Explained: which drugs has Donald Trump been prescribed and why?

The coronavirus drugs prescribed to Donald Trump indicate that the president may be battling a more severe case of Covid-19 than the White House is letting on, according to infectious disease experts.

After testing positive for coronavirus last week, Trump has been given a powerful cocktail of medications including antiviral drug remdesivir, a steroid called dexamethasone and a combination of antibodies. The 74-year-old’s doctors say he is also taking zinc, vitamin D, famotidine, melatonin and aspirin, but “it is not clear if any of these are deliberately for Covid 19”, the BBC reports.

The combination of drugs given to the president “may never have been prescribed together to an individual patient”, adds the Financial Times. Indeed, the breadth of medicines being taken by Trump has led some experts to suggest that the US leader may be more unwell than his lead physician, Sean Conley, has admitted.

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Some experts have raised another possibility: that Trump is directing his own treatment, and is demanding drugs that he does not fully understand.

This phenomenon, says the The New York Times, even has a name: “VIP syndrome, which describes prominent figures who receive poor medical care because doctors are too zealous in treating them - or defer too readily to their instructions”.

“You think you’re helping,” Dr Celine Gounder, a clinical assistant professor of medicine and infectious diseases at the NYU Grossman School of Medicine, told the newspaper. “But this is really a data-free zone, and you just don’t know that.”

Either way, “the use of the experimental treatments will have required a careful weighing of the risks, given the possible side-effects and the chance of adverse interactions between the different chemicals”, says the FT.

Dexamethasone

This steroid works by calming the immune system, but a British professor who led the trial of the drug has said that it works best on serious cases of Covid-19 - “adding to fears over the seriousness of the president’s illness”, The Telegraph reports.

“Dexamethasone reduces mortality or improves survival particularly for patients with severe Covid,” Martin Landray, a professor of medicine and epidemiology at the University of Oxford, told the paper.

Monoclonal antibody therapy

Made by US biotechnology company Regeneron, this combination of antibodies mimics the natural human immune response. There is “huge hope it will be effective”, says the BBC, but “the evidence in patients is still very limited and these monoclonals are still classed as an experimental drug”.

“The president is one of only a handful of people outside those trials to undergo the treatment under what is known as ‘compassionate use’,” the broadcaster adds.

Remdesivir

Developed originally as a treatment for Ebola, remdesivir works by disrupting the ability of the virus to copy itself. Clinical trials have shown the drug can cut the duration of Covid symptoms from 15 days to 11, but it is not a life-saving drug.

And the rest

Vitamin D and zinc both have a role in a healthy immune system, but have never been proven to help fight Covid.

Famotidine decreases stomach acid production and is used for people with stomach ulcers or reflux. Meanwhile, melatonin is a hormone that can improve sleep, while aspirin is a pain killer and blood thinner.

Trials to determine whether aspirin could help fight coronavirus have been launched, but no evidence supporting that hope has emerged.