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. 2020 Sep 25;9(3):27–37. doi: 10.5501/wjv.v9.i3.27

Table 1.

Summary of the most investigated drugs for the treatment of coronavirus disease 2019

Therapeutic agent Mechanism of action Ongoing trials, n Associations Suggested dosage Route of administration Principal side effects Ref. NCT identifier
Hydroxychloroquine Changes the pH of endosomes, prevents viral entry, transport and post-entry replication 224 Azithromycin, tocilizumab, lopinavir-ritonavir 200 mg BID or TID (10 d) Oral-intravenous Retinal toxicity, QT prolongation, nausea [6-10] NCT04315948
Chloroquine Increases the endosomal pH interfering with the process of virus/cell fusion 225 Remdesivir, tocilizumab 2.5 g (3 d) Oral-intravenous Retinal toxicity, QT prolongation, nausea [11] NCT04303507
Convalescent plasma Adaptive immunotherapy (neutralizing antibody tiers above 1:640) 129 Remdesivir, Interferon-alpha, oseltamivir, antibacterial and antifungal frugal drugs, methylprednisolone 200 ml single dose Intravenous Evanescent facial red spot [37-41] NCT04321421
Lopinavir/Ritonavir Inhibition of the HIV protease/inhibition of CitP450-iso3A4 and augmented plasmatic concentration of lopinavir 67 Hydroxychloroquine, azithromycin, dexamethasone 200 mg/50 mg BID Oral Gastrointestinal upset, augmented plasmatic concentration of colchicine [25-28] NCT02735707
And HGAM-CoA reductase inhibitors
Azithromycin Prophylaxis of bacterial super-infection 59 Hydroxychloroquine, tocilizumab, atovaquone 500 mg Oral-intravenous QT prolongation [19-24] NCT04332107
Tocilizumab Monoclonal antibody which targets the IL-6 receptor 50 lopinavir-ritonavir, remdesivir, chloroquine, hydroxychloroquine Dosing according to weight range Intravenous Runny or stuffy nose, sinus pain, sore throat, headache, gastrointestinal upset, urinary tract infection [30] NCT04320615
Ivermectin Suppression of SARS-CoV-2 viral replication in cell cultures (in vitro) 30 Hydroxychloroquine 600 mcg/kg Oral Tiredness, loss of energy, stomach pain, loss of appetite, nausea, vomiting, diarrhea, dizziness [48] NCT04381884
Dutasteride
Azithromycin
Proxalutamide
Statin Reduces chemokine release, adhesion molecules, and modulating T cell activity 23 Standard of care; colchicine + rosuvastatin 20 mg/d atorvastatin Rosuvastatin 40 mg/d or equivalent Oral rabdomiolisis [12] NCT04472611
Remdesivir Nucleotide analogue that is incorporated into the nascent viral RNA chain resulting in its premature termination 20 Hydroxychloroquine, chloroquine, tocilizumab, convalescent plasma 200 mg 1st day – 100 mg (10 d) Intravenous Phlebitis, constipation, headache, ecchymosis, nausea, pain in extremities [13-18] NCT04292899
Methylprednisolone Immunosuppression against cytokine storm 17 Siltuximab, tacrolimus 40 mg BID (5 d) - f 1-2 mg/kg/d (5-7 d) Oral-intravenous Headache, nausea, weight gain, excitement, infections [35] NCT04323592
Sarilumab Monoclonal antibody which targets the IL-6 receptor 17 Not available 400 mg or 200mg single dose Intravenous Neutropenia, increased ALT, injection site redness, upper respiratory infections, nasal congestion, sore throat, urinary tract infections, thrombocytopenia [29] NCT04315298
Colchicine Non-selective inhibitor of NLRP3 inflammasome, inhibitor of microtubule polymerization and leukocyte infiltration 17 Not available 0.5 mg per os (BID) for 3 d - then once daily for the last 27 d Oral-intravenous Gastrointestinal upset, low blood cells count and rhabdomyolysis [33-34] NCT04322682
Heparin Inhibition of Xa factor and thrombin 15 Methylprednisolone Dosed to target activated partial thromboplastin time (aPTT) between 1.5-2.0 times the normal value Subcutaneous injection Reduced creatinine clearance [45] NCT04485429
Anakinra Monoclonal antibody which targets the IL-1 receptor 11 Siltuximab or tocilizumab (single i.v. injection) 1 injection a day (max 28 d) Subcutaneous injection Gastrointestinal upset, headache, joint pain, flu symptoms, redness-bruising-pain in the injection site [30,31] NCT04330638
Dexamethasone Immunosuppression against cytokine storm 10 Not available 20 mg/d (5 d) then 10 mg/d (5 d) Intravenous Headache, weight gain, excitement, infections [36] NCT04325061
Enoxaparin Inhibition of Xa factor and thrombin 5 Not available 4000 UI/d or 100 UI/kg Subcutaneous injection Skin irritation in injection site, bleeding, heparin-induced thrombocytopenia, fatigue, fever [45] NCT04367831
Eculizumab Monoclonal antibody which targets C5 inhibiting its cleavage in C5a and C5b 3 Hydroxychloroquine, lopinavir-ritonavir, ceftriaxone, vitamin C 3600 mg/wk (8-22 wk) Intravenous Fever, headache, nausea and vomiting, body aches, confusion, increased sensitivity to light, stiffness [32] NCT04288713
Vitamin C Antioxidant, increases the synthesis of norepinephrine and vasopressin, attenuate increases in cytokine levels 3 All mentioned drugs 12 g/12 h (7 d) or 50 mg/kg/6 h (4 d) Oral-intravenous Gastrointestinal upset [42-44] NCT04264533

In this table are the most utilized and investigated drugs for the treatment of coronavirus disease 2019. It provides the name of the therapeutic agent, mechanism of action, number of ongoing trials, drug association if available, suggested dosage and maximum period of time the drug should be administered, route of administration, principal side effects, a reference on the drug, and an example of randomized clinical trial (RCT) identified by the national clinical trial number. Drugs investigated in less than three RCTs have been excluded. BID: Bis in die; IL-1: Interleukin 1; NCT: National clinical trial; RCT: Randomized clinical trial; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; TID: Tris in die.