Famotidine is a medication that belongs to a class of drugs called H2 blockers, or H2 receptor antagonists. It is commonly used to reduce stomach acid and treat conditions like heartburn, acid reflux, and stomach ulcers. Because Alzheimer’s disease is a complex condition that affects millions of older adults, it is important to carefully consider the safety of any medication, including famotidine, in people with this diagnosis.
## How Famotidine Works
Famotidine works by blocking histamine receptors in the stomach, which reduces the amount of acid the stomach produces. This can help relieve symptoms caused by too much stomach acid. Unlike some other acid-reducing medications, such as proton pump inhibitors (PPIs), famotidine is generally considered to have fewer drug interactions and a lower risk of certain side effects, especially when used for short periods[1].
## Famotidine and Older Adults
Older adults, including those with Alzheimer’s disease, often take multiple medications for various health problems. This increases the risk of drug interactions and side effects. The American Geriatrics Society Beers Criteria, which is a respected guide for medication use in older adults, lists certain drugs that should be avoided or used with caution in this population. Famotidine is not listed as a medication to avoid in older adults, unlike some other acid-reducing drugs or medications that can worsen confusion or increase fall risk[4]. However, this does not mean it is completely without risk.
## Potential Risks and Side Effects
All medications have potential side effects. For famotidine, common side effects include headache, dizziness, constipation, and diarrhea. Less commonly, it can cause confusion, especially in older adults or those with kidney problems, because the drug is removed from the body by the kidneys. If kidney function is reduced, the drug can build up in the body, increasing the risk of side effects.
There is no strong evidence that famotidine directly worsens Alzheimer’s disease or accelerates cognitive decline. However, any medication that can cause confusion or dizziness could potentially make symptoms of dementia worse, especially in people who are already vulnerable. This is why it is important for healthcare providers to carefully monitor older adults with Alzheimer’s disease when they start any new medication, including famotidine.
## Famotidine and the Brain
Some research has looked at whether famotidine or similar drugs might have effects on the brain beyond reducing stomach acid. There is no strong evidence that famotidine has a direct impact on the progression of Alzheimer’s disease. Unlike some other medications used in older adults, such as certain anticholinergic drugs, famotidine does not appear to significantly increase the risk of dementia or cognitive decline. However, more research is needed to fully understand any long-term effects.
## Drug Interactions
Famotidine generally has fewer drug interactions than some other acid-reducing medications. However, it can interact with certain drugs, especially those that also affect the kidneys or are processed by the liver. People with Alzheimer’s disease often take multiple medications, so it is important for a healthcare provider to review all medications to avoid harmful interactions.
## When Is Famotidine Used in Alzheimer’s Disease?
Famotidine might be prescribed to someone with Alzheimer’s disease if they have symptoms of excess stomach acid, such as heartburn or ulcers. It is sometimes used in hospitals to prevent stomach ulcers in patients who are at high risk, such as those who are critically ill or taking medications that can irritate the stomach. In these cases, the benefits of preventing serious complications may outweigh the risks of side effects.
## Alternatives to Famotidine
There are other medications that can reduce stomach acid, including proton pump inhibitors (PPIs) like omeprazole and pantoprazole, as well as other H2 blockers like ranitidine. PPIs are generally more effective at reducing acid but may have a higher risk of certain side effects, especially with long-term use[1]. The choice of medication depends on the individual’s health, other medications they are taking, and their risk of side effects.
## Monitoring and Safety
For anyone with Alzheimer’s disease, it is important to monitor for new or worsening confusion, dizziness, or falls when starting famotidine or any new medication. Regular check-ups with a healthcare provider can help catch any problems early. Blood tests may be needed to check kidney function, especially in older adults.
## What Do Guidelines Say?
Current guidelines do not specifically warn against the use of famotidine in people with Alzheimer’s disease. The American Geriatrics Society Beers Criteria, which is an authoritative source for medication safety in older adults, does not list famotidine as a medication to avoid in this population[4]. However, the guidelines do recommend caution with any medication in older adults, especially those with cognitive impairment, because they are more vulnerable to side effects.
## Practical Advice for Caregivers
If you are caring for someone with Alzheimer’s disease who is prescribed famotidine, watch for any changes in behavior, confusion, or physical symptoms like dizziness or falls. Keep a list of all medications and share it with all healthcare providers. Do not stop or change medications without talking to a doctor.
## The Bottom Line
Famotidine is generally considered safe for use in older adults, including those with Alzheimer’s disease, when used appropriately and monitored by a healthcare provider[4]. It has fewer risks than some other acid-reducing medications, but no medication is completely without risk, especially in people with dementia. The decision to use famotidine should be based on a careful assessment of the individual’s overall health, other medications, and the potential benefits and risks.
Always consult a healthcare provider before starting or stopping any medication in a person with Alzheimer’s disease. Regular follow-up and monitoring are key to ensuring safety and effectiveness.
[1] [4]
