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Drug interactions: a review of the unseen danger of experimental COVID-19 therapies

Daryl Hodge1, Fiona Marra1,2, Catia Marzolini1,3,4

  • 1Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.

The Journal of Antimicrobial Chemotherapy
|August 5, 2020
PubMed

Insights

Experimental COVID-19 therapies pose drug-drug interaction risks, especially lopinavir/ritonavir and hydroxychloroquine. Careful medication review and management can mitigate these serious risks in critically ill patients.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic has led to the use of experimental therapies.
  • Assessing drug-drug interactions (DDIs) is crucial for managing severely ill COVID-19 patients.

Purpose of the Study:

  • To evaluate the risk of DDIs among experimental COVID-19 treatments.
  • To identify specific drugs with high interaction potential.

Main Methods:

  • Searched ClinicalTrials.gov for experimental COVID-19 therapies (249 drugs identified).
  • Screened 13 primary compounds against 512 comedications for DDIs.
  • Evaluated interactions based on pharmacokinetics, toxicity, and QT prolongation risk.

Main Results:

  • Experimental therapies present significant DDI risks.
  • Lopinavir/ritonavir (10% RED, 41% AMBER) and hydroxychloroquine (7% RED, 27% AMBER) showed the highest risks.
  • Interactions primarily involved pharmacokinetic issues and QT prolongation.

Conclusions:

  • Experimental COVID-19 drugs carry substantial DDI risks.
  • Lopinavir/ritonavir and hydroxychloroquine require careful monitoring.
  • A DDI resource is available to aid medication review for critically ill patients.

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