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Emetine is not ipecac: considerations for its use as treatment for SARS-CoV2


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Bleasel, MD and Peterson, GM ORCID: 0000-0002-6764-3882 2020 , 'Emetine is not ipecac: considerations for its use as treatment for SARS-CoV2' , Pharmaceuticals, vol. 13, no. 12 , pp. 1-17 , doi: 10.3390/ph13120428.

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Emetine is a potent antiviral that acts on many viruses in the low-nM range, with severalstudies in animals and humans demonstrating antiviral activity. Historically, emetine was used to treatpatients with Spanish influenza, in the last stages of the pandemic in the early 1900s. Some of thesepatients were “black” with cyanosis. Emetine rapidly reversed the cyanosis and other symptoms ofthis disease in 12–24 h. However, emetine also has been shown to have anti-inflammatory propertiesand it appears it is these anti-inflammatory properties that were responsible for the effects seen inpatients with Spanish influenza. Emetine, in the past, has also been used in 10s to 100s of millions ofpeople at a dose of ~60 mg daily to treat amoebiasis. Based on viral inhibition data we can calculate alikely SARS-CoV2 antiviral dose of ~1/10th the amoebiasis dose, which should dramatically reducethe risk of any side effects. While there are no anti-inflammatory dose response data available,based on the potential mode of action, the anti-inflammatory actions may also occur at low doses.This paper also examines the toxicity of emetine seen in clinical practice and that seen in the laboratory,and discusses the methods of administration aimed at reducing side effects if higher doses werefound to be necessary. While emetine is a “pure drug” as it is extracted from ipecac, some of thedifferences between emetine and ipecac are also discussed.

Item Type: Article
Authors/Creators:Bleasel, MD and Peterson, GM
Keywords: COVID-19, coronavirus, emetine, ipecac, dehydroemetine, treatment, re-purposing, antiviral, anti-inflammatory, toxicity
Journal or Publication Title: Pharmaceuticals
Publisher: MDPI AG
ISSN: 1424-8247
DOI / ID Number: 10.3390/ph13120428
Copyright Information:

Copyright 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

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