Table 1.

Practical Considerations of Antiviral Therapies Proposed against Severe Acute Respiratory Syndrome Coronavirus 2

Drug	Remdesivir 21 , 22 , 35	Chloroquine 39	Hydroxychloroquine 33 , 40	LPV/r 44 , 55 , 93	Ribavirin 59	Nitazoxanide 68	Nelfinavir 82
Dosing	200 mg IV on day 1, then 100 mg IV/day for 5–10 days	500 mg by mouth twice/day for 10 days	400 mg by mouth twice/day for 1 day, then 200 mg twice/day for 4 days	400 mg/100 mg by mouth twice/day for 14 days	Not established In clinical trials, 400 mg by mouth twice/day for 14 days	500 mg by mouth twice/day Duration not defined	Not studied in humans for SARS‐CoV‐2
Formulation	IV contains β‐cyclodextrin	Oral tablet, oral solution contains propylene glycol	Oral tablet	Oral tablet, oral solution contains ethanol 42.4% a and propylene glycol	Oral tablet, oral solution contains propylene glycol, inhaled, IV not available in United States	Controlled‐release tablet, oral suspension Formulations are not bioequivalent	Oral tablet
Administration	IV over 30 min	Administer with food Can be crushed Consider diluting when used in a feeding tube	Administer with food Do not crush Film coating must be removed to before compounding	Administer with or without food Do not crush tablets Do not dilute solution (risk of precipitation), administer solution down a feeding tube with milk (no water) Solution incompatible with polyurethane feeding tubes	Administer with food Do not crush (hazardous) PPE must be worn during administration with all dosage forms	Administer with or without food Can be crushed and mixed with food Reconstituted powder stable for 7 days	Administer with food Can be crushed Avoid mixing with acidic foods
Dose adjustments	Renal: Clcr < 30 ml/min: Not studied RRT: Not studied Hepatic: Not studied	Renal: N/A RRT: HD = 50% dose reduction CRRT = full dose Hepatic: N/A, use with caution	Renal: N/A RRT: N/A, use with caution Hepatic: N/A, use with caution	Renal: N/A RRT: Avoid against once/day dosing Hepatic: Caution in severe liver impairment	Renal: Clcr 30–50 ml/min: 50% reduction Clcr < 30 ml/min 75% reduction RRT: Not established Hepatic: Child‐Pugh class B and C not recommended	Renal: N/A RRT: No data Hepatic: N/A	Renal: N/A RRT: N/A Hepatic: Child‐Pugh class B and C not recommended
Drug interactions	None identified; metabolized to active form via intracellular kinase	Avoid CYP2D6 inhibitors or inducers Avoid use with LPV/r Avoid antacids within 4 hrs of a dose Caution use with medications that increase QTc or cause hypoglycemia		Avoid CYP3A4, P‐gp, OATP1B1, OATP1B3, and UGT substrates	No Interactions	No interactions	Avoid CYP3A4 and CYP2C19 inducers or inhibitors
Side effects	Data limited, reports of increased LFTs, nausea, vomiting, gastroparesis, rectal bleeding	Nausea, vomiting, abdominal cramping, metallic taste, hemolysis (G6PD deficient), QTc prolongation, skin eruptions		Diarrhea, nausea, vomiting, increased serum amylase and LFTs	Hemolytic anemia, hypocalcemia, hypomagnesemia, nausea, dry cough, rashes, teratogenic	Abdominal pain, nausea, headache, urine discoloration, diarrhea, dizziness, urticaria	Diarrhea, nausea, flatulence, increase LFTs

Cl_cr = creatinine clearance; CRRT = continuous renal replacement therapy; CYP = cytochrome P450; G6PD = glucose‐6‐phosphate‐dehydrogenase deficiency; HD = hemodialysis; IV = intravenous; LFTs = liver function tests; LPV/r = lopinavir/ritonavir; N/A = no adjustment; OATP = organic anion transporting polypeptide; P‐gp = P‐glycoprotein; PPE = personal protective equipment; RRT = renal replacement therapy; SARS‐CoV‐2 = severe acute respiratory syndrome coronavirus 2; UGT = UDP‐glucuronosyltransferase.

^aDisulfiram‐like reactions may occur with disulfiram or other drugs that produce these reactions (e.g., metronidazole).

This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.