Niclosamide: A Potential Treatment Option for Covid-19

Abstract

Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a global health hazard due to its rapid dissemination and limited treatment options. Identification of possible treatments that may kill the virus, speed up the recovery, or reduce the case fatality rate is a need of hour. However, developing and producing particular COVID-19 medicines and vaccines is a time-consuming process with possibilities of clinical failures due to safety or efficacy issue. Medication repositioning is a safer and quicker approach for dealing with the COVID-19 worldwide threat right now. Out of 48 FDA-approved medicines tested against SARS-CoV-2, niclosamide is one amongst few that has shown potential in vitro antiviral activity against SARS-CoV-2. However, the currently available oral conventional formulation of niclosamide results in systemic medication levels those are unsatisfactory to inhibit SARS-CoV-2. Hence, various formulation strategies have been adapted in order to achieve an optimum therapeutic outcome of niclosamide when delivered via oral, inhalation, and intranasal routes. Some of these formulations are presently undergoing clinical trials. The current review focuses on the mechanisms of action of niclosamide and its repurposing effectiveness against COVID-19. The delivery strategies to improve its bioavailability have been overviewed. The recently completed and ongoing clinical trials have also been summarized.

Predicting lung exposure of intramuscular niclosamide as an antiviral agent: Power‐law based pharmacokinetic modeling

“…Various strategies have been proposed to combat COVID‐19, including drug repurposing effects. Niclosamide has emerged as a potent candidate against this virus 6 , 7 , 8 based on in vitro experiments, demonstrating superior antiviral activity, and it has greater potency with a half maximal inhibitory concentration of 0.28 μM surpassing conventional antiviral drug remdesivir (8.24 μM). 9 The pharmacological effects of niclosamide extend beyond antiviral activity to include anticancer, 10 , 11 , 12 antibacterial, 13 and antidiabetic 14 properties.…”