Repurposed Drugs: The Future of Medicine
I am going to go out on a limb and say that part of the future of medicine will be driven by the past. Repurposed drugs will fuel that drive. What do I mean by that? More and more we will use older drugs to treat current and new conditions. Not every medical problem requires a new drug. We can use repurposed drugs. Repurposed drugs are drugs that were initially approved by the FDA for a specific condition but are beneficial in the treatment of other medical conditions for which a drug was not initially approved.
Right now there are 19,000 FDA-approved prescription drugs available on the market that have potential clinical utility in treating other conditions. We saw this with the use of ivermectin and hydroxychloroquine which are anti-parasitic drugs, being used to treat and prevent COVID-19. The future of medicine will be filled with repurposed drugs to treat cancer, COVID-19, heart disease, neurodegenerative diseases, and osteoarthritis.
Past Repurposed Products
Medicine is not the only area where products have been repurposed. Playdough was originally developed to remove soot from walls of homes that were heated by burning coal. Lysol was originally developed as a feminine hygiene product, bubble packaging was developed as textured wallpaper. Nowadays we see buildings being repurposed. I have a patient who bought a 16,000-square-foot church (very inexpensively) which he plans to convert into a house and/or event center.
The Benefits of Repurposed Drugs
There are several benefits to using repurposed drugs.
One, they already exist. Two, they have already been shown to be safe, at least for the original conditions they were approved. Three, they are inexpensive. Fourth, manufacturing and supply chains already exist.
Human function and physiology are nothing more than a series of biochemical and metabolic pathways. See below. This is your body in a nutshell. If you know what pathway you need to target to treat a condition, you can work backward and see if a drug already approved by the FDA Â targets that desired pathway.
New Patented Drugs vs. Repurposed Drugs
It can take 12 to 18 years to bring a new drug to market at a cost of anywhere from $1 billion to $2 billion. To repurpose an existing drug can take as little as 1 to 3 years. Repurposed drugs can be invaluable in the management of rare diseases. If a disease is rare, there is little incentive for drug companies to incur the cost of developing a new drug for a very small market, and if they do, the price tag for the novel medication is likely to be very expensive.
Repurposing: Not Limited to Drugs
Repurposing is not limited to prescription medication. Over-the-counter medication and nutritional supplements many times can be repurposed as part of a treatment regimen.
The Potential of Repurposed Drugs
To illustrate the potential for repurposing drugs and supplements review below this list of drugs and supplements that can be repurposed as part of cancer therapies for which there is strong evidence. This list comes from Paul Marik, MD’s monograph, Cancer Care.
These drugs and supplements are not to be used as a substitute for traditional cancer therapies, but to be used in addition to conventional treatment to achieve better outcomes, minimize side effects, and improve overall health.
1. Vitamin D3: 20,000 to 50,000 IU daily – NOTE: dosage should be adjusted according to blood vitamin D levels, aiming for a 25-OH level of at least 55-90 ng/dl
2. Propranolol 40 – 180 mg daily
3. Melatonin: Start at 1-5 mg and increase to 20-40 mg at night
4. Metformin: 1,000 mg twice daily
5. Curcumin (nano curcumin): 600 mg daily or as per the manufacturer’s suggested dosing
6. Ivermectin 12-18 mg daily (0.5 to 1mg/kg/day)
7. Mebendazole: 100-200 mg daily
8. Green tea catechins: 500-1,000 mg daily
9. Omega 3 fatty acids: 2-4 g daily 1
0. Berberine: 1,000-1,500 mg daily or 500-600 mg two to three times daily. (Depending on blood glucose levels, metformin and berberine can be used together or alternating months)
11. Atorvastatin: 40 mg twice daily. (Simvastatin 20 mg twice daily is an alternative.)
12. Sildenafil: 20 mg daily. (Tadalafil 5 mg daily is an alternative)
13. Disulfiram: 80 mg three times daily or 500 mg once daily
14. Ashwagandha 600- 1200 mg daily
15. Itraconazole 100 -600 mg daily
16. Mistletoe: (given subcutaneously by an integrative oncologist)
17. Cimetidine: 200-400 mg twice daily (predominantly for perioperative prophylaxis)
Teaching an Old Dog New Tricks
We don’t always need to develop new drugs. We can teach “an old drug to do new tricks”. In the upcoming weeks, we will discuss some of the drugs that are being repurposed in the area of musculoskeletal medicine.
