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Life Extension Magazine

LE Magazine March 2001

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Raising public awareness

Shortly before his death this year, Steve Allen appeared with his lovely wife Jayne Meadows on NBC's “The Today Show”. They wanted to bring to light this illness that many would prefer not to discuss in public. Both of their mothers had suffered with the painful virus and in 1999, Meadows had undergone a similar experience, causing her to cancel an appearance with her husband on another popular television talk show.

Following their appearance on “The Today Show” with Matt Lauer, 8,000 telephone calls were received at the Varicella Zoster Virus Research Foundation and nearly 3,000 visits were logged on the Foundation's website. Shingles had come out of the closet and the public wanted to know what to do about it.

With so much public interest in such a painfully debilitating, often embarrassing illness, you would think physicians would make every effort to inform the general public that an OTC drug is available to them. Yet cimetidine (Tagamet), a drug proven in study after study over the past 20 years to be effective in boosting the immune system, is still a common sense, low-cost medication that is virtually ignored by the medical community.

Standard treatment for herpes

Anti-viral drugs are commonly used to treat herpes simplex and herpes zoster. Due to varying intensities of pain and other symptoms associated with herpes zoster, analgesics and various other medications are prescribed. The most popular drug of choice has been Zovirax. Retail cost: Zovirax can cost $ 112 for a month's supply (150 capsules of 200 mg dosage, five times a day). A stronger dosage, 400 mg, five times a day would be $206 for a month's supply. And there is yet a stronger dose, which naturally costs even more. (Some patients may only be required to undergo a two-week course of medication while others take it chronically to prevent outbreaks). More modern versions of acyclovir, such as desciclovir, famciclovir, valaciclovir and penciclovir, cost even more.

Cimetidine may not work against warts

It is important to understand that cimetidine is not a panacea for every disease that might be helped by improving immune function.

One study used cimetidine for three months to evaluate its effects on 54 people with warts. Cure rates obtained were 32% in the cimetidine-treated group and 30.7% in the placebo-treated group. Thus, no significant difference was found between cimetidine and placebo in effectiveness in the treatment of patients with common warts.(9)

In a much smaller study, the effect of cimetidine was investigated in the management of genital and perigenital warts in children. Four had extensive condylomata acuminata of the genital and perigenital areas. They were treated with high doses (30 to 40 mg./kg of cimetidine) in an attempt to eradicate the condyloma (in two patients) and avoid recurrence in the other two. Cimetidine was administered daily in three divided doses during a three-month period. At the 24-month evaluation, all four patients were free of condyloma. The conclusion of the authors was that cimetidine is effective for primary and adjunctive treatment of condyloma in young children. It also seems to be effective as first-line therapy.(10)

Conclusion

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Studies indicate that viruses like herpes simplex and herpes zoster can be put into quick remission, or the breakouts prevented altogether, when T-lymphocyte suppressor cell function is inhibited. The best way of accomplishing this is to take 200 mg of cimetidine (Tagamet) three times a day and then 400 mg at bedtime. Tagamet is available in pharmacies over-the-counter.

Herpes simplex outbreaks have been shown to go into remission in response to the proper dose of cimetidine. In cases of herpes zoster (shingles), which targets the older population, cimetidine has been successfully used to lessen the debilitating pain and intensity of the skin rash and eruptions.

Published studies indicate that viruses like herpes simplex and herpes zoster can be put into quick remission, or the breakouts prevented altogether, when T-lymphocyte suppressor cell function is inhibited. The best way of accomplishing this is to take 200 mg of cimetidine (Tagamet) three times a day and then 400 mg a bedtime. Tagamet is available in pharmacies over-the-counter. Suggested use is to initiate Tagamet as soon as symptoms of a herpes-related virus infection appear. Continue to take it for one to two weeks after all symptoms of the outbreak have abated.

One precautionary note, even though Tagamet (cimetidine) is sold over-the-counter, refer to the package insert to make sure it does not interact with prescription drugs you may already be taking.

Please note that if your doctor prescribes generic cimetidine, it may cost less to obtain it as a prescription drug (especially if you have prescription drug insurance) rather than buying the Tagamet name brand that is available without a prescription.


References

1. Devine SM, Wingard JR 1994, Viral infections in severely immunocompromised cancer patients. Support Care Cancer 1994 Nov;2(6):355-68.

2. Van der Spuy S, Levy DW, Levin W 1980. Cimetidine in the treatment of herpes virus infections. S Afr Med J Jul 19;58(3):112-6.

3. Kapinska-Mrowiecka M, Toruwski G: 1996. Efficacy of cimetidine in treatment of herpes zoster in the first 5 days from the moment of disease manifestation. Pol Tyg Lek Jun;51(23-26):338-9.

4. Hayne ST, Mercer JB 1983. Herpes zoster:treatment with cemetidine. Can Med Assoc J Dec 15;129(12):1284-5.

5. Komlos L, Notmann J, Arieli J, et.al. 1994. In vitro cell-mediated immune reactions in herpes zoster patients treated with cimetidine. Asian Pac J Allelrgy Immunol Jun;12(1):51-8.

6. Miller A, Harel D, Laor A, Lahat N 1989. Cimetidine as an immunomodulator in the treatment of herpes zoster. J Neuroimmunol 1989 Mar;22(1):69-76.

7. Kumar A, 1990. Cimetidine: an immunomodulator. DICP Mar;24(3):289-95.

8. Kelly MD, King J, Cherian M, Dwerryhouse SJ, Finlay IG, Adams WJ, King DW, Lubowski D, Morris DL. 1999. Randomized Trial of Preoperative Cimetidine in Patients with Colorectal Carcinoma with Quantitative Assessment of Tumor-Associated Lymphocytes. Cancer Journal 85: 1658-63.

9. Yilmaz, E, Alpsoy E, Basaran E. 1996. Cimetidine therapy for warts: a placebo-controlled, double-blind study. J Am Acad Dermatol Jun; 34(6):1005-7.

10. Franco I 2000. Oral cemetidine for the management of genital and perigenital warts in children. J Urol Sep;164(3 Pt 2):1074-5.


General References

Bense L., Marcusson JA, Ramsten T 1987. Effect of cimetidine on herpes zoster infection. Drug Intell Clin Pharm Oct;21(10);803-5.

Brockmeyer NH et.al. Immunomodulatory properties of Cimetidine in ARC patients. Clinical Immunology and Immunopathology, no.48, pp.50-60, 1988.

Cooper, David, M.D., Journal of the American Medical Association, Dec 9, 1998. (Contributing Editor: Comments on shingles.)

Fleming DT, McQuillan GM, Johnson RE, Nahmias AJ, Aral SO, Lee FK, St. Louis ME. Herpes Simplex Virus Type 2 in the United States, 1976 to 1994.

New England Journal of Medicine. 1997; 337:16:1105-1111.

New England Journal of Medicine, Nov 23, 2000: 343, No. 21: Editorial: C. Peter N. Watson, M.D., University of Toronto.

News Release: “NIAID: NIAID Spearheads Collaborative Network for Clinical Research on Immune Tolerance,” Oct 6, 1999.

Pharmaceutical Cost Quotes: SAV-ON Pharmacy in Orange County, CA.

Smith D 1989. Cimetidine (Tagamet) as Immunomodulator, Antitumor Treatment. AIDS Treatment News 80:June 2.

UCLA MedNet.: UCLA School of Medicine Library.

VZV Research Foundation: Newsletter: Vol.V, No. 1, Spring/Summer 2000.


Websites:

www.cdc.gov/nchstp/dstd/Genital_Herpes_facts.htm - Centers for Disease Control

www.intelihealth.com/IH

www.ljimm.org/immunobio.htm - La Jolla Institute for Molecular Medicine: Department of Immunobiology

www.niaid.nih.gov - The National Institute of Allergy and Infectious Diseases

www.niaid.nih.gov/shingles/cq.htm - The Shingles Prevention Study NIH Bethesda Team: Common Questions about Shingles

www.onhealth.webmd.com/conditions/resource/pharmacy

www.vzvfoundation.org - News for Scientists and Medical Professionals


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