Interacciones medicamentosas potenciales en pacientes COVID 19 en tratamiento con lopinavir/ritonavir

Brandariz-Núñez, David; Correas-Sanahuja, Marcelo; Guarc, Eva; Picon, Rafael da Veiga Chaves; García, Bárbara; Gil, Rocio

doi:10.1016/j.medcli.2020.06.026

“…Marginal analysis showed a protecting effect for death in ICU admitted patients with age more than 60. It was a new finding in this study; however, its side effects and drug-drug interactions should be regarded for using in such patients [9]. Some meta-analyses did not show a beneficial effect [10,11].…”

Section: Lopinavir/ritonavir (Kaletra)mentioning

confidence: 88%

Effects of Immune System-Related Medications on COVID-19 Outcome in a Cohort of Iranian Patients: Preliminary Report of a Data Mining Study

Bitaraf

¹

,

Ahmadi

²

,

Gandomi‐Mohammadabadi

³

et al. 2021

Journal of Immunology Research

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Background. Regulation of the immune system is critical for fighting against viral infections. Both suppression and hyperactivity of the immune system result in failure of treatment. The present study was designed to show the effects of immune system-related medications on mortality and length of stay (LOS) in a cohort of Iranian patients with coronavirus disease 2019 (COVID-19). Methods. A data mining study was performed on 6417 cases of COVID-19 covered by 17 educational hospitals of Iran University of Medical Sciences, Tehran. Association of a researcher-designed drug list with death and LOS was studied. For death outcome, logistic regression was used reporting odds ratio (OR) with 95% confidence interval (CI). For LOS, right censored Poisson regression was used reporting incidence rate ratio (IRR) with 95% CI. Results. Among the corticosteroids, prednisolone was a risk factor on death ( OR = 1.41 , 95 % CI = 1.03 − 1.94 ). This association was increased after adjustment of age interactions ( OR = 3.45 , 95 % CI = 1.01 − 11.81 ) and was removed after adjustment of ICU admission interactions ( OR = 2.64 , 95 % CI = 0.70 − 9.92 ). Hydroxychloroquine showed a protecting effect on death ( OR = 0.735 , 95 % CI = 0.627 − 0.862 ); however, this association was removed after adjustment of age interactions ( OR = 0.76 , 95 % CI = 0.41 − 1.40 ). Among the antivirals, oseltamivir showed a protecting effect on death ( OR = 0.628 , 95 % CI = 0.451 − 0.873 ); however, this association was removed after adjustment of age interactions ( OR = 0.45 , 95 % CI = 0.11 − 1.82 ). For reduction of LOS, the only significant association was for hydroxychloroquine ( IRR = 0.85 , 95 % CI = 0.79 − 0.92 ). Conclusion. The results of such data mining studies can be used in clinics until completing the evidence. Hydroxychloroquine may reduce mortality in some specific groups; however, its association may be confounded by some latent variables and unknown interactions. Administration of corticosteroids should be based on the conditions of each case.

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“…Most of the published papers on drug interactions in COVID patients consist of presenting potential interactions to which patients have been exposed after reviewing medical records [30][31][32] (no specific outcome). We have found 2 papers [33,34] with individual descriptions of the clinical cases presented in eTable 31 (use suppInfo).…”

Section: Literature Researchmentioning

confidence: 99%

Drug-drug Interactions between COVID-19 Treatments and Antidepressants, Mood Stabilizers/Anticonvulsants, and Benzodiazepines: Integrated Evidence from 3 Databases

Plasencia-García

¹

,

Rico-Rangel

²

,

Rodríguez-Menéndez

³

et al. 2021

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Introduction The SARS-CoV-2 pandemic with psychiatric comorbidities leads to a scenario in which the use of psychotropic drugs may be required. This requires the support of evidence-based medicine to take into account possible interactions between antidepressants, mood stabilizers, benzodiazepines, and coronavirus infection treatments. Methods Three databases were consulted: (a) Lexicomp Drug Interactions, (b) Micromedex Solutions Drugs Interactions, (c)Liverpool Drug Interaction Group for COVID-19 therapies. The CredibleMeds QTDrugs List was also queried. Hydroxychloroquine, chloroquine, azithromycin, lopinavir-ritonavir, remdesivir, favipiravir, tocilizumab, baricitinib, anakinra, and dexamethasone – drugs used for SARS-CoV-2 – were analyzed, and consensus recommendations are made. Results The potential interactions of agomelatine, desvenlafaxine, duloxetine, milnacipran, and vortioxetine with COVID-19 treatments shall be considered less risky. Antidepressant interactions with hydroxychloroquine, chloroquine, and azithromycin enhance the risk of QT prolongation, and ECG monitoring is advised for most antidepressants. Antidepressants with lopinavir/ritonavir involve multiple CYP enzyme interactions (except with milnacipran). Gabapentin, oxcarbazepine, pregabalin, topiramate, and zonisamide are safe treatment options that have no significant interactions with COVID-19 treatments. Lithium is contraindicated with hydroxychloroquine, chloroquine, and azithromycin. Precaution should be taken in using valproic acid with lopinavir-ritonavir. The use of benzodiazepines does not present a risk of drug interaction with COVID-19 treatments, except lopinavir/ritonavir. Conclusions Clinicians prescribing antidepressants, mood stabilizers/anticonvulsants, and benzodiazepines, should be aware of the probable risk of drug-drug interaction with COVID-19 medications and may benefit from heeding these recommendations for use to ensure patient safety.

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“…Fortunately, the findings indicate that immediate anti-androgen treatment with DUT may succeed to decrease inflammatory responses, viral shedding, time to remission, and severity of SARS-CoV-2 infections ( 8 ). Additionally, the findings also indicate that TAM has potential interactions with the concomitant use of lopinavir/ritonavir in patients with COVID-19, as both are potent inhibitors of CYP3A4 ( 9 ). Hence, due to the vast clinical potential of DUT/TAM, there is an urgent need for simple and economical methods to quantify DUT/TAM in their dosage form.…”

mentioning

confidence: 92%

A New Chemometrically Assisted UV Spectrophotometric Method for Simultaneous Determination of Tamsulosin and Dutasteride in Their Pharmaceutical Mixture

Attia

¹

,

Serag

²

,

Eid

³

et al. 2022

Journal of AOAC INTERNATIONAL

2

0

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Background Tamsulosin (TAM) and dutasteride (DUT) are ranked among the most frequently prescribed therapies in urology. Interestingly, studies have also been carried out on TAM/DUT in terms of their ability to protect against recent COVID-19. However, very few studies were reported for their simultaneous quantification in their combined dosage form and were mainly based on chromatographic analysis. Subsequently, it is very important to offer a simple, selective, sensitive, and rapid method for the quantification of TAM and DUT in their challenging dosage form. Objective In this study, a new chemometrically assisted UV spectrophotometric method has been presented for the quantification of TAM and DUT without any prior separation. Methods For the calibration set, a partial factorial experimental design was used, resulting in 25 mixtures with central levels of 20 and 25 μg/mL for TAM and DUT, respectively. In addition, to assess the predictive ability of the developed approaches, another central composite design of 13 samples was used as a validation set. Post-processing by chemometric analysis of the recorded zero-order UV spectra of these sets has been applied. These chemometric approaches include partial least squares (PLS) and genetic algorithm (GA), as an effective variable selection technique, coupled with PLS. Results The models’ validation criteria displayed excellent recoveries and lower errors of prediction. Conclusion The proposed models were effectively used to determine TAM/DUT in their combined dosage form, and statistical comparison with the reported method revealed satisfactory results. Highlights Overall, this work presents powerful simple, selective, sensitive, and precise methods for simultaneous quantification of TAM/DUT in their dosage form with satisfactory results. The predictive ability and accuracy of the developed methods offer the opportunity to be employed as a quality control technique for the routine analysis of TAM/DUT when chromatographic instruments are not available.

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Interacciones medicamentosas potenciales en pacientes COVID 19 en tratamiento con lopinavir/ritonavir

Cited by 9 publications

References 17 publications

Effects of Immune System-Related Medications on COVID-19 Outcome in a Cohort of Iranian Patients: Preliminary Report of a Data Mining Study

Effects of Immune System-Related Medications on COVID-19 Outcome in a Cohort of Iranian Patients: Preliminary Report of a Data Mining Study

Drug-drug Interactions between COVID-19 Treatments and Antidepressants, Mood Stabilizers/Anticonvulsants, and Benzodiazepines: Integrated Evidence from 3 Databases

A New Chemometrically Assisted UV Spectrophotometric Method for Simultaneous Determination of Tamsulosin and Dutasteride in Their Pharmaceutical Mixture

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