Liverpool Drug Interactions Group Interactions with Experimental COVID-19 Antiviral Therapies

Charts updated 26 January 2021 Page 1 of 5 Please check www.covid19-druginteractions.org for updates. Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister. No recommendation to use experimental therapy for COVID-19 is made. Drug interaction data for many agents are limited or absent; therefore, risk-benefit assessment for any individual patient rests with prescribers.

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ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV Anaesthetics & Muscle Relaxants Antibacterials Alcuronium   Amikacin   Amoxicillin  Cisatracurium  Ampicillin  Desflurane   Dexmedetomidine  Capreomycin  Enflurane  Cefalexin  Ephedrine  Cefazolin   Cefixime  Halothane  Cefotaxime  Isoflurane  Ceftazidime   Ceftriaxone  Minaxolone  Chloramphenicol  Nitrous oxide  Ciprofloxacin  Propofol   Rocuronium   Clavulanic acid  Sevoflurane  Clindamycin  Sufentanil  Clofazimine  Suxamethonium (succinylcholine)  Cloxacillin   Cycloserine  Thiopental  Dapsone  Tizanidine  Delamanid  Vecuronium  Doxycycline  Analgesics Ertapenem  Alfentanil     Ethambutol     Celecoxib  Ethionamide  Codeine      Flucloxacillin   Gentamicin  Diamorphine (diacetylmorphine)   Imipenem/Cilastatin  Diclofenac  Isoniazid  Dihydrocodeine      Kanamycin  Fentanyl   Levofloxacin  Hydrocodone  Linezolid  Hydromorphone  Meropenem   Metronidazole   Moxifloxacin  Metamizole  Nitrofurantoin  Methadone  Ofloxacin  Morphine   Para-aminosalicylic acid  Naproxen  Penicillins   Piperacillin  Oxycodone     Pyrazinamide  Paracetamol (Acetaminophen)  Rifabutin  (Meperidine)       Piroxicam  Rifapentine   Remifentanil  Rifaximin  Tapentadol  Spectinomycin  Tramadol  Streptomycin  Antiarrhythmics Sulfadiazine         Tazobactam   Telithromycin    Tetracyclines   Tinidazole   Trimethoprim/Sulfamethoxazole   Vancomycin  (Lignocaine)     

Key to abbreviations Key to symbols ATV Atazanavir HCLQ Hydroxychloroquine NTZ Nitazoxanide ⚫ These drugs should not be coadministered AZM Azithromycin IFN-β Interferon beta RDV Remdesivir  Potential interaction which may require a dose adjustment or close monitoring Potential interaction likely to be of weak intensity. CLQ Chloroquine IVM Ivermectin RBV Ribavirin Additional action/monitoring or dosage adjustment is unlikely to be required FAVI Favipiravir LPV/r Lopinavir/ritonavir ◆ No clinically significant interaction expected

© Liverpool Drug Interaction Group, University of Liverpool, Pharmacology Research Labs, 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF We aim to ensure that information is accurate and consistent with current knowledge and practice. However, the University of Liverpool and its servants or agents shall not be responsible or in any way liable for the continued currency of information in this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude liability for errors, omissions or inaccuracies to the fullest extent permitted by law. Liverpool Drug Interactions Group Interactions with Experimental COVID-19 Antiviral Therapies

Charts updated 26 January 2021 Page 2 of 5 Please check www.covid19-druginteractions.org for updates. Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister. No recommendation to use experimental therapy for COVID-19 is made. Drug interaction data for many agents are limited or absent; therefore, risk-benefit assessment for any individual patient rests with prescribers.

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ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV Anti-coagulant, Anti-platelet and Fibrinolytic Antidepressants Acenocoumarol  Agomelatine  Apixaban      Argatroban  Bupropion  Aspirin (anti-platelet)  Citalopram  Betrixaban    Clopidogrel   Dabigatran    Dalteparin  Duloxetine  Dipyridamole  Escitalopram  Edoxaban    Enoxaparin  Fluvoxamine  Fondaparinux   Heparin  Lithium  Phenprocoumon  Maprotiline   Prasugrel  Mianserin  Rivaroxaban    Milnacipran  Streptokinase  Mirtazapine  Ticagrelor  Nefazodone   Tinzaparin    Warfarin  Paroxetine  Anticonvulsants Phenelzine    Reboxetine  Clonazepam  Sertraline  Eslicarbazepine  St John’s wort    Tranylcypromine   Trazodone   Trimipramine   Venlafaxine   Vortioxetine   Anti-diabetics Perampanel  Acarbose  Phenobarbital (Phenobarbitone)   Canagliflozin    Dapagliflozin   Dulaglutide    Empagliflozin   Exenatide   (Glyburide)  Sultiame   Tiagabine     (Divalproex)  Insulin  Vigabatrin  Linagliptin   Liraglutide  Metformin   Pioglitazone        Rosiglitazone       Saxagliptin  Sitagliptin   Vildagliptin 

Key to abbreviations Key to symbols ATV Atazanavir HCLQ Hydroxychloroquine NTZ Nitazoxanide ⚫ These drugs should not be coadministered AZM Azithromycin IFN-β Interferon beta RDV Remdesivir  Potential interaction which may require a dose adjustment or close monitoring Potential interaction likely to be of weak intensity. CLQ Chloroquine IVM Ivermectin RBV Ribavirin Additional action/monitoring or dosage adjustment is unlikely to be required FAVI Favipiravir LPV/r Lopinavir/ritonavir ◆ No clinically significant interaction expected

© Liverpool Drug Interaction Group, University of Liverpool, Pharmacology Research Labs, 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF We aim to ensure that information is accurate and consistent with current knowledge and practice. However, the University of Liverpool and its servants or agents shall not be responsible or in any way liable for the continued currency of information in this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude liability for errors, omissions or inaccuracies to the fullest extent permitted by law. Liverpool Drug Interactions Group Interactions with Experimental COVID-19 Antiviral Therapies

Charts updated 26 January 2021 Page 3 of 5 Please check www.covid19-druginteractions.org for updates. Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister. No recommendation to use experimental therapy for COVID-19 is made. Drug interaction data for many agents are limited or absent; therefore, risk-benefit assessment for any individual patient rests with prescribers.

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ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV Antifungals Anxiolytics/Hypnotics/Sedatives Amphotericin B  Alprazolam  Anidulafungin  Bromazepam   Caspofungin  Buspirone  Fluconazole  Chlordiazepoxide  Flucytosine  Clobazam  Griseofulvin  Clorazepate  Isavuconazole    Diazepam   Estazolam   Flunitrazepam  Micafungin  Flurazepam  Miconazole  Hydroxyzine  Nystatin   Posaconazole   Lormetazepam  Terbinafine       Midazolam (oral)  Voriconazole   Midazolam (parenteral)  Antipsychotics/Neuroleptics Oxazepam  Amisulpride  Temazepam  Aripiprazole  Triazolam  Asenapine  Zaleplon     Zolpidem   Zopiclone  Fluphenazine  Beta Blockers  Atenolol  Iloperidone  Bisoprolol  Levomepromazine  Carvedilol  Olanzapine  Metoprolol  Paliperidone      Nebivolol  Perazine  Oxprenolol  Periciazine  Pindolol  Perphenazine     Timolol  Pipotiazine  Bronchodilators Quetiapine   Aclidinium bromide  Risperidone  Aminophylline  Sulpiride  Formoterol    Glycopyrronium bromide  Tiapride  Indacaterol  Ziprasidone  Ipratropium bromide  Zotepine  Montelukast       Zuclopenthixol  Olodaterol       Roflumilast       Salbutamol  Salmeterol  Theophylline  Tiotropium bromide  Umeclidinium bromide      Vilanterol       Blockers         

Key to abbreviations Key to symbols ATV Atazanavir HCLQ Hydroxychloroquine NTZ Nitazoxanide ⚫ These drugs should not be coadministered AZM Azithromycin IFN-β Interferon beta RDV Remdesivir  Potential interaction which may require a dose adjustment or close monitoring Potential interaction likely to be of weak intensity. CLQ Chloroquine IVM Ivermectin RBV Ribavirin Additional action/monitoring or dosage adjustment is unlikely to be required FAVI Favipiravir LPV/r Lopinavir/ritonavir ◆ No clinically significant interaction expected

© Liverpool Drug Interaction Group, University of Liverpool, Pharmacology Research Labs, 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF We aim to ensure that information is accurate and consistent with current knowledge and practice. However, the University of Liverpool and its servants or agents shall not be responsible or in any way liable for the continued currency of information in this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude liability for errors, omissions or inaccuracies to the fullest extent permitted by law. Liverpool Drug Interactions Group Interactions with Experimental COVID-19 Antiviral Therapies

Charts updated 26 January 2021 Page 4 of 5 Please check www.covid19-druginteractions.org for updates. Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister. No recommendation to use experimental therapy for COVID-19 is made. Drug interaction data for many agents are limited or absent; therefore, risk-benefit assessment for any individual patient rests with prescribers.

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VM

ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV ATV AZM CLQ FAVI HCLQ IFN I LPV/r NTZ RDV RBV Contraceptives/HRT Gastrointestinal Agents Desogestrel (COC)    Alosetron  Desogestrel (POP)    Antacids  Bisacodyl  Drospirenone (COC)    Cimetidine  Drospirenone (HRT)     Dydrogesterone (HRT)    Esomeprazole  Estradiol    Famotidine  Ethinylestradiol    Lactulose  Etonogestrel (implant)    Lansoprazole  Etonogestrel (vaginal ring)     Mesalazine     Gestodene (COC)    Omeprazole  Levonorgestrel (COC)    Pantoprazole  Levonorgestrel (emergency contrac.)    Prucalopride  Levonorgestrel (HRT)    Rabeprazole  Levonorgestrel (implant)    Ranitidine  Levonorgestrel (IUD)  Senna  Levonorgestrel (POP)    Gastrointestinal Agents (anti-emetics) Aprepitant  Medroxyprogesterone (depot inj.)  Cyclizine   Medroxyprogesterone (oral)    Dolasetron  Norelgestromin (patch)     Norethisterone (COC)    Dronabinol    Norethisterone (HRT)    Granisetron  Norethisterone (IM depot)   Metoclopramide  Ondansetron  Norethisterone (POP)    Prochlorperazine  Norgestimate (COC)    HCV DAAs Norgestrel (COC)    Elbasvir/Grazoprevir   Norgestrel (HRT)    Glecaprevir/Pibrentasvir  Ulipristal    Ledipasvir/Sofosbuvir    Covid-19 Adjunct Therapies Ombitasvir/Paritaprevir/r  Aspirin (Covid-19 adjunct)  Ombitasvir/Paritaprevir/r + Dasabuvir  Dalteparin (Covid-19 adjunct)  Sofosbuvir  Sofosbuvir/Velpatasvir   Enoxaparin (Covid 19 adjunct)  Sofosbuvir/Velpatasvir/Voxilaprevir  Covid-19 Antiviral Therapies HIV Antiretroviral Therapies Atazanavir     Abacavir   Azithromycin   Albuvirtide   Chloroquine   Atazanavir + ritonavir  Favipiravir  Atazanavir/cobicistat  Hydroxychloroquine   Bictegravir/Emtricitabine/TAF  Darunavir + ritonavir    Interferon beta   Darunavir/cobicistat    Ivermectin  Darunavir/Cobi/Emtricitabine/TAF    Lopinavir/ritonavir   Dolutegravir  Nitazoxanide   Dolutegravir/Lamivudine  Remdesivir  Dolutegravir/Rilpivirine   Ribavirin  Dolutegravir/Abacavir/Lamivudine  Covid-19 Immune Therapies Doravirine   Doravirine/Lamivudine/Tenofovir-DF  Anakinra  Efavirenz    Baricitinib   Elvitegravir/Cobi/Emtricitabine/TAF    Canakinumab   Elvitegravir/Cobi/Emtricitabine/TDF    Colchicine  Emtricitabine  Dexamethasone   Emtricitabine/Tenofovir alafenamide  Hydrocortisone (oral or IV)  Emtricitabine/Tenofovir-DF  Etravirine     Ruxolitinib Ibalizumab-uiyk  Sarilumab  Lamivudine  Tocilizumab  Maraviroc  Covid-19 vaccines  Nevirapine    Antibody therapies *  Raltegravir  * Antibody Therapies: Rilpivirine   Convalescent plasma Rilpivirine/Emtricitabine/TAF  Bamlanivimab Tenofovir-DF  Casirivimab/Imdevimab Zidovudine  Key to abbreviations Key to symbols ATV Atazanavir HCLQ Hydroxychloroquine NTZ Nitazoxanide ⚫ These drugs should not be coadministered AZM Azithromycin IFN-β Interferon beta RDV Remdesivir  Potential interaction which may require a dose adjustment or close monitoring Potential interaction likely to be of weak intensity. CLQ Chloroquine IVM Ivermectin RBV Ribavirin Additional action/monitoring or dosage adjustment is unlikely to be required FAVI Favipiravir LPV/r Lopinavir/ritonavir ◆ No clinically significant interaction expected

© Liverpool Drug Interaction Group, University of Liverpool, Pharmacology Research Labs, 1st Floor Block H, 70 Pembroke Place, LIVERPOOL, L69 3GF We aim to ensure that information is accurate and consistent with current knowledge and practice. However, the University of Liverpool and its servants or agents shall not be responsible or in any way liable for the continued currency of information in this publication whether arising from negligence or otherwise howsoever or for any consequences arising therefrom. The University of Liverpool expressly exclude liability for errors, omissions or inaccuracies to the fullest extent permitted by law. Liverpool Drug Interactions Group Interactions with Experimental COVID-19 Antiviral Therapies

Charts updated 26 January 2021 Page 5 of 5 Please check www.covid19-druginteractions.org for updates. Please note that if a drug is not listed it cannot automatically be assumed it is safe to coadminister. No recommendation to use experimental therapy for COVID-19 is made. Drug interaction data for many agents are limited or absent; therefore, risk-benefit assessment for any individual patient rests with prescribers.

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ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV ATV AZM CLQ FAVI HCLQ IFN IVM LPV/r NTZ RDV RBV Hypertension / Agents Immunosuppressants Aliskiren    Adalimumab  Ambrisentan    Anti-thymocyte globulin   Azathioprine  Benazepril  Basiliximab  Bendroflumethiazide  Belatacept  Bosentan   Candesartan  Mycophenolate  Captopril  Pirfenidone   Chlortalidone  Sirolimus  Cilazapril  Tacrolimus  Clonidine  Inotropes & Vasopressors Dopamine  Adrenaline (Epinephrine)  Doxazosin  Dobutamine  Enalapril  Noradrenaline  Eplerenone  Vasopressin  Epoprostenol  Lipid Lowering Agents Eprosartan  Atorvastatin  Fosinopril    Bezafibrate   Clofibrate  Hydralazine  Evolocumab  Hydrochlorothiazide  Ezetimibe  Iloprost  Fenofibrate  Indapamide  Fish oils  Irbesartan    Fluvastatin  Isosorbide dinitrate  Gemfibrozil    Ivabradine  Lovastatin  Labetalol  Pitavastatin   Pravastatin  Lercanidipine  Rosuvastatin  Lisinopril  Simvastatin  Losartan    Other Macitentan  Allopurinol         Methyldopa  Eltrombopag  Metolazone  Levothyroxine   Moxonidine  Oseltamivir  Olmesartan  Steroids Perindopril  Beclometasone  Prazosin  Betamethasone  Quinapril  Budesonide  Ramipril  Ciclesonide   Clobetasol  Riociguat  Fludrocortisone  Sacubitril  Flunisolide  Selexipag  Fluocinolone  Sildenafil (PAH)  Fluticasone  Sodium nitroprusside  Hydrocortisone (topical)  Spironolactone  Megestrol acetate  Tadalafil (PAH)  Methylprednisolone  Telmisartan  Mometasone  Terazosin  Nandrolone  Torasemide   Oxandrolone  Trandolapril  Prednisolone  Treprostinil  Prednisone  Valsartan  Stanozolol  Xipamide  Testosterone  Triamcinolone 

Key to abbreviations Key to symbols ATV Atazanavir HCLQ Hydroxychloroquine NTZ Nitazoxanide ⚫ These drugs should not be coadministered AZM Azithromycin IFN-β Interferon beta RDV Remdesivir  Potential interaction which may require a dose adjustment or close monitoring Potential interaction likely to be of weak intensity. CLQ Chloroquine IVM Ivermectin RBV Ribavirin Additional action/monitoring or dosage adjustment is unlikely to be required FAVI Favipiravir LPV/r Lopinavir/ritonavir ◆ No clinically significant interaction expected

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