RT Journal Article
T1 High rate of major drug-drug interactions of lopinavir-ritonavir for COVID-19 treatment
A1 Macías, Juan
A1 Pinilla, Ana
A1 Lao-Dominguez, Francisco A.
A1 Corma, Anaïs
A1 Contreras-Macias, Enrique
A1 González-Serna, Alejandro
A1 Gutierrez-Pizarraya, Antonio
A1 Fernández-Fuertes, Marta
A1 Morillo-Verdugo, Ramón
A1 Trigo, Marta
A1 Real, Luis M.
A1 Pineda, Juan A.
K1 COVID-19
K1 Antiviral agents
K1 Drug combinations
K1 Drug Interactions
K1 Lopinavir
K1 Ritonavir
K1 Spain
K1 Antivirales
K1 Combinación de medicamentos
K1 Interacciones farmacológicas
K1 Inhibidores de proteasas
K1 España
AB The impact of drug-drug interactions (DDI) between ritonavir-boosted lopinavir (LPV-r) to treat patients with coronavirus disease 2019 (COVID-19) and commonly used drugs in clinical practice is not well-known. Thus, we evaluated the rate and severity of DDI between LPV-r for COVID-19 treatment and concomitant medications. This was a cross-sectional study including all individuals diagnosed of SARS-CoV-2 infection treated with LPV-r and attended at a single center in Southern Spain (March 1st to April 30th, 2020). The frequency [95% confidence interval (95% CI)] of potential and major DDI were calculated. Overall, 469 patients were diagnosed of COVID-19, 125 (27%) of them were prescribed LPV-r. LPV-r had potential DDI with concomitant medications in 97 (78%, 95% CI 69-85%) patients, and in 33 (26%, 95% CI 19-35%) individuals showed major DDI. Twelve (36%) patients with major DDI and 14 (15%) individuals without major DDI died (p = 0.010). After adjustment, only the Charlson index was independently associated with death [adjusted OR (95% CI) for Charlson index ≥ 5: 85 (10-731), p < 0.001]. LPV-r was discontinued due to side effects in 31 (25%) patients. Management by the Infectious Diseases Unit was associated with a lower likelihood of major DDI [adjusted odds ratio (95% CI): 0.14 (0.04-0.53), p = 0.003). In conclusion, a high frequency of DDI between LPV-r for treating COVID-19 and concomitant medications was found, including major DDI. Patients with major DDI showed worse outcomes, but this association was explained by the older age and comorbidities. Patients managed by the Infectious Diseases Unit had lower risk of major DDI.
PB Springer Nature
YR 2020
FD 2020-12-01
LK http://hdl.handle.net/10668/3438
UL http://hdl.handle.net/10668/3438
LA en
NO Macías J, Pinilla A, Lao-Dominguez FA, Corma A, Contreras-Macias E, González-Serna A, et al. High rate of major drug–drug interactions of lopinavir–ritonavir for COVID-19 treatment. Sci Rep. 2020 Dec 1;10(1):20958
DS RISalud
RD Apr 19, 2025