Potential clinically significant life-threatening drug-drug interactions
of lopinavir and ritonavir used in the treatment of COVID-19
Abstract
Aims: Lopinavir (LPV) and ritonavir (RTV) is using as combination
therapy for combating COVID-19 in considerable proportion of patients.
However, the potential clinically significant life-threatening drug-drug
interactions (DDIs) of this combination antiviral therapy used in the
treatment of COVID-19 patients is not systematically reviewed. It was
aimed to identify severe DDI pairs of LPV/RTV from international
resources predicted to cause life-threatening adverse drug reactions
(ADRs) and cross-compared between the resources. Methods: Severe DDI
pairs predicted to cause life-threatening ADRs were identified from the
FDA and Liverpool COVID-19 prescribing information of LPV/RTV. Results:
In total, 62 severe DDI pairs were identified from the FDA and Liverpool
COVID-19 drug interactions resources predicted to cause life-threatening
ADRs in patients with COVID-19. Of these, seven unique DDI pairs were
identified from the FDA only whereas 45 unique DDI pairs were identified
from the Liverpool COVID-19 drug interactions resource. Of interest,
only 10 DDI pairs were recognized by both of these drug interaction
resources. Conclusion: Clinicians should not entirely rely on any
individual DDI resource for checking life threatening ADRs of LPV/RTV in
patients with COVID-19 since there were discrepancies in enlisting
contraindicated drugs.