Off Label Medication to Combat COVID-19: Review Results to Date

Abstract

Background: Severe viral pneumonia cases were seen in the people of Wuhan, China at the end of December 2019. It has already affected almost every country around the globe and was declared a pandemic by the World Health Or-ganization. We aim to evaluate the therapeutics and safety of various off label COVID-19 drugs Methods: PubMed, Research Gate, Science Direct, Google Scholar, Centre for Disease control and prevention (CDC) por-tal, Chinese Centre for Disease Control and prevention (CCDC) portal, World Health Organization (WHO) portal were searched for obtaining reliable data. Result: COVID-19 is creating a storm of deaths and active cases globally which is forcing the pharmaceutical companies and scientists to work day and night to find an effective and safer anti-COVID-19 medication. Various in-vitro and clinical trials had been performed as well as currently ongoing to analyze the mechanisms and therapeutics of off label medications like Chloroquine, Hydroxychloroquine, Amodiaquine, Azithromycin, Remdesivir, Favipiravir, Ritonavir/Lopinavir, Umifenovir, Oseltamivir, Ribavirin, Nafamostat, Camostat, Tocilizumab, Ivermectin, Nitazoxanide, Famotidine, Vitamin D, Corticosteroids and Dexamethasone. In-vitro studies were performed by utilizing Vero E6 cells and hSLAM cells while open/closed, randomized/non-randomized, single-centered/multi-centered and retrospective clinical trials and cases study were organized to determined safety and efficacy Conclusion: Although these drugs have shown promising results against COVID-19 patients, it cannot be concluded that these drugs are truly safe and effective because there are no conclusive evidences to support the facts since only limited re-searches and studies had been investigated

COVID-19 off-label uses of medicines: the role of civil liability and regulation

“…Given the lack of products specifically tested and approved for COVID-19, uses of medicines to treat COVID-19 patients are, by definition, off-label (Shojaei and Salari 2020 ). Examples include the use of medicines authorised for the treatment of malaria (Chloroquine, Hydroxychloroquine and Amodiaquine), bacterial infections (Azithromycin), Ebola (Remdesivir), influenza (Favipiravir, Umifenovir, Oseltamivir and Ribavirin), HIV (Ritonavir/Lopinavir), fibrosis (Nafamostat and Camostat), arthritis (Tocilizumab), parasite infestations (Ivermectin and Nitazoxanide), ulcers (Famotidine) and inflammation (Corticosteroids and Dexamethason) (Neupane et al 2021 ; Pawar 2020 ).…”

Ensayo de toxicidad oral a dosis repetidas de 28 días de ivermectina, azitromicina y acetaminofén en ratones CD1

“…Lo anterior ha resultado en la automedicación con distintos ingredientes activos, entre los que se pueden mencionar a nivel global a la cloroquina, hidroxicloroquina, amodiaquina, azitromicina, remdesivir, favipiravir, ritonavir/lopinavir, umifenovir, oseltamivir, ribavirina, nafamostat, camostat, tocilizumab, ivermectina, nitazoxanida, famotidina, vitamina D, corticoides y dexametasona. No obstante, aunque existen estudios promisorios, existe la escasez de datos sobre su efectividad y seguridad que permitan elaborar conclusiones asertivas (Neupane et al, 2020).…”