Antiviral agents under investigation for COVID-19
| Drug | Mechanism of action | FDA-approved indication(s) | Dosage | Adverse reactions/contraindications | Comments |
|---|---|---|---|---|---|
| Remdesivir inhibitor | Adenosine analog RNA polymerase | Not currently approved | 200 mg IV on day 1, then 100 mg IV daily × 9 additional days | Safety not fully established | Currently undergoing several phase III clinical trials in the US for COVID-19 |
| Lopinavir/ritonavir (Kaletra) | Protease inhibitor | HIV | HIV: varies based on concomitant medications, typically lopinavir/ritonavir 400 mg/100 mg twice daily | Adverse reactions: QTc prolongation, weight gain, fat redistribution, hepatotoxicity, increased cholesterol, hyperglycemia, pancreatitis, skin rash, gastrointestinal effects Caution/avoid use: Lopinavir and ritonavir are strong CYP3A4 inhibitors and thus may have many drug interactions | Clinical trials ongoing in the US and internationally |
| Oseltamivir (Tamiflu) | Neuraminidase inhibitor | Influenza A/B for treatment or prophylaxis | Influenza: 75 mg twice daily Influenza prophylaxis: 75 mg once daily Adjust doses for renal function | Adverse reactions: Vomiting, nausea, headache | Two randomized clinical trials currently ongoing in China |
| Favipiravir (Avigan) | Purine nucleotide RNA polymerase inhibitor | Not currently approved | Varies based on clinical trial | Safety not fully established | Currently undergoing clinical trial evaluation for COVID-19 in China and US |
| Umifenovir (Arbidol) | Viral envelope membrane fusion inhibitor via S-protein/ACE2 interaction | Not currently approved | Varies based on clinical trial | Safety not fully established | Pending further clinical trial evaluation for COVID-19 |
ACE2 = angiotensin-converting enzyme 2 gene; FDA = US Food & Drug Administration; HIV = human immunodeficiency virus; IV = intravenous; QTc = corrected QT interval; RNA = ribonucleic acid; US = United States