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Table 2 Proposed therapeutic regimen for the prophylaxes and treatment of human EBOV infection based on available therapeutic medications and information from in vivo animal testing and in vitro cell culture

From: Human Ebola virus infection in West Africa: a review of available therapeutic agents that target different steps of the life cycle of Ebola virus

Therapeutic regimen based on available medications for ebola virus prophylaxes and treatment

Ebola virus

Available medications

Prophylaxis1

Amiodarone (macrophage, monocyte & endothelial cell)

Post Needle Stick Injury Prophylaxis

IFN-β + amiodarone (macrophage, monocyte & endothelial cell) + toremifene (liver)2,3 + favipiravir4 ± convalescent blood serum

Treatment

Amiodarone (macrophage, monocyte & endothelial cell) + toremifene (liver)2,3 + favipiravir4 + high dose N-acetylcysteine infusion5 + convalescent blood serum + supportive care

  1. 11 ml of blood may contain 10 9 to 10 10 virions in terminally ill patient. Prophylactic amiodarone therapy may protect macrophage, monocyte and endothelial cells immediately from EBOV during needle stick injury and accidental exposure and allow time for the consideration of IFN-β, toremifene, favipiravir and convalescent blood serum therapy.
  2. 2Amiodarone is unable to protect hepatocyte from EBOV infection.
  3. 3Both amiodarone and toremifene can increase the risk of QT prolongation and Torsades de pointes.
  4. 4The recommended dosage for treatment of human EBOV infection may be 2 to 5 times higher than influenza studies. Please confirm the recommended dose with the drug company.
  5. 5N-acetylcysteine intravenous infusion at 100 mg/kg/day to control cytokine dysregulation (e.g. add 5 g of intravenous preparation of N-acetylcysteine into each liter of intravenous replacement fluid).