Per policy, orders for these non-formulary agents will be changed to formulary equivalents.
Non-Formulary Agent
Formulary Equivalent
cimetidine (Tagamet)
famotidine (Pepcid) 20 mg, subject to renal dosing adjustments by pharmacy (see famotidine for more info) famotidine (Pepcid) liquid for pediatric patients
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication:
cimetidine (Tagamet)
Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Drug(s) ⇆ disease or syndrome
H2-receptor antagonists ⇄ Delirium
Rationale
Avoid in older adults with or at high risk of delirium because of the potential of inducing or worsening delirium.
Recommendation
Avoid
Quality of evidence: Low, Strength of Recommendation: Strong
Criteria 5: medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults. (Table 6)
CrCl (mL/min) at which action is required
<50
Rationale
Mental status changes
Recommendation
Reduce dose
Quality of evidence: Moderate, Strength of Recommendation: Strong
famotidine (Pepcid) liquid for pediatric patients