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.
Remdesivir, hydroxychloroquine and chloroquine have gotten attention as potential treatments for coronavirus disease 2019 (COVID-19). However, no medications have been approved by the U.S. Food and Drug Administration (FDA) for this purpose, and no drugs have been proved effective to treat COVID-19.
During the COVID-19 pandemic, however, the FDA has granted permission for doctors to use some medications approved for other diseases to treat COVID-19 when someone is seriously ill and no other options are available.
The FDA has authorized two malaria drugs — hydroxychloroquine and chloroquine — for use in some people hospitalized because of COVID-19 who aren't eligible for clinical trials. These drugs can cause many side effects, including serious and even fatal heart rhythm problems. For this reason, doctors must closely monitor people receiving them. These drugs can also cause serious drug interactions. Ongoing research and trials study their effectiveness and safety in treating or preventing COVID-19.
Doctors are also testing medications developed to fight other viruses (antiviral drugs) to see if they will work against COVID-19. Remdesivir is one of these, and the FDA has authorized this drug for use in some people hospitalized because of COVID-19. It's given through a needle in the skin (intravenously). Other antiviral drugs being studied include favipiravir, lopinavir and ritonavir. Studies and trials are ongoing for these drugs.
Researchers study other potential medications and treatments for COVID-19, including:
- Combinations such as hydroxychloroquine and azithromycin (an antibiotic). Researchers generally recommend avoiding this combination because it can cause heart problems.
- Anti-inflammatory therapy. Researchers study various anti-inflammatory drugs to treat or prevent lung injury from infection-associated inflammation.
- Immune-based therapy. Researchers are studying the use of a type of immune-based therapy called convalescent plasma. Convalescent plasma is blood donated by people who've recovered from COVID-19 that is used to treat people who are seriously ill with the disease.
- Amlodipine. One study found that this high blood pressure drug might help improve the outcome of people with high blood pressure and COVID-19, especially when combined with chloroquine.
- Ivermectin. One laboratory study researched the potential of using this anti-parasitic drug as a treatment, but it's too early to know its effectiveness to treat or prevent COVID-19 as it hasn't been tested in people with COVID-19.
- Drugs to prevent COVID-19. Researchers study drugs to prevent COVID-19 before and after exposure to the disease.
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.
May 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.
- Frequently asked questions on the EUA for chloroquine phosphate and hydroxychloroquine sulfate. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#covidtherapeutics. Accessed April 21, 2020.
- AskMayoExpert. COVID-19: Inpatient evaluation, management, and treatment. Mayo Clinic; 2020.
- Kim AY, et al. Coronavirus disease 2019 (COVID-19): Management in adults. https://www.uptodate.com/contents/search. Accessed April 21, 2020.
- 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 April 22, 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.
- Zhang L, et al. Calcium channel blocker amlodipine besylate is associated with reduced case fatality rate of COVID-19 patients with hypertension. Medrxiv. 2020; doi:10.1101/2020.04.08.20047134.
- Marshall WF III (expert opinion). Mayo Clinic. April 29, 2020.