Implications of potential clinically relevant interactions between COVID-19 vaccines and concomitant medications

COVID-19 was announced as a global pandemic in 2020. Several types of COVID-19 vaccines are available such as mRNA vaccines, adenovirus vector vaccines, and protein subunit or inactivated virus vaccines. Vaccines are often administered in patients with chronic diseases who are likely to be treated with several drugs. A growing number of clinical observations indicated the possibility of interactions between COVID-19 vaccines and drugs. A hyperinflammatory state may spark significant imbalances in drug metabolism that may result in the alteration of drug pharmacokinetics and therapeutic response. Furthermore, interactions may result in additive or antagonistic or synergistic vaccine immune response. Information about COVID-19 vaccine-drug interactions is needed by physicians and pharmacists to make rational drug-use decisions. In this review, several individual and categorical evidence-based potential COVID-19 vaccine-drug interactions of clinical importance are described. Vigilance is needed to detect previously unreported COVID-19 drug interactions and to further assess known interactions. The clinical significance of which is not fully determined. Evidence suggests that adverse events to some drugs are rare after COVID-19 vaccination and their possibility should not affect vaccination of patients at risk. Clinicians prescribing medications should be aware of the likely risk of interaction with COVID-19 vaccines and may benefit from taking into account present recommendations of the best measures to avoid consequences of such interactions to preserve vaccine efficacy and patient safety.