Dec
25
2021

Drugs that May be Useful in the Treatment of Covid-19

This article deals with drugs that may be useful in the treatment of Covid-19. There are several drugs that may be useful in the treatment of Covid-19. Lately an antidepressant like Luvox has been in the limelight. But antiviral drugs like ritonavir from Pfizer and remdesivir from Gilead Sciences also reduced the number of hospitalized patients with Covid-19. Finally, Merck introduced molnupiravir, an antiviral drug against Covid-19. The health authorities in Great Britain recently approved this drug for use in Covid-19 patients in Great Britain. Apart from drugs, vitamin D3 is still an important factor in preventing and treating Covid-19 as I will mention below.

Luvox for better survival from Covid-19

The Lancet published a study on January 2022 about the effect of Luvox on patients with Covid-19 symptoms. 741 patients received the antidepressant Luvox, 756 received placebo pills. In the Luvox group patients received 100 mg of Luvox twice per day for 10 days. From the Luvox treated patients only 11% had to go to tertiary care for treatment. In contrast, from the placebo group 16% had to go to tertiary care. There were 17 deaths in the Luvox group and 25 deaths in the placebo group. The Luvox group definitely showed a positive effect, although the results were not outstanding. In the following I am discussing other drugs that may be useful in the treatment of Covid-19.

Antiviral agent Remdesivir Improving survival from Covid-19

Here is a run-down of the survival statistics with remdesivir. This drug is manufactured by Gilead Sciences in cooperation with Pfizer. 541 patients received a loading dose of 200 mg on day 1. Subsequently they received 100 mg daily for another 9 days. 521 received placebo pills. The median recovery time in patients with remdesivir was 10 days. Those on placebo pills recovered only after 15 days. The mortality rates were 6.7% with remdesivir and 11.9% for the placebo group on day 15. There was a mortality of 11.4% with remdesivir and mortality of 15.2% with placebo pills on day 29. Although the effect between the remdesivir group and the placebo group was significant, the effect would not be enough to stop transmission of the virus on a population basis. Health Canada made the decision to use remdesivir in severe COVID-19 disease cases.

Merck introduced molnupiravir, another antiviral drug against Covid-19

Molnupiravir was approved in the UK as an antiviral drug for early and moderately severe cases of Covid-19. It is difficult to get data on the Merck’s molnupiravir drug. But this publication states that there is a 50% reduction of mild to moderate cases of Covid-19 cases with molnupiravir. Professor Peter Horby from the University of Oxford pointed out “the proportional reduction in the risk of hospitalisation or death is impressive. But it is important to remember that the absolute risks were 14% reduced to 7%, so quite a lot of people need to be treated to prevent one hospitalisation or death.” Others pointed out that the side-effects are very similar between placebo pills and molnupiravir pills. Overall molnupiravir appears to be a useful addition in the treatment of Covid-19.

Higher doses of vitamin D3 effective in treating and preventing Covid-19

Higher doses of vitamin D3 will mitigate the course of influenza and of Covid-19 coronavirus. Researchers outlined 3 mechanisms of how vitamin D works:

  • Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate.“
  • Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the bloodstream within 1 to 2 days.”
  • And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” It is people who get the viral pneumonia that are at a high risk of death. By bringing the blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.
Drugs that May be Useful in the Treatment of Covid-19

Drugs that May be Useful in the Treatment of Covid-19

Conclusion

Beside distancing, the wearing of masks and frequent hand washing other methods are emerging to fight the virus that causes Covid-19. Vaccinations are very effective, although they are less effective in patients with a weakened immune system. But there are also drugs that may be useful in the treatment of Covid-19. Newer studies have shown that the antidepressant Luvox has a mild effect on helping Covid-19 patients. Last year remdesivir came into the market. And this year Merck added molnupiravir, another antiviral pill. We should not forget that vitamin D3 is an effective antiviral vitamin. But it is only effective, provided the patient takes enough vitamin D3. The blood level must reach the high normal level of 50-80 ng/mL vitamin D in the blood. Up to now vaccinations and booster shots are the most effective way to prevent Covid-19 infection. Vitamin D3 and molnupiravir are also very effective.

Part of the above was previously published here.

Dec
24
2016

Spironolactone Helps Against Herpes Infections

There are limited numbers of antiviral drugs for herpes, but certainly now research showed that spironolactone helps against herpes infections. Spironolactone is an older heart medicine that helps with cardiac failure, but it is also used in unwanted hair growth in women with a hormone disbalance, called hirsutism.

Dr. Swaminathan and colleagues have shown in new research from the University of Utah School of Medicine, Salt Lake City, UT that spironolactone blocks the multiplication of herpes viruses.

Common herpesvirus infections

Although there are 100’s of different herpes virus strains, you will recognize some of the following names.

Herpes, type 1 (HSV-1)

HSV-1 causes cold sores on the lips or inside the mouth.

Herpes, type 2 (HSV-2)

HSV-2 is the cause of genital herpes.

Herpes, type 3 (HSV-3)

HSV-3 causes both chickenpox and shingles (herpes zoster). When the immune system is immature, it presents as chickenpox (mostly in children). But when there is partial immunity from a chickenpox childhood infection, shingles can present in an aging person as a localized shingle infection (medically called “herpes zoster”). An interesting vaccination study showed that vaccination against varicella caused a suppression of chronic HSV-1 so that there were no more cold sores compared to the non-vaccinated group that did.

Herpes, type 4 (HSV-4)

You may know HSV-4 as the Epstein-Barr virus. It is the cause of infectious mononucleosis. Other names for this disease are glandular fever or “kissing disease”.

Treatments for herpes infections

The typical antiviral treatments for HSV-1 and HSV-2 are acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). As a matter of fact, all these drugs belong to the same pharmacological class of drugs. The same drugs work for chickenpox and shingles/herpes zoster (HSV-3).

In a 2013 publication researchers gave acyclovir (Zovirax) to patients who had been hospitalized with infectious mononucleosis.

They had a shorter duration of hospitalization and fever than a control group not treated with acyclovir. The authors did propose that patients with mononucleosis should receive acyclovir.

Drug-resistant herpes strains

One problem that has surfaced is that herpes drug resistant herpes strains seem to evolve, which are resistant to all of the newer anti-herpes drugs as well. The reason for this is that current anti-herpes drugs work by inhibiting the ability of the virus to replicate DNA, thus stopping its proliferation. When the virus learns to overcome that barrier we call this resistance and this will also affect all of the drugs that utilize the same mechanism of action.

The team from the University of Utah screened several drugs and came upon spironolactone, which is a standard medicine for treating heart failure. Dr. Swaminathan and his team found that spironolactone was also able to stop the viral proliferation, however the drug blocked the virus through a different mechanism. Spironolactone inhibited the action of a protein, the SM protein.

This different mechanism of treating herpes virus infections has opened a new door to further research for newer drugs. Hopefully these new drugs will only have the anti-herpes virus effect, but not the anti-heart failure effect. Dr. Swaminathan is confident that his team will be able to separate these two actions and then come up with a new group of anti-virus drugs.

Spironolactone helps against herpes infections, has few side-effects

Spironolactone has been on the market for over 50 years and has a very good low side effect profile. It is useful for people with heart failure to reduce the retained fluid that can accumulate around the heart or in the lungs. This allows the patient to breathe easier and have more energy. Spironolactone also helps with fluid accumulation in patients who have cirrhosis or have nephrotic syndrome, a kidney disease.

In a completely different set of patients spironolactone can help women who produce too much male hormone in their ovaries. This normalizes the hormones and help them lose the awkward, unwanted facial hair growth.

Some generalized side effects are: mild nausea, vomiting or diarrhea. Breast swelling or tenderness can develop. Dizziness, headache and mild drowsiness can occur. Some people develop leg cramps. Males can experience impotence and difficulties having an erection.

Spironolactone Helps Against Herpes Infections

Spironolactone Helps Against Herpes Infections

Conclusion

It is not often that an existing drug that has been well researched in the past finds a new application in a completely different area than originally developed for. This is the case for spironolactone, which is effective as an anti-herpetic drug. Further research will likely be able to separate the anti-viral effect of spironolactone from the anti-heart failure effect. Dr. Swaminathan and his team did not think that this was too difficult a problem. In the meantime physicians can use spironolactone for severe herpetic infections when the other drugs do not help. These may be cases of drug resistance.

Overall the detection of an anti-herpetic effect of spironolactone has been an important step forward. This is also true with respect to treating the whole group of herpetic diseases.

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