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This quadruple combination therapy regimen was evaluated in a Phase 3 investigator-initiated clinical trial (NCT04673214) for the early intervention treatment of mild COVID-19 in patients with comorbidities. The regimen consists of four repurposed small molecule drugs: azithromycin (a macrolide antibiotic), ivermectin (an antiparasitic agent), rivaroxaban (an oral Factor Xa inhibitor anticoagulant), and paracetamol (an analgesic and antipyretic). The study, led by Dr. Gilberto Cruz Arteaga at the Instituto Mexicano del Seguro Social (IMSS) in Mexico, aimed to determine if the addition of ivermectin to a standard triple therapy of azithromycin, rivaroxaban, and paracetamol could produce a 25% or greater improvement in clinical evolution and symptom resolution over a 14-day follow-up period. The components target different aspects of the disease, including potential viral replication, secondary bacterial infections, COVID-19-associated coagulopathy, and symptomatic relief of fever and pain.
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