against pylorus ligation induced ulcer and to find out the anxiolytic action in elevated plus maze model. Chloroform extract at the dose of 200mg/kg protected the gastric mucosa in the pylorus ligation ulcer induction significantly (p<0.001) when compared with that of the standard drug famotidine (10mg/kg) and acts as a potent antiulcer effect. Elevated plus maze results were significant in alleviating the anxiety in the animals’ results in increased time spent and entries into the open arm compared with the standard drug diazepam (1mg/kg).

Formulation and evaluation of novel stomach specific floating microspheres bearing famotidine for treatment of gastric ulcer and their radiographic study

Objective: To develop and characterize multiple-unit-type oral floating microsphere of famotidine to prolong gastric residence time and to target stomach ulcer. Methods: The floating microspheres were prepared by modified solvent evaporation method. Eudragit S-100 was used as polymer. Microspheres were characterized for the micromeritic properties, floating behavior, entrapment efficiency and scanning electron microscopy. The in-vitro release studies and floating behavior were studied in simulated gastric fluid at pH 1.2. Different drug release kinetics models were also applied for all the batches. Selected formulations were also subjected for X-ray radiographic study. Results: Floating microspheres were successfully prepared by modified solvent evaporation technique. Microspheres showed passable flow properties. The maximum yield of microspheres was up to (95.11±0.35)%. On the basis of optical microscopy particle size range was found to be ranging from (52.18±182.00) to (91.64±5.16) μm. Scanning electron microscopy showed their spherical size, perforated smooth surface and a cavity inside microspheres. Microspheres were capable to float up to 20 h in simulated gastric fluid. X-ray radiographic studies also proved its better retention in the stomach. Conclusions:On the basis of the results, such dosage forms may be a good candidate for stomach targeting and may be dispensed in hard gelatin capsules.

Formulation and evaluation of novel stomach specific floating microspheres bearing famotidine for treatment of gastric ulcer and their radiographic study

Objective: To develop and characterize multiple-unit-type oral floating microsphere of famotidine to prolong gastric residence time and to target stomach ulcer. Methods: The floating microspheres were prepared by modified solvent evaporation method. Eudragit S-100 was used as polymer. Microspheres were characterized for the micromeritic properties, floating behavior, entrapment efficiency and scanning electron microscopy. The in-vitro release studies and floating behavior were studied in simulated gastric fluid at pH 1.2. Different drug release kinetics models were also applied for all the batches. Selected formulations were also subjected for X-ray radiographic study. Results: Floating microspheres were successfully prepared by modified solvent evaporation technique. Microspheres showed passable flow properties. The maximum yield of microspheres was up to (95.11±0.35)%. On the basis of optical microscopy particle size range was found to be ranging from (52.18±182.00) to (91.64±5.16) μm. Scanning electron microscopy showed their spherical size, perforated smooth surface and a cavity inside microspheres. Microspheres were capable to float up to 20 h in simulated gastric fluid. X-ray radiographic studies also proved its better retention in the stomach. Conclusions: On the basis of the results, such dosage forms may be a good candidate for stomach targeting and may be dispensed in hard gelatin capsules.

Design and evaluation of famotidine mucoadhesive nanoparticles for aspirin induced ulcer treatment

The present study was performed to design and evaluate the famotidine loaded mucoadhesive nanosuspension for aspirin induced ulcer. A 3-factor, 3-level Box-Behnken design was applied to study the effects of amount of the beads (X1), PVPK-30(X2) and Tween-80 (X3) on the particle size (Y1), and cumulative percentage drug released after 1h (Y2). The optimization was performed using the desirability function and contour plots. The scanning electron microscopy (SEM) showed the nanoparticles as spherical in shape. The differential scanning calorimetry (DSC) analysis indicated that there was substantial crystallinity change in the nanoparticle compared with the pure drug. Ex-vivo mucoadhesion study showed that famotidine mucoadhesive nanoparticles possessed higher mucoadhesion than the famotidine nanoparticles. The in vivo studies on aspirin-induced rats indicated the lowering in ulcer index for famotidine mucoadhesive nanoparticles was 0.46+0.011, which was significantly better than the effect of traditional famotidine suspension (0.66+0.035). Famotidine mucoadhesive nanosuspension could be prepared using the media milling technique and allowing significant reduction in ulcer index compared to famotidine suspension.

Gastroprotective effect of leaf extracts of Basella alba var. alba against experimental gastric ulcers in rats

The aqueous and ethanol extracts of the leaves of Basella alba L. var. alba Wight, Basellaceae, were investigated for antiulcer activity on rats employing the pylorus ligation and ethanol induced ulcer models. The various gastric secretion parameters such as total acidity, free acidity, gastric acid volume, pH and histopathological parameters such as ulcer index and percent protection were comparatively examined between control, test and standard groups. The antiulcer activity of aqueous extract of B. alba (AEBA) and ethanol extract of B. alba (EEBA) were studied in rats treated with the doses of 1 mL/kg of absolute ethanol, 200 and 400 mg of test extracts and 20 mg/kg of famotidine for control, test and standard groups respectively in both the models. The animals pretreated with AEBA and EEBA showed a dose-dependent protection against gross damaging action of ethanol and pylorus ligation on gastric mucosa of animals. Histopathological evaluation also revealed that Group I treated with absolute ethanol showed severe gastric mucosal damage. The AEBA and EEBA showed 68.25 and 58.11% protection in gastric mucosal damage as compared to control group. Both the extracts of B. alba var. alba were able to decrease the gastric acidity and increase the mucosal defense in the gastric mucosal area. This study indicate that B. alba var. alba possesses significant gastroprotective effect and the same is substantiated by the histopathological examination of the ulcerated stomachs of the animals.

Simultaneous estimation of ibuprofen and famotidine in pure and combination dosage form by RP-HPLC.

A new simple, accurate, precise and reproducible RP-HPLC method has been developed for the simultaneous estimation of ibuprofen and famotidine in tablet dosage forms using C18 column (Phenomenex, 250 x 4.6 mm, 5 μm) in isocratic mode. The mobile phase consisted of Methanol: Water: Phosphate buffer in the ratio of 70:20:10 (v/v/v). The flow rate was 1.0 ml/min and detection wavelength was carried out at 284 nm. The retention times of ibuprofen and famotidine were 3.6 min and 7.8 min, respectively. The method was linear over the concentration range for ibuprofen 2-10 μg/ml and for and famotidine 2-10 μg/ml. The recoveries of ibuprofen and famotidine were found to be in the range of 99.037-100.766% and 99.703-100.433% respectively. The validation of method was carried out utilizing ICHguidelines. The described HPLC method was successfully employed for the analysis of pharmaceutical formulations containing combined dosage form.

Clinical observation on hematological adverse reactions of oral omeprazole in aged patients / 中国综合临床

ObjectiveTo discuss the hematological adverse reactions of oral omeprazole administration with convention dosage and treatment course in aged patients.MethodsFour hundred and nine cases of reflux esophagitis by endoscopic diagnosis from Beijing Hospital during January 2000 to December 2010 were divided into three groups according to their ages: group A ( 168 cases) aged from 60 to 69 years,group B ( 152 cases) aged from 70 to 79 years and group C (89 cases) aged equal to or above 80 years.Each group of patients was randomly divided into three subgroups,A 1 ( 56 cases),B 1 ( 51 cases) and C 1 ( 30 cases ) were administered with oral omeprazole,20 mg,bid; A2 ( 56 cases ),B2 ( 51 cases ) and C2 ( 30 cases ) were administered with oral famotidine,20 mg,bid; A3 ( 56 cases),B3 ( 50 cases),C3 ( 29 cases ) and all above subgroups were administered with oral sucralfate,10 ml,tid.The treatment course lasted for one month.The clinical efficacy,WBC count,RBC count,the Hemoglobin level,platelet count,as well as the prothrombin time,thrombin time,activated partial thromboplastin time,fibrinogen,Plasma fibronectin and serum D-Dimer were tested and compared after 10-days and 30-days treatment.ResultsAfter the treatment,all the patients had alleviated symptoms,to varied extend,especially in subgroups treated with oral omeprazole and sucralfate.After 30 days' treatment,blood WBC counting in B1 subgroup declined to lower than normal values in two cases; PLT counting drops in 1 case; blood WBC dropped in 6 cases and PLT dropped in4 cases of the C1 subgroup;blood WBC counting dropped in 1 case and PLT dropped in 2 cases of the C2 subgroup.Hemoglutination did not show significant change in all groups (P ＞ 0.05 ).Conclusion The hematological adverse reactions of oral omeprasole in aged patients,under convention dosage and treatment course,occured with age increase,especially for blood WBC and platelet counting.

The effect analysis of omeprazole or famotidine combined with itopride in the treatment of reflux esophagitis / 中国基层医药

Objective To observe the effect of omeprazole or famotidine combined with itopride in the treatment of reflux esophagitis.Methods 86 patients with reflux esophagitis were randomly divided into two groups,which group A with 43 eases was treated with omeprazole combined with itopride,and group B with 43 cases was treated with famotidine combined with itopride.The clinical effect and main symptoms were observed and compared.Results The total effective rate in group A was 91.3％,significantly higher than that of group B ( 71.4％ ) ( x2 =5.460,P ＜0.05 ).After treatment,the scores of heartburn,acid reflux and chest pain were significantly decreased ( all P ＜ 0.05 )in both two groups.Moreover,the scores of heartburn,acid reflux and chest pain in group A after treatment were significantly lower than those of group B ( all P ＜ 0.05 ).Conclusion Omeprazole combined with itopride in the treatment of reflux esophagitis is better than famotidine combined with itopride.

The effects of famotidine combined with vitamin K1 on the therapy of neonatal alimentary tract hemorrhage / 中国基层医药

Objective To observe the therapeutic efficacy of famotidine combined with vitamin K1 on neonatal alimentary tract hemorrhage. Methods 69 neonates with neonatal alimentary tract hemorrhage were divided into control group (24 neonates who accepted the conventional therapy combined with vitamin K,) and therapy group (45 neonates who got the treatment of control group combined with famotidine). The effects were evaluated by the offtime of hemorrhage. Results The total curative effect of the therapy group was 95.6% .which significantly higher than that in control group(70. 8% ) ,P < 0.05. Conclusion Famotidine combined with vitamine K1 could improve the therapeutic efficacy of the treatment of neonatal alimentary tract hemorrhage. It was a safe and effective method in the treatment of neonatal alimentary tract hemorrhage.

Effects of the histamine H2 receptor antagonist famotidine on the healing of colonic anastomosis in rats

BACKGROUND: Failure of anastomotic healing is one of the major complications in colorectal surgery. Because histamine plays an important role in immune and inflammatory reactions, we demonstrate the effects of famotidine on the healing of colonic anastomosis in rats. METHODS: Twenty-eight Sprague-Dawley rats were used in the study. Excision and end-to-end anastomosis was performed in the distal colon of the rat. The Famotidine Group received 2 mg/kg/day famotidine; the Control Group received the same amount of saline. Bursting pressure of anastomoses and hydroxyproline content of perianastomotic tissues were evaluated on the third and seventh days following surgery. RESULTS: Bursting pressures and hydroxyproline contents for the Famotidine Group were significantly lower than the equivalent parameters for the Control Group on both the third and seventh days post-surgery. CONCLUSIONS: According to our findings, famotidine exerts detrimental effects on the anastomotic bursting pressure and hydroxyproline content of perianastomotic tissues in the colon of rats.