Reported Mechanisms and Toxicity of Investigational Treatments for SARS-COV-2

Chloroquine and Hydroxychloroquine

 • Mechanisms: Interference with ligand binding, interference with viral RNA release into cytosol, decreased viral budding, and alteration in immune viral response

 • Toxicity: Cardiac conduction abnormalities, myocardial depression, hypokalemia, hypoglycemia, ocular toxicity, ototoxicity, neuropsychiatric effects

Azithromycin

 • Mechanisms: Inhibits viral internalization, inhibits viral replication, upregulation of interferon I and 3 response

 • Toxicity: QTc prolongation, hepatotoxicity, sensorineural hearing loss, GI symptoms

Lopinavir/Ritonavir

 • Mechanism: Inhibition viral protein cleavage decreasing viral replication

 • Toxicity: Drug-drug interactions, elevated triglycerides, potential increased MI risk with chronic use

Remdesivir and Favipiravir

 • Mechanism: Nucleoside analogues, results in early termination of viral RNA replication

 • Toxicity (expected): myopathy, hepatitis, neuropathy, lactic acidosis, renal injury (Remdesivir)

Ivermectin

 • Mechanism: Interference with nuclear import of viral

 • Toxicity: Neurotoxicity (overdose or when combined with certain medications), hypotension (overdose), hepatotoxicity



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