Famotidine

Popular Brand Names:

Pepcid Heartburn Relief Pepcid AC Zantac 360 Acid Controller

Famotidine is a well-established heartburn drug, first approved in 1981 for treating peptic ulcers or gastroesophageal reflux disease (GERD). It is sold over the counter (OTC) without a prescription under various brand names, the most well-known of which is Pepcid.

Famotidine belongs to a class of drugs known as Histamine-Receptor-2 antagonists, commonly referred to as H2 blockers. By blocking the receptor for histamine-2, famotidine reduces the production of acid by the cells in the lining of the stomach, thereby allowing ulcers to heal.

The potential for famotidine to treat COVID-19 was first published in the medical literature in JMIR on April 7th, 2020, by Rogosnitzky, Berkowitz, and Jadad. They proposed the drug’s broad antiviral activity coupled with its cardio protective and anti-inflammatory properties, and its ability to reduce excessive blood clotting and modulate the immune response made it a good candidate for treating COVID-19.

In parallel, other groups of researchers began examining the potential benefits of famotidine and through a $21 million grant from the US government, the first clinical trial commenced at the end of April 2020 in New York.

Many publications have since appeared regarding the role of famotidine in treating COVID-19. The doses used in different clinical trials and case series have varied between studies, and range from 40 mg per day to 640 mg per day. In some studies, famotidine was combined with other drugs such as celecoxib, or cetirizine.

A number of retrospective studies carried out to identify any benefit for regular users of famotidine against COVID-19 have shown conflicting results. Some have reported immense benefits, and others failed to find any benefits. After much scientific debate, the universal opinion seems to be that famotidine is safer for treating COVID-19 patients than proton pump inhibitors and that clinical studies using appropriate doses of famotidine are needed to determine the extent of its benefit.

Famotidine is a pleiotropic drug, which means it has multiple unrelated effects on the body. It has off-label uses for over 25 medical conditions, a number of which are well-established off-label uses.

Key Facts for Famotidine

Description: Antiulcer agent (H2 antagonist)
Year Approved: 1981
Approved Uses:

Peptic ulcer disease
GERD (gastroesophageal reflux disease)
Zollinger-Ellison Syndrome

Typical Dose Range: 20 - 80 mg daily
Maximum Reported Safe Dose in Adults: 800 mg /daily
Populations of Use: Pediatric, Adult, Geriatric
Typical Duration of Use: Long Term
Further Drug Information: medicine.com

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Famotidine's Anti-COVID Properties

  • Antihistamine
  • Inhibits TLR-3 receptors to reduce inflammation
  • Inhibits CCL-2 to reduce acute respiratory distress
  • Inhibits IL-6 to reduce inflammation and inhibit acute protein synthesis needed for viral replication
  • Broad-spectrum antiviral activity
  • Anti-inflammatory properties
  • Cardioprotective
  • Immune system modulator – increases the immune response
  • Inhibits excessive blood clotting
  • Inhibits the SARS-CoV-2 papain-like protease (PLpro) required for viral replication
  • Inhibits the SARS-CoV-2 3-chymotrypsin-like protease (3CLpro) required for viral replication
  • Blocks viral replication by inhibiting non-structural viral proteins
  • H2 receptor blocker – Binds to H2 receptors of neutrophil and eosinophil cells which inhibits cytokine production, reducing inflammation.

Published Medical Literature About Famotidine’s Role in COVID

Access all Research

February 20, 2022 | Peer Reviewed: Yes | Publication Type: Original , Clinical Prospective

Efficacy of oral famotidine in patients hospitalized with COVID-19

Efficacy of Oral Famotidine in Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2
February 11, 2022 | Peer Reviewed: Yes | Publication Type: Original , Clinical Retrospective

Impact of famotidine on chances of survival in hospitalized COVID-19 patients

Efficacy of Various Treatment Modalities on Patient-related Outcome in Hospitalized COVID-19 Patients – A Retrospective Study
February 10, 2022 | Peer Reviewed: Yes | Publication Type: Original , Clinical Prospective

A Phase II trial of high-dose famotidine in non-hospitalized COVID-19 patients

Oral famotidine versus placebo in non-hospitalised patients with COVID-19: a randomised, double-blind, data-intense, phase 2 clinical trial
October 25, 2021 | Peer Reviewed: Yes | Publication Type: Original , Clinical Retrospective

Pre-hospitalization use of famotidine in US army veterans results in decreased risk of death from COVID-19

Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans

Videos Discussing Famotidine’s Role in COVID

Pepcid/Famotidine And COVID-19: Helpful Or Hurtful? Large Study Including Almost 8,000 Patients!

Whiteboard Doctor | December 11, 2020

In this video we will be discussing Pepcid (generic name Famotidine), which is a histamine blocker often used for Acid Reflux and GERD. We have covered this topic before as it relates to COVID-19 with several studies suggesting Pepcid may actually decrease severity of disease. This study was published in the journal of Gastroenterology and looked back at several thousand patients that had been hospitalized in Florida with COVID-19.

SPARK Drug Repurposing Conference Tel Aviv University Oct 2020

MedInsight Research Institute | October 26, 2020

Generic Drug Repurposing for Covid-19. A conference hosted by Tel Aviv University, SPARK Tel Aviv, and the MedInsight Institute. Famotidine is one of the drugs discussed at this conference.

Famotidine/Pepcid And Cetirizine/Zyrtec For COVID-19: Study On Efficacy Of Dual Histamine Blockers

Whiteboard Doctor | August 1, 2020

WhiteBoard style discussion on a study in pre-print looking at dual histamine blockers (pepcid or famotidine and zyrtec or cetirizine) in the treatment of COVID-19. They compared patients with standard of care versus those who received these two antihistamine medications and looked at inpatient outcomes with positive results.

Daniel Freedberg, MD, “Famotidine and COVID-19”

Columbia University - New York | May 20, 2020

Dr. Freedberg presented a retrospective analysis on Columbia patients on the use of Famotidine, the active ingredient in Pepcid AC, for mitigating COVID-19. The famotidine patients took a range of doses via IV (28%) or orally (72%) and they found that famotidine patients were less likely to die or be intubated.

Coronavirus Pandemic Update 62: Treatment with Famotidine (Pepcid)?

MedCram - Medical Lectures Explained CLEARLY | April 29, 2020

Interesting preliminary data and 3-D analysis of the common heartburn medication famotidine (Pepcid) shows a possible coronavirus treatment benefit and is being utilized in a clinical trial. Dr. Seheult illustrates a process of how this medication and others may work for COVID-19 treatment and continues his discussion of oxidative stress.

Scientists in New York focused on popular heartburn drug for treatment of COVID-19 | WNT

ABC News | April 28, 2020

The treatment in question is called famotidine, and it’s the active ingredient in Pepcid, an over-the-counter medication commonly used to alleviate heartburn.

Heartburn drug trial shows ‘reasonable confidence’ famotidine could help treat coronavirus, hospital CEO says

CNBC | April 28, 2020

Northwell Health CEO Michael Dowling said that scientists working on a drug trial for famotidine have “a reasonable confidence” that the drug may make a difference in the treatment of Covid-19. Famotidine is a common heartburn medication found in Pepcid.

Urgent search for coronavirus treatment, testing of antacid drug

Good Morning America | April 28, 2020

Several existing medications are now being studied in the search for COVID-19 treatments, including the active ingredient in a popular over-the-counter heartburn drug. Specifically, Famotidine acts like a decoy throwing a wrench into the virus machinery limiting its spread.

Famotidine Studied As COVID-19 Treatment

Newsy | April 27, 2020

Researchers in New York City are exploring whether famotidine, the active ingredient in Pepcid, could be used to treat COVID-19.


Clinical Trials of Famotidine in COVID

April 8, 2021 | Hospital-Based |

Effect of H2 Receptor Antagonist and Proton Pump Inhibitor on the Positivity Rates and Clinical Outcomes of COVID-19

Dose and frequency not stated

January 26, 2021 | Community/Outpatient Based |

A Randomized, Double-Blind, Comparative Trial of the Safety and Efficacy of Famotidine vs Placebo for the Treatment of Non-Hospitalized Symptomatic Adults With COVID-19

80mg x 3 daily for a maximum of 14 days, or until hospital admission

November 9, 2020 | Community/Outpatient Based |

A Phase 2 Screening Study of Candidate Non-prescription Treatments for COVID-19: A Patient-driven, Randomized, Factorial Study Evaluating Patient-reported Outcomes (PROFACT-01)

1 liter of filtered water with famotidine, lactoferrin and green tea extract (FLG), chlorine dioxide aquesous solution and FLG, zinc acetate and FLG, chlroine dioxide, zinc acetate and FLG (dose and frequentcy not stated)

September 25, 2020 | Community/Outpatient Based |

Proof-of-concept Randomized Placebo-controlled Trial of Famotidine for Outpatients With COVID-19

20 milligram tablet, 1 tablet every 12 hours and increase to 1 tablet every 8 hours if not improved by the second day of treatment

August 17, 2020 | Hospital-Based |

The effect of Famotidine on the improvement of patients with COVID-19

Oral famotidine 160 mg four times a day until the day of discharge, for a maximum of fourteen days

August 7, 2020 | Hospital-Based |

Role of Famotidine in the Clinical Recovery and Symptomatic Improvement of COVID-19 Patients.

40mg to 60mg 8-hourly on an empty stomach along with other treatments

July 27, 2020 | Hospital-Based |

I-SPY COVID TRIAL: An Adaptive Platform Trial to Reduce Mortality and Ventilator Requirements for Critically Ill Patients

The course of treatment is a total of 21 days. High dose 80 mg PO/PNGT four times daily (QID) for 7 days. Upon completion of the high dose, subjects should receive a lower 40 mg PO twice daily (BID) for a course of 14 days. For those with a serum Cr corresponding to an eGFR 30-59 mL/min/1.73m2, reduce the dose to 40 mg PO QID for 7 days, followed by 20 mg PO twice BID for 14 days. Stop at hospital discharge if a subject is discharged before day 21.

May 15, 2020 | Community/Outpatient Based |

Famotidine Use in Non-hospitalized Patients With COVID-19: A Case Series

Any dose of oral Famotidine during period of COVID-19

April 30, 2020 | Hospital-Based |

A Multi-site, Randomized, Double-Blind, Comparative Trial of the Safety and Efficacy of Standard of Care (SOC) Plus Famotidine vs SOC Plus Placebo for the Treatment of COVID-19 in Hospitalized Adults

Famotidine Injection, 10mg/mL mixed with Normal Saline given intravenously at 120mg (30% of 400 mg oral dose). The total daily dose proposed is 360mg/day famotidine IV for a maximum of 14 days, or hospital discharge, whichever comes first