Table 1.

Drugs used to treat COVID-19: doses, eligibility criteria and contraindications or cautions

Medication	Route	Dose	Indication	Contraindications
Dexamethasone	Oral or IV	6 mg OD for up to 10 days	PCR-confirmed infection. Features of severe or critical COVID-19 (Fig 1).	Avoid live virus vaccines. Systemic infection (unless specific therapy is given). Use with caution in a patient with coexisting heart failure, diabetes mellitus, diverticulitis, epilepsy, glaucoma, steroid myopathy, tuberculosis, hypertension, hypothyroidism, peptic ulcers, psychiatric reactions, recent intestinal anastomosis, recent myocardial infarction, severe affective disorders, thromboembolic disorders or ulcerative colitis.
Tocilizumab	IV	8 mg/kg (max dose 800 mg) stat dose	Hypoxaemia with evidence of inflammation but not yet critically ill requiring respiratory support and CRP >75 ng/mL. Within 48 hours of respiratory support (high-flow nasal oxygen, CPAP, NIV or IMV) regardless of CRP level.	Children aged under 12 years old. Patients weighing less than 40 kg. Known hypersensitivity reaction to tocilizumab. Caution if: co-existing infection which might be worsened by IL-6 inhibitor therapy baseline ALT or AST >5 times the upper limit of normal pre-existing condition or treatment resulting in immunosuppression. Not to be used in pregnancy unless clinically necessary.
Sarilumab	IV	400 mg stat dose	As per tocilizumab. To be considered if tocilizumab is not available.	As per tocilizumab plus: platelets <150 x 10⁹/L known hypersensitivity reaction to sarilumab.
Baricitinib	Oral	4 mg OD for up to 14 days	Requiring respiratory support (high-flow nasal oxygen, CPAP, NIV or IMV). To be given as an alternative to tocilizumab or sarilumab.	Lymphocyte count <0.5 x 10⁹/L. Neutrophil count <1 x 10⁹/L. Haemoglobin less than 8 g/dL. Active tuberculosis.
Remdesivir	Oral	200 mg loading dose followed by 100 mg OD for 3 days with mild–moderate disease and for 5 days with severe disease.	Onset of symptoms within 7 days (outpatient) or 10 days (hospitalised due to COVID-19). On low-flow supplemental oxygen.	Children aged under 12 years. Patients weighing less than 40 kg. eGFR <30 mL/min (unless known end-stage renal failure or dialysis). ALT >5 times the upper limit of normal.
Paxlovid	Oral	300 mg nirmatrelvir (PF-07321332) and 100 mg ritonavir BD for 5 days	Adults who do not require supplemental oxygen and are at increased risk for progression to severe COVID-19. Onset of symptoms within 5 days.	Children aged under 18 years. Severe renal or hepatic impairment. Pregnancy. Hypersensitivity to the active substances (nirmatrelvir (PF-07321332) or ritonavir). Concomitant use of drugs highly dependent on CYP3A for clearance or potent inducers of CYP3A, eg amiodarone, apixaban, rivaroxaban, dabigatran, warfarin, clopidogrel, simvastatin, rosuvastatin, digoxin and phenytoin.
Molnupiravir	Oral	800 mg BD for 5 days	Aged ≥18 years. PCR-confirmed infection within 5 days. Onset of symptoms within 5 days. Member of the ‘highest-risk’ group.	Pregnancy. Breastfeeding (to be interrupted during treatment and resumed 4 days after last dose).
Sotrovimab	IV	500 mg stat dose	PCR-confirmed infection within 5 days. Onset of symptoms within 5 days. Member of the ‘highest-risk’ group	Children aged under 12 years. Patients weighing less than 40 kg. A pattern of illness that suggests recovery rather than risk of deterioration. Likely to require hospitalisation in the next 24 hours. Requiring supplemental oxygen for the management of COVID-19 symptoms or increase in baseline oxygen flow rate due to COVID-19. Known hypersensitivity reaction to sotrovimab.

ALT = alanine transaminase; AST = aspartate aminotransferase; BD = twice daily; CPAP = continuous positive airways pressure; CRP = C-reactive protein; eGFR = estimated glomerular filtration rate; IL = interleukin; IMV = invasive mechanical ventilation; IV = intravenous; NIV = non-invasive ventilation; OD = once per day.