Options for Controlling COVID-19 With Off-Patent Medications and Nutraceuticals
Drugs by physician prescription only; observe all contraindications
First Phase Anti-Virals – Administer to high-risk patients as soon as symptoms manifest or infection is diagnosed
Bromhexine – 8-16 mg 3 times daily (1-5)
Hydroxychloroquine – 1st day 400 mg twice; subsequent days 200 mg twice daily (6-10)
Azithromycin 500 mg once daily (6-12)
Doxycycline 100 mg twice daily (alterative to azithromycin for patients with heart issues) (13-16)
Options for Managing Second Phase - Anti-inflammatory/Antithrombotic agents
Ivermectin 8-16 mg, one time only; may repeat after 10 days (17-19)
Pentoxifylline 400 mg 3 times daily (20-24)
Dipyridamole 50 mg 3 times daily (20,25,26)
Heparin (27)
Corticosteroids (28,29)
Statins (30-34)
Suggested Nutraceuticals
Zinc Sulfate 220 mg once daily (50 mg zinc;may aid efficacy of hydroxychloroquine) (35-39)
Vitamin D 5,000 IU once daily (40-44)
Quercetin 250 mg twice daily (45,46)
N-Acetylcysteine 600 mg twice daily (47-52)
Lipoic Acid 600 mg twice daily (47,48,53)
Ferulic Acid 250 mg twice daily (48,54,55)
Spirulina 15 g once daily (48,54)
Glucosamine 3,000 mg once daily (48,56)
Berberine 600 mg twice daily (nutraceutical alternative to metformin) (57-60)
Beta Glucan 200 mg once daily (61)
Melatonin 20 mg at bedtime (63)
Selenium 100 mcg once daily (64)
Suggested for Primary Prevention
Bromhexine 8 mg 3 X daily (62)
Hydroxychloroquine 200 mg once daily (62)
Nutraceuticals
Dedicated to our fine friends in the pharmaceutical industry
References
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(25) Liu X, Li Z, Liu S et al. Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19. Acta Pharm Sin B 2020 April 20.
(26) Kanthi Y, Knight JS, Zuo Y, Pinsky DJ. New (re)purpose for an old drug: purinergic modulation may extinguish the COVID-19 thromboinflammatory firestorm. JCI Insight 2020 July 23;5(14).
(27) Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020 May;18(5):1094-9.
(28) Horby P, Lim WS, Emberson JR et al. Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report. N Engl J Med 2020 July 17.
(29) Lee KH, Yoon S, Jeong GH et al. Efficacy of Corticosteroids in Patients with SARS, MERS and COVID-19: A Systematic Review and Meta-Analysis. J Clin Med 2020 July 27;9(8).
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(31) Delbosc S, Morena M, Djouad F, Ledoucen C, Descomps B, Cristol JP. Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are able to reduce superoxide anion production by NADPH oxidase in THP-1-derived monocytes. J Cardiovasc Pharmacol 2002 October;40(4):611-7.
(32) Zhang XJ, Qin JJ, Cheng X et al. In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19. Cell Metab 2020 August 4;32(2):176-87.
(33) De SA, Bronselaer A, Teo JT et al. The Effects of ARBs, ACEis, and Statins on Clinical Outcomes of COVID-19 Infection Among Nursing Home Residents. J Am Med Dir Assoc 2020 July;21(7):909-14.
(34) Teoh N, Farrell G. Statins as early therapy to mitigate COVID-19 (SARS-CoV-2)-associated ARDS and cytokine storm syndrome - time is of the essence. J Clin Transl Res 2020 June 9;5(5):227-9.
(35) Prasad AS, Beck FW, Bao B et al. Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress. Am J Clin Nutr 2007 March;85(3):837-44.
(36) Prasad AS. Zinc is an Antioxidant and Anti-Inflammatory Agent: Its Role in Human Health. Front Nutr 2014;1:14.
(37) Shittu MO, Afolami OI. Improving the efficacy of Chloroquine and Hydroxychloroquine against SARS-CoV-2 may require Zinc additives - A better synergy for future COVID-19 clinical trials. Infez Med 2020;28(2):192-7.
(38) Derwand R, Scholz M. Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today's battle against COVID-19? Med Hypotheses 2020 May 6;142:109815.
(39) Lagier JC, Million M, Gautret P et al. Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis. Travel Med Infect Dis 2020 June 25;36:101791.
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Comments
I have mentioned PEA (palmitoylethanolamide)
on this site before. Now it is the subject of a clinical trial related to Covid. Phase one on safety is done and it passed very well. Now it's on to Phase 2.
https://www.businesswire.com/news/home/20200602005990/en/FSD-Pharma-Rece...
It has a long history of usage and was originally used as an anti-viral in children in an experiment in 1951.
https://www.researchgate.net/publication/257072840_Palmitoylethanolamide...
The interest now is in its ability to calm the cytokine storm effect that often comes with the Covid infection.
I have been taking it for 6 years to support my eye health because I am a glaucoma suspect (have been for 15 years with no conversion to glaucome) and glaucoma is a disease related to inflammation . PEA protect the retina. I take 1600 mg daily and have had no side effects at all.
"Without the right to offend, freedom of speech does not exist." Taslima Nasrin
@Fishtroller 02 Thanks for this tip - I
Mark F. McCarty
This might be a good place
to pass along a rather long article a friend sent me. He is dealing with the onset of arthritis so it was interesting to him to help understand some of the biology of his condition and Covid which inspired the article. Another friend, an internist with a long ID (Infectious Disease) career recently completed, was very interested in the article. He said a lot of it is outside his specialty but presented information he understands as well as lots of new stuff. A side benefit of Covid has been the collaboration of so many different specialties that is advancing understanding and offering opportunity to find new treatments. Grab a drink, relax, and enjoy.
How Covid Sends Some Bodies to War With Themselves
"Ah, but I was so much older then, I'm younger than that now..."