I've heard several drugs mentioned as possible treatments for COVID-19. What are they and how do they work?
Answer From William F. Marshall, III M.D.
Although there is no product approved by the U.S. Food and Drug Administration (FDA) to treat coronavirus disease 2019 (COVID-19), many medications are being tested.
One investigational drug called remdesivir has been authorized by the FDA for emergency use during the COVID-19 pandemic. Remdesivir may be prescribed for people who are hospitalized with COVID-19. It's given through a needle in the skin (intravenously).
Researchers are studying other potential treatments for COVID-19, including:
- Antiviral drugs. In addition to remdesivir, other antiviral drugs being tested include favipiravir and merimepodib. Studies have found that lopinavir and ritonavir aren't effective.
- Dexamethasone. The corticosteroid dexamethasone is one type of anti-inflammatory drug being studied to treat or prevent organ dysfunction and lung injury from inflammation. A recent study found it reduced deaths by about 30% for people on ventilators and by about 20% for people who needed supplemental oxygen. The U.S. National Institutes of Health has recommended this drug for people hospitalized with COVID-19 who are on mechanical ventilators or need supplemental oxygen. Other corticosteroids, such as prednisone, methylprednisolone or hydrocortisone, may be used if dexamethasone isn't available. However, their effectiveness isn't yet known. Dexamethasone and other corticosteroids may be harmful if given for less severe COVID-19 infection.
- Anti-inflammatory therapy. Researchers study many anti-inflammatory drugs to treat or prevent dysfunction of several organs and lung injury from infection-associated inflammation.
- Immune-based therapy. Researchers are studying the use of a type of immune-based therapy called convalescent plasma. The FDA has granted emergency use authorization for convalescent plasma therapy to treat COVID-19. Convalescent plasma is blood donated by people who've recovered from COVID-19. It is used to treat people who are ill with COVID-19 in the hospital.
- Drugs being studied that have uncertain effectiveness. Researchers are studying amlodipine, ivermectin, losartan and famotidine. But it is not yet known how effective these drugs may be in treating or preventing COVID-19.
- Hydroxychloroquine and chloroquine. These malaria drugs were authorized for emergency use by the FDA during the COVID-19 pandemic. However, the FDA withdrew that authorization when data analysis showed that the drugs are unlikely to be effective. They can also cause serious heart problems.
- Drugs to prevent COVID-19. Researchers are studying drugs to prevent COVID-19 before and after exposure to the virus.
It's not known if any of these will prove to be effective against COVID-19. It's critical to complete medical studies to determine whether any of these medications are effective against COVID-19.
Don't try these medications without a prescription and your doctor's approval, even if you've heard that they may have promise. These drugs can have serious side effects. They're reserved for people who are seriously ill and under a doctor's care.
Sept. 02, 2020
William F. Marshall, III M.D.
See more Expert Answers
- Information for clinicians on investigational therapeutics for patients with COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html. Accessed April 21, 2020.
- Emergency use authorization. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#coviddrugs. Accessed June 15, 2020.
- AskMayoExpert. COVID-19: Inpatient evaluation, management, and treatment. Mayo Clinic; 2020.
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- Giudicessi JR, et al. Urgent guidance for navigating and circumventing the QTc-prolonging and torsadogenic potential of possible pharmacotherapies for coronavirus disease 19 (COVID-19). Mayo Clinic Proceedings. 2020; doi:10.1016/j.mayocp.2020.03.024.
- Coronavirus disease 2019 (COVID-19) treatment guidelines. National Institutes of Health. https://covid19treatmentguidelines.nih.gov/introduction/. Accessed Aug. 4, 2020.
- Coronavirus disease 2019 (COVID-19) frequently asked questions. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/coronavirus-disease-2019-covid-19-frequently-asked-questions. Accessed April 23, 2020.
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- Marshall WF III (expert opinion). Mayo Clinic. July 1, 2020.
- Q&A: Dexamethasone and COVID-19. World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-dexamethasone-and-covid-19. Accessed June 30, 2020.
- Horby P, et al. Effect of dexamethasone in hospitalized patients with COVID-19: Preliminary report. medRxiv. 2020; doi:10.1101/2020.06.22.20137273.
- Janowitz T, et al. Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: A case series. Gut. 2020; doi:10.1136/gutjnl- 2020- 321852.