Chloroquine and hidroxichloroquine
|
Blockade of viral entry and immunomodulatory effects through inhibition of cytokine production (both share the same mechanism). |
500 mg by mouth every 1224 hours for 5 or 7 days (500 mg of chloroquine phosphate [salt] = 300 mg chloroquine base). |
Abdominal cramps, anorexia, diarrhea, nausea, vomiting, QTc prolongation, hemolysis in G6PD deficiency, hypoglycemia, retinal toxicity, neuropsychiatric, and central nervous system effects. |
Creatinine clearance <10 mL/min administer 50% of the dose. Hepatic: No dose adjustments (use with caution). |
Lopinavir/ritonavir
|
Inhibiting 3C-like protease (3CLpro). |
400/100 mg by mouth every 12 hours for up to 5-10 days maximum (at the beginning of the symptoms, first 7-10 days). |
Diarrhea, nausea, vomiting, hepatotoxicity, hypertriglyceridemia and hypercholesterolemia, anxiety, headache, myalgia, pancreatitis. |
No kidney or hepatic dose adjustments recommended (use with caution in hepatic impairment). |
Remdesivir
|
RNA polymerase inhibitor. |
Loading dose 200 mg intravenous followed 100 mg intravenous of maintenance once daily from day 2 to 10. |
The main side effect is hypotension due to infusion. Other possible adverse reactions are nausea, vomiting, diarrhea, constipation, and abdominal pain. |
Not recommended if creatinine clearance <3Ο mL/min. |
Tocilizumab
|
IL-6 inhibition-reduction in cytokine storm. |
Dose adjustments by weight: - ≥ 75 kg 600 mg one dose. - < 75 kg 400 mg one dose. Second dose 8-12 hours after the first dose if inadequate response. |
Increase in upper respiratory tract infections (including tuberculosis), nasopharyngitis, headache, hypertension, increased AST, infusion-related reactions. Hematologic effects, infections, hepatotoxicity, gastrointestinal perforations, hypersensitivity reactions. |
No dose adjustments recommended in mild or moderate kidney impairment. No hepatic dose adjustments recommended (not studied). Caution in patients with neutropenia (<500 cells/μL) or thrombocytopenia (<50000/μL) |
Metilprednisolone
|
Regulate a vast array of physiological processes, and synthetic derivatives of these molecules are widely used in the clinic for treating inflammatory disorders, autoimmune diseases. |
40 to 80 mg / IV / day, without exceeding 2 mg / kg (maximum 5 days). |
Most frequent Nausea, vomiting, heartburn, headache, dizziness, trouble
sleeping, appetite changes, increased sweating, or acne may occur. |
kidney or hepatic failure (caution). |
Favipiravir
|
RNA polymerase inhibitor. |
Doses vary based on indication; limited data available. |
Hyperuricemia, diarrhea, elevated transaminases, reduction in neutrophil count. |
No required kidney adjustment (limited data available). Dose adjustment in Child-Pugh C is recommended. |
Anakinra
|
Antagonist of IL-1β. The inhibition of IL-1β reduces the cytokine storm caused by infection. |
100 mg subcutaneous injection per day. |
Diarrhea, fever or chills, headache, itching, pain, redness, swelling, tenderness or warmth on the skin, joint pain, muscle aches and pains, nausea or vomiting, runny nose or sneezing and sore throat. |
Creatinine clearance <30 mL/min or terminal renal failure (dialysis included) administer 100% of de dose every other day. Severe hepatic failure (caution). |