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Indigestion Drug Famotidine Shows Promise for Helping COVID-19 Symptoms

Pharmacists should expect Pepcid AC and generic versions to continue flying off of the drugstore shelves now that a small case study suggests it helps with COVID-19 symptoms in patients recovering at home. Find out what effects the indigestion drug had and why researchers are calling for a clinical trial to test its benefits.

NEW HYDE PARK, NY – A common over-the-counter drug for treating indigestion is showing promise for treating COVID-19 in patients whose infection is moderate enough to recover at home

That’s according to a small case series reported in the journal Gut.

Northwell Health Cancer Institute-led researchers point out that the effects were evident within 24 to 48 hours of taking famotidine and all for a clinical trial to determine if the drug could be an effective treatment for COVID-19, say the researchers.

The histamine-2 receptor famotidine, marketed as Pepcid AC and in generic versions, reduces the amount of stomach acid produced. It can be used in dosages of 20-160 mg, up to four times a day, for the treatment of acid reflux and heartburn.

This study focused on 10 patients – six men and four women -- who developed COVID-19 infection; all were already taking famotidine during their illness. The most frequently used famotidine regimen was 80 mg three times daily, used by six of the participants, for a median of 11 days (range: 5–21 days).

Of the patients, seven tested positive for COVID-19, using a swab test; two had antibodies to the infection; and one patient wasn't tested but was diagnosed with the infection by a clinicians. Participants ranged in age from 23 to 71 and had a diverse range of ethnic backgrounds and known risk factors for COVID-19 severity, including high blood pressure and obesity.

Symptoms of COVID-19 had been going on from two to 26 days when the patients started taking famotidine.

Researchers quantitively assessed longitudinal changes in patient reported outcome measures in the non-hospitalized patients with COVID-19 who self-administered high-dose famotidine orally. Patients, who were enrolled consecutively after signing written informed consent, provided data on demographics, COVID-19 diagnosis, famotidine use, drug-related side effects, temperature measurements, oxygen saturations and symptom scores were obtained using questionnaires and telephone interviews.

The severity of five cardinal symptoms--cough; shortness of breath; fatigue; headache and loss of taste/smell as well as general unwellness--was measured using a version of a 4-point scale normally applied to assess the severity of cancer symptoms (ECOG PS).

Results indicate that, not only was famotidine well tolerated, all patients reported marked improvements of disease-related symptoms after starting famotidine. Researchers report that the combined symptom score improved significantly within 24 hours of starting famotidine. In addition, peripheral oxygen saturation increased in two patients, and device recorded activity went up in one.

Researchers observe that cough and shortness of breath, improved more rapidly than systemic symptoms, such as fatigue.

“The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in non-hospitalized patients with COVID-19,” the authors conclude. “The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in in non-hospitalized patients with COVID-19.

"Our case series suggests, but does not establish, a benefit from famotidine treatment in outpatients with COVID-19," the authors add.