Table 2. Dose recommendations and possible adjust of the drugs used to treat covid-19.
Drugs | Recommended doses12 , 13 , 14 , 15 , 16 , 17 , 40 | Dose adjustment (GFR mL/min)15 , 16 , 18 | Dialysis15 , 16 , 18 | |||||
---|---|---|---|---|---|---|---|---|
50-31 | 30-10 | < 10 | APD/CAPD | HD | HDF/AF | CAV/VVHD | ||
Chloroquine | Day 1: 450 mg bid PO Days 2 to 5: 450 mg once per day PO |
Usual dose | Usual dose | 50% of the dose | ND | ND | NR | ND |
Hydroxychloroquine | Day 1: 400 mg bid PO Days 2 to 5: 400 mg once per day PO |
Usual dose | 50% of the dose | 50% of the dose | ND | ND | NR | NR |
Azithromycin | 500 mg once per day PO for 5 days | No adjustment | ND | NR | NR | NR | ||
Nitazoxanide | 600 mg bid PO for 5 days | No adjustment | NR | NR | NR | NR | ||
Ivermectin | 200 mcg/kg single dose, can be repeated on day 7 | No adjustment | NR | NR | NR | NR | ||
Dexamethasone | 6 mg once per day PO or IV for 10 days | No adjustment | ND | ND | NR | I | ||
Methylprednisolone | 1-2 mg/kg once per day IV for 5-7 days | No adjustment | D (dose usual) |
D (dose usual) |
D (dose usual) |
D (dose usual) |
||
Tocilizumab | 8 mg/kg (maximum of 800 mg) IV single dose, can be repeated 1-2 times if there is no clinical improvement within 24 hours | No adjustment | NR | NR | NR | NR | ||
Unfractionated heparin | 10.000-15.000 U once per day | No adjustment | ND | ND | ND | ND | ||
Enoxaparin | P: 40 mg once per day* SQ T: 0,5-1 mg/kg bid SQ |
Usual dose | P: 20-30 mg/day T: 0,5-1mg/kg/day |
P: 20-30 mg/day T: 0,5-1mg/kg/day |
ND | ND | D (dose GFR < 30) |
ND |
Lopinavir/ Ritonavir |
400 mg/100 mg once per day PO for 10-14 days | No adjustment | L: I R: ND |
L: I R: ND |
L: I R: ND |
L: NR R: I |
||
Oseltamivir | 75 mg bid PO for 5 days | 30 mg bid | 30 mg/day | 30 mg single dose | D (30 mg) |
D (30 mg) |
D** | D (30 mg) |
Remdesivir | Day 1: 200 mg once per day IV Days 2 to 5 or 10: 100 mg once per day IV |
Usual dose | Not recommended | Not recommended | NR | NR | NR | NR |
Legends: APD/CAPD (automated peritoneal dialysis/continuous ambulatory peritoneal dialysis); bid (twice a day); CAV/VVHD (continuous arteriovenous hemofiltration/veno-venous hemofiltration); D (dialyzed); GFR (glomerular filtration rate); HD (intermittent hemodialysis); HDF/AF (intermittent hemodialysis/high flow); PO (oral administration); I (improbable); IV (intravenous administration); L (lopinavir); ND (not dialyzed); NR (not reported); P (prophylaxis); R (ritonavir); SQ (subcutaneous administration); T (treatment).
Body Mass Index (BMI) ≥ 40 kg/m2: increase the dose in about 30%; or 0.5 mg/kg/day using current weight for the calculation.
Flow Rate 1-1.8 L/hr: 30 mg/day, flow rate 1.9-3.6 L/hr: 30 mg bid, flow rate > 3.6 L/hr: 75 mg bid.