Potential drug-drug interactions in COVID 19 patients in treatment with lopinavir/ritonavir()

Brandariz-Nuñez, David; Correas-Sanahuja, Marcelo; Guarc, Eva; Picón, Rafael; García, Bárbara; Gil, Rocío

OBJECTIVES: To determine the prevalence of potential interactions in COVID19 patients receiving lopinavir/ritonavir (LPV/r). The secondary objective was to develop recommendations and identify the risk factors associated with presenting potential interactions with LPV/r. SUBJECTS AND METHODS: Cross-sectional and multicenter study with the participation of 2 hospitals. COVID 19 patients over 18 years of age, admitted to hospital and under treatment with LPV/r were included. A screening of potential interactions related to LPV/r and home and hospital medication was carried out. Lexicomp® (Uptodate), HIV-drug interactions and COVID-drug interactions were used as the query database. RESULTS: 361 patients with a mean age of 62.77 ± 14.64 years were included, where 59.6% (n = 215) were men. 62.3% (n = 225) had 1 or more potential interactions and 26, 87% (n = 97) 2 or more. The independent variables associated with presenting ≥1 potential interactions were age (> 65) (OR 1.95; 95% CI 1.06-3.59, P = 0.033), ICU admission (OR 9.22; CI 95% 1.98-42.93; P = 0.005), previous respiratory pathology (OR 2.90; 95% CI 1.15-7.36; P = 0.024), psychiatric (OR 4.14; 95 CI % 1.36-12.61; P = 0.013), dyslipidemia (OR 3.21; 95% CI 1.63-6.35; P = 0.001) and the number of drugs prescribed (OR 4.33; 95% CI 2.40-7.81; P = 0.000). CONCLUSION: The prevalence of potential interactions in COVD 19 patient undergoing treatment with LPV/r is high, with age (> 65), ICU admission, previous respiratory and psychiatric pathology, dyslipidemia and the number of prescribed drugs acting as risk factors.