Primary

Care Telemedicine TREATMENT recommendation for COVID-19 patients

BUDAPEST+ COVID PROTOCOL (by Dr. Rago and Dr. Merenyi)
For mild and moderate COVID symptoms, T < 39,5C, spO2 >= 92%, in COPD spO2 >= 86%, 50/min < P < 110/min, 80/50Hgmm <BP< 180/110 Hgmm and . All
symptoms must be evaluted individually, knowing the patient's medical history and medications.
Tele-consult (videocall, phone,
email, texting) with your
afternoon duration of treatment
patients 2 times a day until morning noon evening food contraindications (C) precautions (P)
(16 pm) in day
symptom's resign. Call 112 in
case of emergency.
Avoid products in case of allergy for
Basic drugs and supplements (combination of 7) for all Covid positive pts with mild-moderate symptoms any compounds
Antivirals. Should be indicated promtly after confirmation of Covid-19 by either RT-PCR or Antigen tests or only by specific symptoms.
C: pregnancy, lactating, cumarins, body
3-7 days. Usually you weight under 15 kg, damaged BBB (blood-
should administer brain barrier), like encephalitis,
ivermectin for as many meningitis, brain tumor, post-stroke
days as many elapse status P: avoid alcohol
between the first consumption within 48 hr before, after
symptoms and first and during taking ivermectin, avoid
Ivermectin (mg/kg) 0,2 (mean: 12 mg/day) after fatty food intake of ivermectin. coffein during medication
and/or

P: known heart disease, arythmia, K, Mg

imbalance, epilepsy, eye disease,
uncontrolled diabetes. Monitor pts when
given with medicines prolong the QT
interval. Might increase liver enzymes.
hydroxchloroquine (mg) 200 200 after food 5 Might lower blood sugar.
or

Day 1: 1600 mg, Day 1: 1600 mg,

favipiravir (mg) Days 2-5: 600 mg Days 2-5: 600 mg after food 5 check safety data in studies

Antibiotics with antiviral effect

5 days and then + 5 days
if respiratory symptoms
Doxycyclin (mg) 100 100 after food persist check the drug's SmPC
or
azithromycin (mg) 250 250 after food 5 check the drug's SmPC

Vitamins, minerals,
antiplatelets, probiotics
D vitamin (NE) 3000 3000 after food 14 check precautions

P: not recommended to take longer then 14

Zink (mg) 50 50 after food 14 days, or pause for 2 weeks and then restart
take always after food check other
C vitamin (mg) 1000 1000 after food 14 precautions

Aspirin (mg) 100 100 after food 10 check the drug's SmPC
Clopidogrel in case of aspirin allergy
or aspirin non-responders 75 after food 10 check the drug's SmPC
Probiotics per os (minimum
0,5-1Billion/dose) 1 14 check precautions if any
 Avoid products in case of allergy for
+ Individual medication by symptoms any compounds
afternoon duration of treatment
morning noon evening food
(16 pm) in day
FEVER: in case of body temperature
is once above 37,5 C
paracetamol (mg) 500 500 after food 3-5 days or until needed check the drug's SmPC

Gastrointestinal symptoms
famotidine (mg) (in case of nausea,
diarrhea, stomach and abdominal 2-3 days or until
dyscomfort) 20 20 20 mins before food sypmtoms last check the drug's SmPC
For kids: 1mg/10kg 3x a day P: decrease
metoclopramid (mg) (loss of
1-2 days or until the dose in case of liver and kidney
appetite, anorexia)
10 10 10 before food sypmtoms last diseases.

Respiratory symptoms
N-acetyl-cystein (mg) (cough/dry 5-7 days or until
cough) 200 200 200 after food sypmtoms last check the drug's SmPC
inhalative steroid (like fluticasone
250 mcg/dose) (initiate after 4-5 5-7 days or until P: rinse mouth with water after each
days of cough, or at any dyspnoe) 1 1 not relevant sypmtoms last administration of inhaled steroids
azelastin nasal spray (1 puff: 0,14
mg, 1-1 puff 2 times a day) (loss of 1-3 days or until
taste and smell) 1-1 1-1 not relevant sypmtoms last check the drug's SmPC
warm steam inhalation with
menthol oil in case of cough or extra
mucous in the respiratory tract
(minutes) 10 10 10 before food 7 P: avoid hot steam

thrombolytics (in case of elevated D-

dimer and pts at risk of thrombo-
embolism)
in case of patient on aspirin/clopidrogel
as DVT antiplatelet treatment consult with the
LMWH (NE) prophylaxis not relevant until recovery cardiologist/neurologist
in case of patient on aspirin/clopidrogel
as DVT antiplatelet treatment consult with the
NOACs prophylaxis not relevant until recovery cardiologist/neurologist
 Avoid products in case of allergy for
PROPHYLAXIS for asymptomatic COVID positives and close COVID contacts any compounds
afternoon duration of treatment
morning noon evening food
(16 pm) in day

Optional: oral gargels with listerin

mint mouth wash (minutes) 1/2 1/2 1/2 30 mins after food 7 P. Do not overdo
C: pregnancy, lactating, cumarins, body
weight under 15 kg, damaged BBB (blood-
brain barrier), like encephalitis,
meningitis, brain tumor, post-stroke
status P: avoid alcohol
consumption within 48 hr before, after
and during taking ivermectin, avoid
Ivermectin (mg/kg) 0,2 (mean: 12 mg/day) after fatty food Day 1 and Day 3 coffein during medication
P: not recommended to take longer then
14 days, or pause for 2 weeks and then
Zink (mg) 50 50 after food 14 restart

Avoid products in case of allergy for

Prolonged PROPHYLAXIS for people at high risk (like healthcare workers) any compounds
C: pregnancy, lactating, cumarins, body
weight under 15 kg, damaged BBB (blood-
brain barrier), like encephalitis,
meningitis, brain tumor, post-stroke
Once in every week for status P: avoid alcohol
HCWs in Covid wards. consumption within 48 hr before, after
Once in every 2 weeks and during taking ivermectin, avoid
Ivermectin (mg/kg) 0,2 (mean: 12 mg/day) after fatty food for others. coffein during medication
P: 7 days on then 7 days off, repeat it until
Zink (mg) 50 50 after food 7 IVM is taken