Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun 30;2021(2):e202111.
doi: 10.21542/gcsp.2021.11.

Cardiovascular adverse effects of lopinavir/ritonavir and hydroxychloroquine in COVID-19 patients: Cases from a single pharmacovigilance centre

Ioanna Istampoulouoglou  1   2 , Barbara Zimmermanns  1   3   2 , Tanja Grandinetti  1   2 , Catia Marzolini  4   2 , Annette Harings-Kaim  3   2 , Sarah Koechlin-Lemke  1   3   2 , Irene Scholz  5 , Stefano Bassetti  6   2 , Anne B Leuppi-Taegtmeyer  1   3   2
Affiliations
Review

Cardiovascular adverse effects of lopinavir/ritonavir and hydroxychloroquine in COVID-19 patients: Cases from a single pharmacovigilance centre

Ioanna Istampoulouoglou et al. Glob Cardiol Sci Pract. .

Abstract

In this article we summarize the cardiovascular adverse events that were observed in three patients during their treatment for COVID-19 and discuss their association with lopinavir/ ritonavir (LPV/r) and hydroxychloroquine (HCQ). The cases were reported to our regional pharmacovigilance centre in April 2020. All three patients were above 75 years in age, male and multimorbid, and had been hospitalized for treatment of COVID-19. As part of their treatment, all of them received a very strictly monitored off-label therapy with LPV/r and HCQ, for which they had given their prior, written, informed consent. In one patient, erythromycin was also administered. All three patients developed a significant QTc time prolongation during or shortly after therapy with the above drugs. On account of this, the treatment had to be discontinued early in each case and QTc time recovered in all three patients.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Major pathways of hydroxychloroquine metabolism.
See this image and copyright information in PMC

References

    1. Repurposed antiviral drugs for Covid-19—Interim WHO solidarity trial results. New England Journal of Medicine. 2021;384(6):497–511. doi: 10.1056/NEJMoa2023184. doi: 10.1056/NEJMoa2023184. - DOI - DOI - PMC - PubMed
    1. de Barros CM, Almeida CA de F, Pereira B, Costa KCM, Pinheiro FA, Maia LDB, Trindade CM, Garcia RCT, Torres LH, Diwan S, Boralli VB. COVID-19 Pandemic—A narrative review of the potential roles of chloroquine and hydroxychloroquine. Pain Physician. 2020;23(4S):S351–S366. - PubMed
    1. Osborne V, Davies M, Lane S, Evans A, Denyer J, Dhanda S, Roy D, Shakir S. Lopinavir-Ritonavir in the treatment of COVID-19: A dynamic systematic benefit-risk assessment. Drug Saf. 2020;43(8):809–821. doi: 10.1007/s40264-020-00966-9. doi: 10.1007/s40264-020-00966-9. - DOI - DOI - PMC - PubMed
    1. Khatib R, Sabir FRN, Omari C, Pepper C, Tayebjee MH. Managing drug-induced QT prolongation in clinical practice. Postgraduate Medical Journal. 2020 doi: 10.1136/postgradmedj-2020-138661. doi: 10.1136/postgradmedj-2020-138661. - DOI - DOI - PMC - PubMed
    1. Marzolini C, Stader F, Stoeckle M, Franzeck F, Egli A, Bassetti S, Hollinger A, Osthoff M, Weisser M, Gebhard CE, Baettig V, Geenen J, Khanna N, Tschudin-Sutter S, Mueller D, Hirsch HH, Battegay M, Sendi P. Effect of systemic inflammatory response to SARS-CoV-2 on lopinavir and hydroxychloroquine plasma concentrations. Antimicrob Agents Chemother. 2020;64(9) doi: 10.1128/AAC.01177-20. doi: 10.1128/AAC.01177-20. - DOI - DOI - PMC - PubMed

LinkOut - more resources