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There is only one product approved by the U.S. Food and Drug Administration (FDA) to treat coronavirus disease 2019 (COVID-19). But many medications are being tested.
The FDA has approved an antiviral drug called remdesivir (Veklury) to treat COVID-19 in adults and children who are age 12 and older. Remdesivir may be prescribed for people who are hospitalized with COVID-19 and need supplemental oxygen or have a higher risk of serious illness. It’s given through a needle in the skin (intravenously).
The FDA has authorized for emergency use a drug called Paxlovid. This drug combines two types of medications in one package. The first drug is nirmatrelvir. It blocks the activity of a specific enzyme needed for the virus that causes COVID-19 to replicate. The second drug is an antiviral drug called ritonavir. It helps slow the breakdown of nirmatrelvir. Paxlovid is authorized to treat mild to moderate COVID-19 in people age 12 and older who are at higher risk of serious illness. The medications are taken by mouth as pills.
The FDA has authorized for emergency use another drug called molnupiravir to treat mild to moderate COVID-19 in adults who are at higher risk of serious illness and not able to take other treatments. The medication is taken by mouth as a pill.
The FDA has authorized for emergency use the rheumatoid arthritis drug baricitinib (Olumiant) to treat COVID-19 in some cases. Baricitinib is a pill that seems to work against COVID-19 by reducing inflammation and having antiviral activity. Baricitinib may be used in people who are hospitalized with COVID-19 who are on mechanical ventilators or need supplemental oxygen.
Researchers are studying other potential treatments for COVID-19, including:
Dexamethasone. The corticosteroid dexamethasone is one type of anti-inflammatory drug that researchers are studying to treat or prevent organ dysfunction and lung injury from inflammation. Studies have found that this drug reduces the risk of death by about 30% for people on ventilators and by about 20% for people who need supplemental oxygen.
The U.S. National Institutes of Health has recommended dexamethasone for people hospitalized with COVID-19 who are on mechanical ventilators or need supplemental oxygen. If dexamethasone isn’t available, other corticosteroids, such as prednisone, methylprednisolone or hydrocortisone, may be used. Dexamethasone and other corticosteroids may be harmful if given for less severe COVID-19 infection.
In some cases, the drugs remdesivir, tocilizumab or baricitinib may be given with dexamethasone in hospitalized people who are on mechanical ventilators or need supplemental oxygen.
Immune-based therapy. Researchers study immune-based therapies, including convalescent plasma, mesenchymal stem cells and monoclonal antibodies. Monoclonal antibodies are proteins created in a lab that can help the immune system fight off viruses.
The FDA has authorized for emergency use the monoclonal antibody combination of tixagevimab and cilgavimab (Evusheld) to prevent COVID-19 in some people with weakened immune systems or a history of severe reactions to a COVID-19 vaccine.
Other monoclonal antibodies aren’t effective against treating COVID-19 caused by the omicron variant. These drugs were previously used to treat mild to moderate COVID-19 in people who had a higher risk of developing serious illness due to COVID-19.
Researchers also study the use of a type of immune-based therapy called convalescent plasma. The FDA has authorized for emergency use convalescent plasma therapy to treat COVID-19. Convalescent plasma is blood donated by people who’ve recovered from COVID-19. Convalescent plasma with high antibodies may be used to treat some hospitalized people with COVID-19 who are either early in their illness or have weakened immune systems.
Drugs to prevent COVID-19. Researchers are studying drugs to prevent COVID-19 before and after exposure to the virus.
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 health care provider’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 health care provider’s care.
With
Daniel C. DeSimone, M.D.
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