i) Miscellaneous agents
Bictegravir an integrase inhibitor is a recently approved drug for HIV which can cause gastrointestinal, headache, and hepatic side effects with dofetilide and rifampin contraindication (45, 58, 59).
Arbidol (Umifenovir): Arbidol prevents virus entrance into the cells through inhibition of the interaction between virus and plasma membrane (60). Arbidol also can induce interferons and activate macrophages and be an immune enhancer (61). Some patients received arbidol treatment at a dose of 0.4 g three times a day. Arbidol treatment improved the discharging rate and decreased the mortality rate (62).
Prulifloxacin is a fluoroquinolone with CYP1A2 inhibitory property which also showed anti-SARS-CoV-2 potential based on computational studies (63, 64).
Disulfiram an aldehyde dehydrogenase inhibitory agent, used in the treatment of alcoholism shows promise in inhibiting SARS-COV-2. Disulfiram has little side effects but causes drug-drug interactions with multiple drugs including phenytoin, isoniazid, oral anticoagulants. Alcohol consumption in a patient of disulfiram medication can lead to vomiting, sweating, throbbing headache, hypotension, and confusion. Its safety is not established in pregnancy (45, 65).
Carmofur is a known anti-neoplastic agent used in colorectal and breast cancers. It is known to cause leukoencephalopathy (45).
Tideglusib a glycogen synthase kinase 3 inhibitor with anti-inflammatory features that was primarily developed for Alzheimer’s disease (45, 66).
1-methylpropyl 2-imidazolyl disulfide (PX-12) is an inhibitor of thioredoxin-1 (Trx-1) which is associated with colorectal, gastric, and lung cancer (45, 67).
TDZD-8 is a thiadiazolidine derivative that has potential inhibitory effects on viral M protein. (45, 68)
Ivermectin is an anti-protozoal drug that has been in use since 1970, is another option to be considered. According to studies, it has shown promising potential in laboratory studies and also had exhibited potential infection control in similar infections such as West Nile virus (69).
Moexipril , a long-acting ACE inhibitor prodrug;Daunorubicin and Mitoxantrone , anthracycline antibiotics which are most widely used chemotherapy drugs(65); Bepotastine , a non-sedating histamine 1 receptor antagonist(70); rosuvastatin , an HMG-CoA reductase inhibitor which in some cases can cause hepatic toxicity and Atovaquone , (65) the antimalarial drug that is also used in pneumonia P. jiroveci (71) are also therapeutic options to be nominated for further investigations based on recent studies.