Is ivermectin–Azithromycin combination the next step for COVID-19?

Abstract

Different experimental and approved drugs were tested for coronavirus infection disease (COVID-19) to detect effective one that attenuates or prevents the pathogenesis of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Repurposing of old approved drugs with the potential arrhythmogenic effect such as chloroquine in COVID-19 may increase the risk of sudden cardiac death due to torsadogenic potential. The Food and Drug Administration approved the drugs, such as ivermectin, which can kill SARS-CoV-2 within 48 h. Azithromycin augments the antiviral activity of chloroquine in COVID-19 with a high risk of morbidity and mortality through torsadogenic potential. There were no obvious interactions between ivermectin and azithromycin and without risk of torsadogenic effect despite the prolongation of QT by azithromycin. Therefore, azithromycin–ivermectin is regarded as an effectual combo for COVID-19 in elderly patients with underlying cardiac abnormalities.