Hiding in Plain Sight

Can a common heartburn drug help us fight coronavirus?

While the world is slowly opening back up from the coronavirus shutdown, medical professionals are hunkering down to try to find a treatment and vaccine. At the time of publication, many methods have been (and are still being) tested, but there seems to be a growing interest in an unlikely medication called famotidine, the key ingredient in certain heartburn medications, like Pepcid.

The potential for famotidine as a viable coronavirus treatment emerged in Wuhan, China — ground-zero for the virus — earlier this year, when researchers made an interesting discovery. They found that the common denominator among patients hospitalized for coronavirus who were experiencing better outcomes was the presence of famotidine in their systems as opposed to omeprazole, the active ingredient found in another heartburn drug, Prilosec.

This data quickly spread to the U.S., where doctors decided to continue testing famotidine even further. Now, Northwell Medical, New York’s largest health care provider, is conducting clinical trials on patients who have tested positive for COVID-19 to see if famotidine has potential, according to a report in Science magazine.

Locally, Dr. Gregory Borak of Gastroenterology Consultants of Savannah believes it’s too soon to know how effective the drug is, but says he’s open to the idea, as are the other medical professionals. “It’s a medicine we’re comfortable with, we’ve used it for a long time, and, as far as medicines go, it’s relatively safe,” Borak says. “Even at high doses, I would suspect that the benefits would outweigh the risks.”

But what are the risks?

In April, the Food and Drug Administration announced its request for all drugs with the main compound of ranitidine — yet another heartburn medication — to be taken off the shelves immediately because of its potential link to cancer. Ranitidine is most commonly found in the over-the-counter medication Zantac, and along with famotidine, is in a class of medications called H2 blockers. These blockers work by decreasing the amount of acid made by the cells in the lining of the stomach.

The similarities between the two heartburn medications may seem troubling at first glance, but despite the similar effects of heartburn prevention the two medications share, the carcinogen in Zantac has not been found in Pepcid.

What does elicit possible concern is not the drug itself, as of now, but the stockpile mentality that has recently swept the nation. If Pepcid were to be a possible promising player in coronavirus treatment, it could become more elusive than an eight-pack of Charmin.

“There’s always a risk that people will abuse the right to get it, and stockpile it if medical researchers are too forthright about everything they’re looking at,” Borak says.

The world got a glimpse into the dangers of stockpiling medication
with the testing of the malaria drugs chloroquine and hydroxychloroquine (Plaquenil) as potential treatments. Because of widespread publicity, demand skyrocketed, and some doctors began prescribing Plaquenil on an off-label basis, according to the Lupus Research Alliance. This led to a shortage of the drug for patients who actually needed it, like those suffering from lupus and rheumatoid arthritis. Moreover, a panel of experts convened by the National Institute of Allergy and Infectious Diseases strongly recommends against taking the drugs because of its risk of heart rhythm problems, including increasing the risk of sudden cardiac death.

The testing of Pepcid is still under the radar, but like just about everything else pertaining to coronavirus, it’s constantly evolving. While we wait patiently for a treatment or cure, Borak offers practical, professional advice. “Treat everyone like they are a potential carrier, and keep practicing safe measures and good hygiene,” he says. “Hopefully, COVID-19 will continue to reduce.”

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