An Antacid for Heart Failure?

Here’s another example of a new use for an old drug – or at least the possibility of it. Researchers report in the Journal of the American College of Cardiology that the antacid Pepcid® (famotidine) can improve heart function in people with congestive heart failure. Cardiac test results of over 150 patients who were taking Pepcid (20 to 40 mg) were compared with those from 150 other patients not taking the drug. The patients in the control group were taking teprenone, an anti-ulcer drug that does not block histamine, but protects the stomach-lining cell layer. Those using Pepcid had significantly lower systolic and diastolic blood pressure, lower heart rate, and lower B-natriuretic peptide level (B-natriuretic peptide is produced by the left ventricle in response to overload, and can be used to help diagnose congestive heart failure).

With these results in hand, the researchers did a prospective study – that is to say, they gave 25 patients with congestive cardiac failure Pepcid (30 mg) for 6 months, while 25 were given teprenone. Eight of the 25 on Pepcid improved a whole class of severity of heart failure, blood B-natriuretic peptide decreased significantly, and the frequency of hospital admission for worsening failure was lower in the Pepcid group than in the controls (4% vs. 24%).

It looks as if, after many years, blockade of histamine H2 receptors has found a new use. We shall follow the development of this approach with interest.