Famotidine: Shortages Persist, IDSA Guidelines Address COVID-19 Reports

Following recent ranitidine recalls and anecdotal reports suggesting use in treating the coronavirus disease 2019 (COVID-19), famotidine supply continues to run short at some major retailers.

“We are experiencing increased consumer-driven demand for Pepcid and supply is temporarily out of stock in some stores and online. We are taking all possible measures to maximize product availability in a timely and quality-based manner,” McNeil Consumer Pharmaceuticals Co. said in a document on its web site.¹

Soon after Science Magazine reported on a clinical trial in which patients with severe COVID-19 were receiving intravenous famotidine, the FDA added famotidine to its list of drug shortages.^2,3 A pre-proof version of the study suggesting famotidine’s use in patients with COVID-19 was published in May.⁴

However, at this time, there are not enough data to support its use in this treatment setting. In late June, the Infectious Diseases Society of America (IDSA) recommended against the use of famotidine for the sole purpose of treating COVID-19 outside of a clinical trial.⁵

While there are anecdotal reports from China that individuals who were already taking famotidine had improved survival over those who were already taking proton pump inhibitors, there are not enough data to make a recommendation, IDSA said in its updated COVID-19 management guidelines, Infectious Disease Special Edition reported.^4,5

Community pharmacists told Drug Topics® in May that the COVID-19 clinical trial is likely not the root cause of famotidine shortages. Instead, the ranitidine recalls that began late last year first triggered the famotidine shortage.

“I had to order it at Amazon a couple of months ago because we can’t get it in our store,” said Kyona Nason, PharmD, a pharmacist for a national drugstore chain. "It’s been a problem for months since the various ranitidine recalls.”

Some Walmart pharmacies are experiencing a shortage of famotidine. “We are seeing a shortage of famotidine 20 mg and 40 mg tablets from all manufacturers through McKesson, but the OTC famotidine 20 mg is still being shipped to the store from the Walmart warehouse,” Brittany Dwyer, PharmD, a staff pharmacist for Walmart, told Drug Topics®.

Although patients are aware they can get OTC famotidine, some prefer to get it through the Walmart pharmacy as a prescription. “We have a list going of people waiting for us to be able to order it through McKesson,” Dwyer said.

However, no patients have asked about the famotidine in relation to COVID-19, according to Dwyer.

“We have had issues since before ranitidine, but they are way worse now,” said Alexsis Williams, PharmD, pharmacist in charge at a national drugstore chain. “I was checking out the expected dates manufacturers think they will have it back in stock….some said June, some said December.”

References

1. Pepcid COVID-19 Update and Usage Guidelines. McNeil Consumer Products. Accessed July 16, 2020. https://www.pepcid.com/covid-19-update#i-can-t-find-pepcid-online-or-in-store

2. Borrell B. New York clinical trial quietly tests heartburn remedy against coronavirus. Science. April 26, 2020. doi:10.1126/science.abc4739

3. FDA Drug Shortages. FDA; May 5, 2020. Accessed May 7, 2020. https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Famotidine%20Injection&st=c

4. Freedberg DE, Conigliaro J, Wang TC, et al. Famotidine use is associated with improved clinical outcomes in hospitalized COVID-19 patients: A propensity score matched retrospective cohort study. Journal Pre-proof. Gastroenterology. May 14, 2020. https://www.gastrojournal.org/article/S0016-5085(20)34706-5/pdf

5. IDSA Updates COVID-19 Treatment Guidelines. Infectious Disease Special Edition; June 26, 2020. Accessed July 16, 2020. https://www.idse.net/Covid-19/Article/06-20/IDSA-Updates-COVID-19-Treatment-Guidelines/58829