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Table 7d. Characteristics of Miscellaneous Drugs

Last Updated: December 20, 2023

  • The information in this table is derived from data on the use of these drugs for FDA-approved indications or in investigational trials. It is supplemented with data on the use of these drugs in patients with COVID-19 or MIS-C, when available.
  • For dose modifications for patients with organ failure or those who require extracorporeal devices, please refer to product labels, when available.
  • There are currently not enough data to determine whether certain medications can be safely coadministered with therapies for the treatment of COVID-19. When using concomitant medications with similar toxicity profiles, consider performing additional safety monitoring.
  • The potential additive, antagonistic, or synergistic effects and the safety of using certain combination therapies for the treatment of COVID-19 are unknown. Clinicians are encouraged to report AEs to the FDA MedWatch program.
  • For drug-drug interaction information, please refer to product labels and visit the Liverpool COVID-19 Drug Interactions website.
Table 7d. Characteristics of Miscellaneous Drugs
Dosing Regimens
Adverse EventsMonitoring ParametersDrug-Drug Interaction PotentialComments
Not recommended by the Panel for the treatment of COVID-19 in nonhospitalized patients.

Doses for COVID-19 in Clinical Trials

  • Fluvoxamine 50 mg PO twice daily
  • Fluvoxamine 100 mg PO twice daily
  • Fluvoxamine 100 mg PO 3 times daily
  • Nausea
  • Diarrhea
  • Dyspepsia
  • Asthenia
  • Insomnia
  • Somnolence
  • Sweating
  • Suicidal ideation (rare)
  • Hepatic function
  • Drug-drug interactions
  • Withdrawal symptoms during dose tapering
  • CYP2D6 substrate
  • Fluvoxamine inhibits several CYP isoenzymes (CYP1A2, CYP2C9, CYP3A4, CYP2C19, CYP2D6).
  • Coadministration of tizanidine, thioridazine, alosetron, or pimozide with fluvoxamine is contraindicated.
  • Fluvoxamine may enhance the anticoagulant effects of antiplatelets and anticoagulants. Consider additional monitoring when these drugs are used concomitantly with fluvoxamine.
  • The use of MAOIs concomitantly with fluvoxamine or within 14 days of treatment with fluvoxamine is contraindicated.
Intravenous Immunoglobulin
Primarily used for the treatment of MIS-C. Currently under investigation in clinical trials.
Dose for MIS-C
  • 1 dose of IVIG 2 g/kg IBW IV, up to a maximum total dose of 100 g
  • In the event of cardiac dysfunction or fluid overload, consider administering IVIG in divided doses (i.e., IVIG 1 g/kg IBW IV, up to 50 g daily x 2 doses).
  • Allergic reactions, including anaphylaxis
  • Renal failure
  • Thromboembolic events
  • Aseptic meningitis syndrome
  • Hemolysis
  • Transmission of infectious pathogens
  • AEs may vary by formulation.
  • Risk and severity of AEs may increase with high dose or rapid infusion.
  • Transfusion-related reactions
  • Vital signs at baseline and during and after infusion
  • Renal function; discontinue treatment if renal function deteriorates.
  • Not a CYP substrate; no drug-drug interactions expected
  • Rapid infusion should be avoided in patients with renal dysfunction or those who are at risk of thromboembolic events.
There is insufficient evidence for the Panel to recommend either for or against the use of metformin in nonhospitalized patients. Not recommended by the Panel for the treatment of COVID-19 in hospitalized patients, except in a clinical trial.
Doses for COVID-19 in Clinical Trials
  • Immediate-release metformin 500 mg PO on Day 1; 500 mg twice daily on Days 2–5; and 500 mg in morning and 1,000 mg in evening on Days 6–14
  • Extended-release metformin 750 mg PO twice daily for 10 days
  • Diarrhea
  • Nausea and vomiting
  • Headache
  • Lactic acidosis
  • Renal function
  • Hepatic function
  • Drug-drug interactions
  • Alcohol use disorder
  • OCT1 and OCT2 substrate
  • Drugs that interfere with OCT systems (e.g., cimetidine, dolutegravir, ranolazine, vandetanib) could increase systemic exposure to metformin.
  • Concomitant use with carbonic anhydrase inhibitors (e.g., acetazolamide, topiramate, zonisamide) may increase the risk of lactic acidosis.
  • Alcohol intake may increase the risk of lactic acidosis.