Table 3.
Drugs that impact chronic fatigue syndrome
| Drug | The effect on chronic fatigue |
|---|---|
| Anakinra | Anakinra does not lessen chronic fatigue syndrome (CFS) [132]. |
| AA | Vitamin C reported to reduce fatigue in office workers [133]. |
| AZM | Patients with CFS who responded to AZM reported a decrease in the symptoms and lower levels of plasma acetylcarnitine [134]. |
| Baricitinib | In a randomized, double-blind, phase 3 clinical trial, baricitinib resulted in reductions of pain and fatigue, and improved daily activity and work productivity compared to placebo with RA patients [135]. |
| Colchicine | Colchicine associated with drug-induced fatigue [136]. |
| Corticosteroid | Corticosteroid did not improve the severity of associated CFS symptoms in CFS patients who do not have allergic rhinitis [137]. |
| DEX | DEX was effective in treating cancer-related fatigue (CRF). DEX acts rapidly in relieving CRF in patients with advanced cancer [138]. |
| Emtricitabine | Case study found fatigue was attributed to HIV patients switching back from emtricitabine to lamivudine [139]. |
| EPO | Fatigue can be a symptom of pulmonary hypertension. EPO has been both associated with fatigue [140] at high doses as a side effect, as well as improving fatigue [141]. |
| Famotidine | Case study of COVID19 patients treated with famotidine showed quicker improvements in clinical symptoms other than fatigue, with one instance of increasing fatigue [142]. |
| Favipiravir | A study comparing favipiravir and arbidol found more COVID19 patients on favipiravir suffered from fatigue albeit not statistically significant (P value 0.0579) [143]. |
| HCQ | HCQ treatment for Sjogren’s syndrome (pSS) found that when treating fatigue related to pSS, HCQ was no different than placebo [144]. |
| IC14 | Patients with myalgic encephalomyelitis/CFS have elevated soluble CD14 in their blood. As an anti-CD14 monoclonal antibody, it could be explored for its potential on chronic fatigue [145]. |
| IFN | CD4 T cells from CFS patients produced less interferon-γ than did cells from controls [146]. |
| IFN-α | Can induce persistent fatigue in some patients. There is an increase in the levels of IL-6 and IL-10 concurrent with IFN-α treatment [147]. IFN-α treatment of CFS patients improved for a subset of patients with diminished natural killer (NK) function. IFN-α increased NK function [148]. |
| Ivermectin | A case report of fatigue developed with ivermectin treatment [149]. Ivermectin along with other anti-virals are associated with fatigue [150]. |
| Leronlimab | Fatigue has been reported with monoclonal CCR5 antibody albeit not specifically with leronlimab [151]. |
| LPV/RTV | LPV/RTV is associated with improvements in fatigue [152]. |
| NTZ | NTZ used in treating diarrhea and enteritis associated with blastocystis hominis reported fatigue as an adverse event [153]. |
| NO | NO metabolites (nitrates) levels are elevated in CFS patients [154]. In contrast, a study found NO levels are similar in CFS and control patients and unrelated to CFS [155]. |
| RUX | Treating myelofibrosis patients with RUX has been associated with instances of fatigue or increasing fatigue [156, 157]. |
| Sarilumab | Reported to improve fatigue in RA patients [158]. |
| Sirolimus (rapamycin) | Sirolimus treatment of complex vascular malformations [159] as well as sirolimus-associated pneumonitis in renal transplant patients is associated with fatigue. Discontinuation of sirolimus resulted in recovery within 6 months [160]. |
| Sofosbuvir | Adverse effects of sofosbuvir in treating chronic hepatitis C patients include fatigue [161]. |
| Statins | Statin is associated with exertional fatigue [162]. Coenzyme Q10 (CoQ10) was significantly lower in patients with myalgic encephalomyelitis (ME)/CFS and was associated with fatigue. Statins decrease CoQ10 levels, so statins could be counterproductive [163]. |
| Tenofovir | Fatigue is one of the more commonly reported adverse events in treating chronic hepatitis B patients with tenofovir disoproxil fumarate [164] or tenofovir alafenamide [165]. |
| THD | One of the common side effects of THD use is fatigue [166, 167]. |
| TCZ | TCZ was effective in reducing the disease activity and improving fatigue in patients with RA. The hypothalamic-pituitary-adrenal (HPA) axis activated by IL-6 and IL-6 blocking agents has been shown to relieve fatigue in RA patients [168]. TCZ as an anti-IL-6 receptor may explain how it could mitigate fatigue. |
| Umifenovir (Arbidol) | Fewer COVID19 patients on arbidol reported fatigue as compared to favipiravir but it was not statistically significant (P value 0.0579) [143]. |