In an observational study, the use of Famotidine (Pepcid) was associated with a lower incidence of mortality, a lower chance of intubation, and lower inflammatory markers. The reason for this association is unclear. Famotidine inhibits histamine release which is found in most tissue. The release of histamine causes a cascade of other inflammatory cytokines and proteases to be release.
Viruses, including COVID, act on cells in the lung to cause histamine release. It is postulated that blocking histamine release, reduces the inflammatory response to this viral infection. It appears that PPIs (Proton pump inhibitors) have the opposite effect. By taking PPIs, you can increase the risk of COVID positivity. However, the increased risk is dose dependant.
You should take the medication once a day as two daily doses could increase the chance of COVID positivity. The PPIs decrease stomach acid secretion. Stomach acid plants an important role in destroying ingested bacteria and viruses. Without gastric acid, patients are at an increased risk for enteric infections including COVID 19. The GI tract is a major conduit for COVID infections invading the small bowel cells which can result in the inflammation of the stomach, small bowel, and colon.
PPIs are immensely popular drugs. It seems that everyone takes these medications. However, the medications usually don’t require chronic use. Most GI conditions require three months of treatment then taper off. Due to the rebound hyperacidity, the longer the drug is taken, the more difficult it is to stop. Consultation with a GI specialist will assist in determining the appropriate use of these medications.