A Review on Repurposed Drugs in Covid-19 Management: A Pharmaceutical and Clinical Perspective

The COVID-19 pandemic, caused by SARS-CoV-2 in late 2019, created an urgent need for immediate treatments in the absence of specific vaccines and antivirals, making drug repurposing the most feasible strategy. This review evaluates the clinical utility of repurposed therapeutics for COVID-19 and emphasizes the vital role of pharmacy professionals. Initially, treatment was based on in-vitro evidence using antivirals, antimalarials, and antibiotics; however, as understanding of the disease progressed, management became more targeted. Antivirals like remdesivir and nirmatrelvir/ritonavir were used to control early viral replication, while immunomodulators such as dexamethasone, tocilizumab, and baricitinib proved life-saving in severe cases by controlling hyperinflammation. Additionally, anticoagulants addressed the thrombotic complications and monoclonal antibodies benefited high-risk outpatients. Furthermore, the review focuses on the safety, adverse effects, and the significant contributions of clinical pharmacists in dose optimization, drug interaction management, and pharmacovigilance, alongside pharmaceutical scientists who ensured formulation and supply chain stability. Despite challenges like the early use of ineffective drugs and inequitable global access, adaptive trials provided rapid evidence. Ultimately, lessons from COVID-19 repurposing offer a valuable blueprint for future pandemics through prepared drug libraries, AI-based screening, and permanent trial networks to build a more resilient healthcare system.