Drug interaction risk between cardioprotective drugs and drugs used in treatment of COVID-19: A evidence-based review from six databases

Abstract

Background and aims: This Review discusses the potential drug interactions risk between Drugs used in treating COVID-19 infection and Drugs used in treating comorbid conditions (Diabetes, hypertension, cardiovascular illness).

Method: Six Databases were consulted a) Micromedex drug interaction b) Medicine complete.com c) Liverpool Drug Interaction Group for COVID-19 therapies d) Epocrates e) Medscape f) drugs.com. To acquire information on possible interaction effects between drugs used for COVID-19 treatment such as atazanavir, lopinavir/ritonavir, remdesivir, molnupiravir, paxlovid(nirmatrelvir/ritonavir), dexamethasone, azithromycin, chloroquine, and FDA approved monoclonal antibodies with primarily used antidiabetic drugs, antihypertensive drugs, and drugs acting on the cardiovascular system.

Results: Potential interaction effects such as worsening glycemic control were prominent with lopinavir/ritonavir and the primarily used antidiabetic drugs, which needs dosage adjustment and close monitoring. The risk of hypotension and irregular heart rhythm is the potential interaction effects with concomitant use of drugs for COVID-19 treatment and antihypertensive drugs. Caution is advised with drugs such as atazanavir and lopinavir/ritonavir when concomitantly used in treating comorbid conditions. Drugs such as remdesivir, molnupiravir, and some monoclonal antibodies are safer in use with drugs used in treating the comorbid condition.

Conclusions: Drug-drug interaction remains one of the significant factors in altering the therapeutic efficacy. Drugs used to manage comorbid conditions may influence the COVID-19 treatment with potential interaction effects. These enhance the view on safety concerns about the drug interaction risk in managing COVID-19 infection in patients with comorbid conditions. This primary evidence may concern preventing potential or unintentional effects resulting from Drug-drug interaction, Improving patient quality of life.

Keywords: COVID- 19 treatment; COVID-19; Comorbidity; Drug-drug interaction; Polypharmacy.