Table 3.

More common treatments for influenza and COVID-19.

	Treatments	Adverse effects and Challenges	Ref
Influenza	Amantadines/Rimantadines	•CNS and gastrointestinal side effects •The incidence of CNS side effects, including nervousness, anxiety, difficulty concentrating, and lightheadedness is higher among persons taking amantadine compared to those taking rimantadine •Serious side effects (e.g., marked behavioral changes, delirium, hallucinations, agitation, and seizures)	[176]
	Oseltamivir	•Nausea, vomiting, sporadic, transient neuropsychiatric events (self-injury or delirium)	[176]
	Zanamivir	•Allergic reactions: oropharyngeal or facial edema •Diarrhea, nausea, sinusitis, nasal signs and symptoms, bronchitis, cough, headache, dizziness, and ear, nose and throat infections	[176]
	Laninamivir	•Psychiatric disorders (abnormal behavior, etc.), gastrointestinal disorders (diarrhea, nausea, etc.) and nervous system disorders (dizziness, etc.) •No serious ADRs occurred	[[175], [176]]
COVID-19	Tocilizumab	•Injection site reaction •New bacterial, viral or fungal infections (Severe liver failure due to herpes simplex virus 1 reactivation, leading to death) •Elevation of liver enzyme levels (dose-dependent) •Neutropenia or thrombocytopenia (uncommon) •Not approved for the treatment of patients with COVID-19 •High cost	[[83], [177],,178]
	Siltuximab	•Serious risk of infections •Rash, severe bacterial infections in long-term dosing (once every three weeks) •High cost •Not approved for the treatment of patients with COVID-19	[83,178]
	HCQ	•Prolongation of QTc interval, Torsades de Pointes, AV block, ventricular arrhythmia •Gastrointestinal effects (e.g., nausea, vomiting, diarrhea) •Hepatitis •Hypoglycemia •Myopathy •Anxiety, agitation, hallucinations, psychosis •Allergic reaction/rash •Given the risk of heart rhythm problems, the FDA cautions against using HCQ to treat COVID-19 outside of a hospital or a clinical trial	[83]
	Remdesivir	•Only for use in hospitalized patients with COVID-19 who require supplemental oxygen but who do not require oxygen delivery through a high-flow device, noninvasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) •Gastrointestinal symptoms (e.g., nausea, vomiting) •Elevated transaminase levels •Increase in prothrombin time (without a change in the international normalized ratio) •Renal toxicity (SBECD accumulation) •Supplies are limited	[83]
	Azithromycin	•Gastrointestinal effects (e.g., diarrhea, nausea, vomiting) • Hepatotoxicity •Prolongation of QTc interval when prescribed with HCQ	[83]
	Lopinavir/Ritonavir	•Gastrointestinal effects (e.g., nausea, vomiting, diarrhea) •Transaminase elevation •QTc interval prolongation and Torsades de Pointes •PR interval prolongation •Unknown optimal drug concentrations that can inhibit the SARS-CoV-2 proteases •Did not show efficacy in a moderately sized randomized controlled trial in COVID-19 patients	[83]