An overview of safety assessment of the medicines currently used in the treatment of COVID-19 disease

Javorac, Dragana; Grahovac, Lazar; Manić, Luka; Stojilković, Nikola; Anđelković, Milena; Bulat, Zorica; Đukić - Ćosić, Danijela; Curcic, Marijana; Djordjevic, Aleksandra Buha

On 11(th) March 2020, the pandemic of the new coronavirus was declared by the World Health Organization. At the moment, there are no new registered medicines that can effectively treat the coronavirus infection. However, a number of ongoing clinical trials are investigating the efficacy and safety of the medicines which have already been registered and used for the treatment of other diseases, in the treatment of the coronavirus infection. The proposed combinations of these medicines could potentially present a safety risk, since most of these medicines have the potential to cause numerous side or toxic effects, even when used in monotherapy. Thus, the aim of this study was to review and evaluate the literature data on the toxicity of the selected individual drugs (ritonavir, lopinavir, remdesivir, chloroquine, and umifenovir) and the available clinical data concerning the possible adverse effects of the selected drug combinations (lopinavir/ritonavir+umifenovir, lopinavir/ritonavir+interferon β, chloroquine+remdesivir, and chloroquine+azithromycin). The most often reported toxic effects of these medicines such as hepatotoxicity, retinal damage, nephrotoxicity, and cardiotoxicity, together with the fact that the health status of the patients with COVID-19 disease is often complicated by co-existing illnesses and therapy implicate that the decision on the therapeutic strategy should be made with caution.