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.
β β
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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 Bupivacaine Amoxicillin Cisatracurium Ampicillin Desflurane Bedaquiline Dexmedetomidine Capreomycin Enflurane Cefalexin Ephedrine Cefazolin Etidocaine Cefixime Halothane Cefotaxime Isoflurane Ceftazidime Ketamine Ceftriaxone Minaxolone Chloramphenicol Nitrous oxide Ciprofloxacin Propofol Clarithromycin Rocuronium Clavulanic acid Sevoflurane Clindamycin Sufentanil Clofazimine Suxamethonium (succinylcholine) Cloxacillin Tetracaine Cycloserine Thiopental Dapsone Tizanidine Delamanid Vecuronium Doxycycline Analgesics Ertapenem Alfentanil Erythromycin Aspirin Ethambutol Buprenorphine Celecoxib Ethionamide Codeine Flucloxacillin Dextropropoxyphene Gentamicin Diamorphine (diacetylmorphine) Imipenem/Cilastatin Diclofenac Isoniazid Dihydrocodeine Kanamycin Fentanyl Levofloxacin Hydrocodone Linezolid Hydromorphone Meropenem Ibuprofen Metronidazole Mefenamic acid Moxifloxacin Metamizole Nitrofurantoin Methadone Ofloxacin Morphine Para-aminosalicylic acid Naproxen Penicillins Nimesulide Piperacillin Oxycodone Pyrazinamide Paracetamol (Acetaminophen) Rifabutin Pethidine (Meperidine) Rifampicin Piroxicam Rifapentine Remifentanil Rifaximin Tapentadol Spectinomycin Tramadol Streptomycin Antiarrhythmics Sulfadiazine Amiodarone Tazobactam Bepridil Telithromycin Digoxin Tetracyclines Disopyramide Tinidazole Dofetilide Trimethoprim/Sulfamethoxazole Flecainide Vancomycin Lidocaine (Lignocaine) Mexiletine Propafenone Quinidine
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.
β β
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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 Amitriptyline Argatroban Bupropion Aspirin (anti-platelet) Citalopram Betrixaban Clomipramine Clopidogrel Desipramine Dabigatran Doxepin Dalteparin Duloxetine Dipyridamole Escitalopram Edoxaban Fluoxetine Enoxaparin Fluvoxamine Fondaparinux Imipramine Heparin Lithium Phenprocoumon Maprotiline Prasugrel Mianserin Rivaroxaban Milnacipran Streptokinase Mirtazapine Ticagrelor Nefazodone Tinzaparin Nortriptyline Warfarin Paroxetine Anticonvulsants Phenelzine Carbamazepine Reboxetine Clonazepam Sertraline Eslicarbazepine St John’s wort Ethosuximide Tranylcypromine Gabapentin Trazodone Lacosamide Trimipramine Lamotrigine Venlafaxine Levetiracetam Vortioxetine Oxcarbazepine Anti-diabetics Perampanel Acarbose Phenobarbital (Phenobarbitone) Canagliflozin Phenytoin Dapagliflozin Pregabalin Dulaglutide Primidone Empagliflozin Retigabine Exenatide Rufinamide Glibenclamide (Glyburide) Sultiame Gliclazide Tiagabine Glimepiride Topiramate Glipizide Valproate (Divalproex) Insulin Vigabatrin Linagliptin Zonisamide Liraglutide Metformin Nateglinide Pioglitazone Repaglinide Rosiglitazone Saxagliptin Sitagliptin Tolbutamide 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.
β β
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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 Itraconazole Estazolam Ketoconazole Flunitrazepam Micafungin Flurazepam Miconazole Hydroxyzine Nystatin Lorazepam Posaconazole Lormetazepam Terbinafine Midazolam (oral) Voriconazole Midazolam (parenteral) Antipsychotics/Neuroleptics Oxazepam Amisulpride Temazepam Aripiprazole Triazolam Asenapine Zaleplon Chlorpromazine Zolpidem Clozapine Zopiclone Fluphenazine Beta Blockers Haloperidol Atenolol Iloperidone Bisoprolol Levomepromazine Carvedilol Olanzapine Metoprolol Paliperidone Nebivolol Perazine Oxprenolol Periciazine Pindolol Perphenazine Propranolol Pimozide Timolol Pipotiazine Bronchodilators Quetiapine Aclidinium bromide Risperidone Aminophylline Sulpiride Formoterol Thioridazine Glycopyrronium bromide Tiapride Indacaterol Ziprasidone Ipratropium bromide Zotepine Montelukast Zuclopenthixol Olodaterol Roflumilast Salbutamol Salmeterol Theophylline Tiotropium bromide Umeclidinium bromide Vilanterol Calcium Channel Blockers Amlodipine Diltiazem Felodipine Nicardipine Nifedipine Nisoldipine Nitrendipine Verapamil
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.
β β
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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) Cisapride Dydrogesterone (HRT) Esomeprazole Estradiol Famotidine Ethinylestradiol Lactulose Etonogestrel (implant) Lansoprazole Etonogestrel (vaginal ring) Loperamide 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) Domperidone 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.
β β
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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 / Heart Failure Agents Immunosuppressants Aliskiren Adalimumab Ambrisentan Anti-thymocyte globulin Amiloride Azathioprine Benazepril Basiliximab Bendroflumethiazide Belatacept Bosentan Ciclosporin 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 Furosemide Clofibrate Hydralazine Evolocumab Hydrochlorothiazide Ezetimibe Iloprost Fenofibrate Indapamide Fish oils Irbesartan Fluvastatin Isosorbide dinitrate Gemfibrozil Ivabradine Lovastatin Labetalol Pitavastatin Lacidipine 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 Ranolazine 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
© 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.