Copyright ©The Author(s) 2021.
World J Gastroenterol. Jul 14, 2021; 27(26): 4160-4171
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4160
Table 1 Side effects of most common drugs during coronavirus disease-2019 treatment
Pharmacological intervention
Mechanism of action
Adverse effects
HydroxychloroquineElevated endosomal pH; Disruption of lysosome-endosome fusion. Inhibition of cell-virus fusion when interacting with N-terminal domain of the SARS-CoV-2 peakQ-T segment prolongation; Gastrointestinal Adverse Effects[62-64]
ChloroquineInhibits RNA-dependent polymerases, decreases endosomal iron release required for DNA replication, and inhibits glycosylation of viral envelope glycoproteinsGastrointestinal adverse effects; visual and extrapyramidal disturbances; Arrhythmogenic cardiotoxicity[65-67]
RemdesivirTranscription InhibitorCaution in patients with severe renal impairment [estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73] or severe liver disease[68]
Lopinavir/RitonavirLopinavir binds to the viral protease and prevents the cleavage of the Gag-Pol polyprotein, resulting in the production of non-infectious immature viral particles. Ritonavir increases the plasma concentration of lopinavir by inhibiting the metabolism of cytochrome P450 3A (CYP3A)Gastrointestinal adverse effects[64,65,68-72]
RibavirinInterferes with RNA polymerase and viral protein synthesisHemolytic anemia; Leukopenia; Teratogenic[68]
InterferonDegradation of viral RNA; Alteration of RNA transcription; Inhibition of protein synthesis and apoptosisWorsening psychiatric conditions, cytopenia, and uncontrolled seizures[68]
Cortocosteroids, dexametasoneInhibitor of the inflammatory processImpair the immune response; Bacterial pneumonia risk; Hyperglycemia; Osteoporosis; Hypertension[68-70]
AzithromycinBacteriostatic antibiotics; Anti-inflammatory effects Immunomodulatory effectsQTc with the risk of arrhythmias[71,73]
HeparinAntiplateletRisk GI symptoms; Bleeding; Heparin-induced thrombocytopenia[74]
FavipiravirCompetitive inhibitor of RNA-dependent RNA polymeraseGI adverse effects; liver injury[75,76]