Antiviral agents under investigation for COVID-19
| Drug | Mechanism of action | FDA-approved indication(s) | Dosage | Adverse reactions/contraindications | Comments |
|---|---|---|---|---|---|
| Remdesivir | Adenosine analogRNA polymeraseinhibitor | Not currentlyapproved | 200 mg IV on day 1,then 100 mg IV daily× 9 additional days | Safety not fullyestablished | Currently undergoingseveral phase III clinicaltrials in the US forCOVID-19 |
| Lopinavir/ritonavir(Kaletra) | Protease inhibitor | HIV | HIV: varies based onconcomitant medications,typically lopinavir/ritonavir400 mg/100 mg twice daily | Adverse reactions: QTc prolongation, weightgain, fat redistribution,hepatotoxicity, increasedcholesterol, hyperglycemia,pancreatitis, skin rash,gastrointestinal effects Caution/avoid use: Lopinavir and ritonavirare strong CYP3A4inhibitors and thus mayhave many druginteractions | Clinical trials ongoingin the US andinternationally |
| Oseltamivir(Tamiflu) | Neuraminidaseinhibitor | Influenza A/Bfor treatmentor prophylaxis | Influenza: 75 mg twice dailyInfluenza prophylaxis:75 mg once dailyAdjust doses for renalfunction | Adverse reactions: Vomiting, nausea,headache | Two randomizedclinical trials currentlyongoing in China |
| Favipiravir(Avigan) | Purine nucleotideRNA polymeraseinhibitor | Not currentlyapproved | Varies based on clinical trial | Safety not fullyestablished | Currently undergoingclinical trial evaluationfor COVID-19 inChina and US |
| Umifenovir(Arbidol) | Viral envelopemembrane fusioninhibitor viaS-protein/ ACE2interaction | Not currentlyapproved | Varies based on clinical trial | Safety not fullyestablished | Pending further clinicaltrial evaluation forCOVID-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