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.