List of Antiviral Medications which are in use for COVID-19 treatment

In March 2020, the World Health Organisation declared Coronavirus or COVID-19 as a pandemic. Coronavirus emerged from Wuhan, China. No treatment or medicine have been found for coronavirus worldwide yet but there are some existing medications or techniques that are helpful in reducing coronavirus count, the medications may enhance the immunity or reduce the symptoms of coronavirus. Some of the below-mentioned medications either decrease the symptoms of coronavirus or reduce its count.

LOPINAVIR RITONAVIR:

Lopinavir ritonavir is a fixed-dose combination medication that is used in the treatment of HIV or AIDS. In this combination, the dose of ritonavir is quite less as it works as a pharmacokinetic booster for lopinavir.

A combination of lopinavir and ritonavir tablets was given when there were 500 cases worldwide. The researches of Jin Yin-tan Hospital started their research at 199 COVID-19 positive patients. Their research includes treating half patients with a combination of lopinavir-ritonavir and another half with standard care. In research, it was found that the patient who was treated with lopinavir-ritonavir recovered fastly as compared to a patient with standard care. In the trial of medicine, it was also found that the lopinavir-ritonavir combination is only beneficial at the secondary endpoint stage, it is ineffective at the final stage.

On February 20, 2020, General Tedros Adhanom Ghebreyesus, which is the Director of WHO, said: "Preliminary results from two clinical trials testing potential treatments for the COVID-19 coronavirus are expected in 3 weeks. Having better outcomes will save the lives of infected people, the medication will be really a key." One trial will be done by combining two HIV drugs Lopinavir and Ritonavir, on the other hand, it would be testing of the Remdesivir.
On April 22, 2020, WHO and National Health Commission of the People's Republic of China issued the guideline for diagnosis and treatment of COVID-19. Also, they suggested lopinavir/ritonavir, ribavirin antiviral therapy can be used in patients with COVID-19 infection”.

ATAZANAVIR

Atazanavir is an antiretroviral medication that is used in the treatment of HIV or AIDS. It is also helpful in avoiding potential exposure to HIV virus.
Atazanavir is administered to the COVID-19 patient if he is suffering from COVID-19 pneumonia. Atazanavir of 400 mg is given once daily for about two weeks. This concentration is quite helpful in the treatment of COVID-19 pneumonia.
                     

DARUNAVIR

Darunavir is a protease inhibitor that is used in the treatment of HIV. This generally works as a booster and is always combined with other medications before administration.
According to Li, a professor at Zhejiang University, on the basis of preliminary tests, which showed that two drugs named Abidol and Darunavir may effectively inhibit the virus in vitro cell experiments. Apart from this, there is no basic such evidence to find out that darunavir is quite effective in the case of COVID-19 treatment.

ATAZANAVIR RITONAVIR

Atazanavir ritonavir is a combined drug that is used in the treatment of HIV. It is generally used as a replacement for the lopinavir-ritonavir combination.
The researchers made it clear that the atazanavir has an inhibitory potency with Kd of 94.94 nM against the SARS-CoV-2 coronavirus-like proteinase, followed by efavirenz (199.17 nM), ritonavir (204.05 nM), and dolutegravir (336.91 nM).
AI predicted that the potential of atazanavir is able to bind the affinity to the multiple components of the coronavirus, binding to RNA-dependent RNA polymerase or RNA replicase is an enzyme that catalyzes the replication of RNA from an RNA template, helicase, 3′-to-5′ exonuclease, 2′-O-ribose methyltransferase, and EndoRNAse, specifying that all the subunits of the SARS-CoV-2 coronavirus replication complex may be inhibited simultaneously by atazanavir.
In South Korea, clinical trials on atazanavir have been already initiated but it would be too early in order to predict the efficacy and toxicity effects of atazanavir on patients who are in severe critical conditions.

ABACAVIR

Abacavir easy medication used in the treatment of HIV or AIDS it belongs to nucleoside analogue reverse transcriptase inhibitors class that is used to prevent the infection or post-exposure infection of HIV
The study on abacavir regarding its use in the treatment of COVID-19 is still going on. It is expected that its use in coronavirus will be declared soon.

NEVIRAPINE

Nevirapine is an antiretroviral drug that belongs to the non-nucleoside reverse transcriptase inhibitors class. This antiretroviral drug is mainly used in the treatment of Human Immunodeficiency Virus. The main function of this drug is to increase the CD4 cells that help in strengthening the immune system.
Research is ongoing on Nevirapine in China. It is assumed that nevirapine increases CD4 cell count in the human body and it strengthens the immune system to fight against coronavirus.

LAMIVUDINE

Lamivudine generally is known as 3TC is used to prevent and treat HIV or AIDS. It is effective in case of both HIV Type 1 and HIV type 2.
Effect of lamivudine on coronavirus patients is under observation. Several trials and research are ongoing. Lamivudine in combination with other drugs is found effective in case of COVID-19 treatment.

DARUNAVIR RITONAVIR

Darunavir ritonavir combination is the most effective antiretroviral therapy against human immunodeficiency virus( HIV )  or AIDS. The use of darunavir ritonavir combination is generally used in European countries.

Several reports claim that darunavir ritonavir combination is effective against COVID-19 however several trials and Research are ongoing to check in vitro effect against SARS COVID-19. Johnson and Johnson's organisations are partnering to track the solution of COVID-19  using darunavir ritonavir combination.

EFAVIRENZ EMTRICITABINE AND TENOFOVIRIt is the fixed-dose combination of Efavirenz, Emtricitabine and tenofovir disoproxil. It is basically used in the treatment of HIV or AIDS. This medication works by blocking the activity of reverse transcriptase of viral genetic material.
This fixed-dose combination medication is currently undergoing clinical trials or have trials planned in the management of COVID-19.

                    

 OSELTAMIVIR PHOSPHATE

Oseltamivir has the potential with its antiviral activity against the influenza, seeking attention as a potential treatment option for COVID-19. This was exacerbated by the initial
On the basis of a report, that came from Huang and colleagues in Wuhan, where the patients being managed with COVID-19 receiving the oseltamivir in addition to the broad spectrum antimicrobials. It is quite necessary in order to mark that the oseltamivir was not used as the targeted therapy of SARS CoV-2, despite it driven by the less awareness of the causative pathogen at the moment of
treatment and the desire to empirically treat influenza.

ENTECAVIR

Entecavir is an antiviral medication that is used in the treatment of chronic hepatitis B virus infection it is also used when a person is infected with HIV as well as HBV that is Hepatitis B virus.
The use of entecavir in case of COVID-19 treatment is still under research, the trials are ongoing.

RIBAVIRIN

Ribavirin, which is a guanosine analog, firstly approved in the year of 1980 and has been used clinically for viral hemorrhagic fever, respiratory syncytial virus and it combines with interferon for the treatment of patients with hepatitis C.

Chinese guidelines recommend ribavirin 500 mg IV 2-3 times daily in combination with lopinavir/ritonavir or inhaled INF-α (5 million units nebulized twice daily) as one of the “standard treatment” options for COVID-19.  Several combinations of ribavirin and other antiviral agents are being studied in numerous clinical trials at this moment.

VORICONAZOLE

Voriconazole is basically indicated for the treatment of patients with invasive aspergillosis and candidiasis and fungal infections caused by Scedosporium and Fusarium species.
Voriconazole is currently undergoing clinical trials or have trials planned in the management of COVID-19.

CARVEDILOL

Carvedilol is a non-selective beta adrenergic receptor blocker (β1, β2) and also an alpha adrenergic receptor blocker (α1). This medication is recommended for treating the high blood pressure, congestive heart failure (CHF), and left ventricular dysfunction in such people who are otherwise stable.
This medication is currently undergoing clinical trials or have trials planned in the management of COVID-19.

HYDROXYCHLOROQUINE

On March 20, 2020, Teva Pharmaceutical declared that they are going to donate approximately 6 million doses of hydroxychloroquine sulfate tablets on an immediate basis. The donation of hydroxychloroquine would take place through the wholesalers to the hospitals in the entire United States in order to fulfill the urgent demand for the medicine as an investigational target in treating the COVID-19 disease. Despite, the medication is not approved yet for use in the treatment of COVID-19. On the other hand it is approved by the U.S. Food and Drugs Administration for the treatment of lupus erythematosus, rheumatoid arthritis, and malaria.
On March 29, 2020, Vas Narasimhan Chief Executive of Novartis addressed as, the antimalarial drug hydroxychloroquine sulfate is the biggest hope of the company against ongoing pandemic (coronavirus).
On March 26th, Novartis pledged that they will donate about 130 million doses.

FAVIPIRAVIR

On February 23, 2020, Katsunobu Kato the health minister of Japan addressed that the anti-influenza medication Favipiravir will be used for COVID-19 treatment, as part of an observational study.
On March 31, 2020, FUJIFILM Toyama Chemical Ltd stated as "today, we've started the phase-3 trial in order to evaluate the safety as well as efficacy of the Avigan, an influenza antiviral drug. Avigan, the brand name of medication favipiravir, which is recommended in Japan for patients with COVID-19 infection, a respiratory infection caused by the novel Coronavirus SARS-CoV-2.
On April 30, 2020, Glenmark Pharmaceuticals declared that they got the approval from the Drug Controller General of India in order to conduct the clinical trials on Favipiravir so that after successful trials it can be used for COVID-19 patients. Favipiravir is the generic version of Avigan.