Table 1.
Recommendations, action mechanisms and adverse effects of potential drugs indicated the positive role in the treatment of COVID-19 patients.
| Drugs | Recommended use (Days/Dose) | EC50 value (μM) for SARS-CoV-2 | Action mechanism of drugs | Recommendation for COVID-19 treatment | Used before in other viral infections | Adversative effects | References |
|---|---|---|---|---|---|---|---|
| Chloroquine (CQ) | 500 mg twice per day | 1.13–5.47 | Inhibit viral replication process by increasing endosomal pH | Alternative of Hydroxychloroquine shortage | In the treatment of malaria and prophylaxis, | Electrolyte | [78,84] |
| For 10 days | Inhibits infection of cells by SARS-CoV-2 in vitro | imbalance | |||||
| - Fatal | |||||||
| dysrhythmias | |||||||
| Hydroxychloroquine (HCQ) | 400 mg orally per day for 7−10 days | 0.72 | Inhibit viral replication process by increasing endosomal pH | Recommended in with | In the treatment of malaria and prophylaxis, | Electrolyte | [11,78,84] |
| Azithromycin (500 mg for 1 day 1followed by 250 mg for next 2−5 days) for the treatment of moderate to severe disease | Inhibits infection of cells by SARS-CoV-2 in vitro, | imbalance | |||||
| Approved for | - Fatal | ||||||
| treatment of T2DM in India | dysrhythmias | ||||||
| Remdesivir (Nucleotide analog) | 200 mg IV within 30 min followed by 100 mg OD for 2–10 days | 0.77 | Terminate premature chain of RNA by combining with viral RNA chain | Recommended for sever patients and respiratory failure | Effective role against SARS and MERS viral infections | Gastrointestinal (GI) discomfort, elevated | [78,84] |
| transaminases, infusion site | |||||||
| reactions | |||||||
| Favipiravir (Nucleoside analog) | 1600−600 mg | 61.88 | inhibits viral RNA | Shown promising comparative results in inhibition of RNA viruses, but | influenza, arenavirus, bunyavirus and | Abnormal | [61,84,116] |
| For 1−6 days | polymerase | not recommended at this | filovirus infections | Transaminases, GI distress, serum uric acid increased, | |||
| time | Psychological symptoms | ||||||
| Ribavirin (Guanosine analog) | – | 109.5 | Also inhibits viral RNA replication | Has broad-spectrum antiviral activity In vitro activity against SARS-CoV-1, but not recommended at this time | No evidence in SARS and MERS diseases | Hemolytic anemia | [78,84] |
| Lopinavir/ritonavir (Protease inhibitors) | 400−100 mg | – | Inhibit the creation of new active viral peptides | Effective against SARS-CoV-1 both in vitro and human studies, not recommended at this | Approved for | GI pain, QT prolongation, drug–drug | [78,84] |
| Per day | time | HIV-1 treatment | interactions | ||||
| (ritonavir) | |||||||
| Corticosteroids | – | – | Inhibit the production of inflammatory mediators through binding with cytoplasmic | Low doses may be | – | Avascular necrosis, psychosis, hyperglycemia, adrenal suppression | [84] |
| receptors resulting to change the | beneficial by reducing harmful inflammatory responses in patients with severe COVID-19, while high dose steroid treatment may have | ||||||
| transcription of mRNA | deteriorated consequences in SARS, | ||||||
| Not recommended for routine use | |||||||
| Ibuprofen | – | – | Inhibiting production of | May be useful for its anti-inflammatory and antipyretic effects, no evidence in the contradiction of its use | – | GI ulcers/bleeding, may up regulate | [84] |
| prostaglandins by blocking COX-1 and COX-2 synthesis | ACE2 | ||||||
| Indomethacin | – | – | Inhibiting production of | May be useful for its anti-inflammatory | – | GI ulcers/bleeding, may up regulate | [84] |
| prostaglandins by blocking COX-1 and COX-2 synthesis | and antipyretic | ACE2 | |||||
| effects, no evidence of its antiviral | |||||||
| effects against SARS-CoV-2 | |||||||
| Tocilizumab Sarilumab | – | – | Monoclonal antibody | Recommended in patients with evidence of CRS and deteriorating respiratory function, Tocilizumab reduced fever and oxygen requirement in COVID-19 | Approved for rheumatoid arthritis | Abnormal | [78,84] |
| against the IL-6 receptor | No data on SARS or MERS | Transaminases, GI perforation, neutropenia, infusion reactions | |||||
| Convalescent plasma | – | – | Passive | May be considered in patients with deteriorating conditions | Recently used in SARS, historically has been used in | Hypersensitivity | [84] |
| immunization | refractory to other treatment, recommendations are | 1918 flu | Reactions, serum sickness | ||||
| using plasma from | debatable, while there is some evidence of benefit in COVID-19 | ||||||
| recovered patients |
(EC50- Half maximal effective concentration).