Miscellaneous Drugs

Fluvoxamine

• The COVID-19 Treatment Guidelines Panel (the Panel) recommends against the use of fluvoxamine for the treatment of COVID-19 in nonhospitalized patients (AIIa).
• There is insufficient evidence for the Panel to recommend either for or against the use of the combination of inhaled budesonide plus fluvoxamine for the treatment of COVID-19 in nonhospitalized patients.
• Patients with COVID-19 who are receiving fluvoxamine for an underlying condition should continue this therapy as directed by their health care provider (AIII).

Intravenous Immunoglobulin

• The Panel recommends against the use of intravenous immunoglobulin (IVIG) for the treatment of acute COVID-19 in adults and children, except in a clinical trial (AIII). This recommendation should not preclude the use of IVIG when it is otherwise indicated for the treatment of underlying conditions or complications that arise during the course of COVID-19.
• For the Panel’s recommendations on the use of IVIG in people with multisystem inflammatory syndrome in children (MIS-C) or multisystem inflammatory syndrome in adults (MIS-A) and a discussion of the clinical data that support those recommendations, see Therapeutic Management of Hospitalized Children With MIS-C, Plus a Discussion on MIS-A.

Ivermectin

• The Panel recommends against the use of ivermectin for the treatment of COVID-19 (AIIa).

Metformin

• There is insufficient evidence for the Panel to recommend either for or against the use of metformin for the treatment of COVID-19 in nonhospitalized patients.
• The Panel recommends against the use of metformin for the treatment of COVID-19 in hospitalized patients, except in a clinical trial (BIII).
• Patients with COVID-19 who are receiving metformin for an underlying condition should continue this therapy as directed by their health care provider (AIII).

The Panel reviewed clinical trials that evaluated the use of the anti-inflammatory drug colchicine for the treatment of COVID-19; however, these trials failed to show a benefit of using colchicine in patients with COVID-19.