Antiviral agents under investigation for COVID-19

DrugMechanism of actionFDA-approved indication(s)DosageAdverse reactions/contraindicationsComments
Remdesivir inhibitorAdenosine analog RNA polymeraseNot currently approved200 mg IV on day 1, then 100 mg IV daily × 9 additional daysSafety not fully establishedCurrently undergoing several phase III clinical trials in the US for COVID-19
Lopinavir/ritonavir (Kaletra)Protease inhibitorHIVHIV: varies based on concomitant medications, typically lopinavir/ritonavir 400 mg/100 mg twice dailyAdverse 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 inhibitorInfluenza A/B for treatment or prophylaxisInfluenza: 75 mg twice daily Influenza prophylaxis: 75 mg once daily Adjust doses for renal functionAdverse reactions:
Vomiting, nausea, headache
Two randomized clinical trials currently ongoing in China
Favipiravir (Avigan)Purine nucleotide RNA polymerase inhibitorNot currently approvedVaries based on clinical trialSafety not fully establishedCurrently undergoing clinical trial evaluation for COVID-19 in China and US
Umifenovir (Arbidol)Viral envelope membrane fusion inhibitor via S-protein/ACE2 interactionNot currently approvedVaries based on clinical trialSafety not fully establishedPending 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