Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice
Cardiovascular disease is associated with progression to severe COVID-19 and patients with the condition are among those in whom early antiviral therapy should be warranted. The combination of nirmatrelvir/ritonavir (Paxlovid®) has been approved for clinical use by the Food and Drug Administration a...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2024-08-01
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| Series: | European Cardiology Review |
| Online Access: | https://www.ecrjournal.com/articleindex/ecr.2024.04 |
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| author | Andrea Di Lenarda Nicola Ferri Massimiliano Lanzafame Eva Agostina Montuori Luciano Pacelli |
| author_facet | Andrea Di Lenarda Nicola Ferri Massimiliano Lanzafame Eva Agostina Montuori Luciano Pacelli |
| author_sort | Andrea Di Lenarda |
| collection | DOAJ |
| description | Cardiovascular disease is associated with progression to severe COVID-19 and patients with the condition are among those in whom early antiviral therapy should be warranted. The combination of nirmatrelvir/ritonavir (Paxlovid®) has been approved for clinical use by the Food and Drug Administration and European Medicines Agency. Because patients with cardiovascular disease are often on polypharmacy, physicians need to be aware of potential drug–drug interactions (DDIs) when treating COVID-19 with nirmatrelvir/ritonavir. Guidance is given for avoiding DDIs, emphasising that preventing and managing potential DDIs with nirmatrelvir/ritonavir requires thorough assessment and knowledge. The present review summarises the clinical pharmacology of nirmatrelvir/ritonavir and provides details on potential DDIs with a focus on daily practice in patients with cardiovascular disease. Particular attention is needed for drugs that are predominantly metabolised by cytochrome P450 3A4, are substrates of P-glycoprotein and have a narrow therapeutic index. Proper management of potential DDIs must balance the benefit of nirmatrelvir/ritonavir to prevent severe disease with the risk of serious adverse events. |
| format | Article |
| id | doaj-art-a855a7cb71f94b61adfa0f8095c15e3a |
| institution | Kabale University |
| issn | 1758-3756 1758-3764 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | European Cardiology Review |
| spelling | doaj-art-a855a7cb71f94b61adfa0f8095c15e3a2024-12-14T16:05:12ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642024-08-011910.15420/ecr.2024.04Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily PracticeAndrea Di Lenarda0Nicola Ferri1Massimiliano Lanzafame2Eva Agostina Montuori3Luciano Pacelli4Cardiovascular Center, Territory Specialist Department, Azienda Sanitaria Universitaria Giuliano Isontina – ASUGI, Trieste, ItalyDepartment of Medicine, University of Padova, Padua, Italy; Veneto Institute of Molecular Medicine (VIMM), Padua, ItalyMedical Department, Infectious Diseases Unit, Santa Chiara Hospital, APSS, Trento, ItalyMedical Department, Pfizer, Rome, ItalyMedical Department, Pfizer, Rome, ItalyCardiovascular disease is associated with progression to severe COVID-19 and patients with the condition are among those in whom early antiviral therapy should be warranted. The combination of nirmatrelvir/ritonavir (Paxlovid®) has been approved for clinical use by the Food and Drug Administration and European Medicines Agency. Because patients with cardiovascular disease are often on polypharmacy, physicians need to be aware of potential drug–drug interactions (DDIs) when treating COVID-19 with nirmatrelvir/ritonavir. Guidance is given for avoiding DDIs, emphasising that preventing and managing potential DDIs with nirmatrelvir/ritonavir requires thorough assessment and knowledge. The present review summarises the clinical pharmacology of nirmatrelvir/ritonavir and provides details on potential DDIs with a focus on daily practice in patients with cardiovascular disease. Particular attention is needed for drugs that are predominantly metabolised by cytochrome P450 3A4, are substrates of P-glycoprotein and have a narrow therapeutic index. Proper management of potential DDIs must balance the benefit of nirmatrelvir/ritonavir to prevent severe disease with the risk of serious adverse events.https://www.ecrjournal.com/articleindex/ecr.2024.04 |
| spellingShingle | Andrea Di Lenarda Nicola Ferri Massimiliano Lanzafame Eva Agostina Montuori Luciano Pacelli Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice European Cardiology Review |
| title | Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice |
| title_full | Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice |
| title_fullStr | Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice |
| title_full_unstemmed | Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice |
| title_short | Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice |
| title_sort | cardiovascular drug interactions with nirmatrelvir ritonavir for covid 19 considerations for daily practice |
| url | https://www.ecrjournal.com/articleindex/ecr.2024.04 |
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