Interactions with Experimental COVID-19 Therapies

Liverpool Drug Interactions Group Interactions with Experimental COVID-19 Therapies

Charts updated 3 April 2020 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

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

Key to abbreviations Key to symbols ATV Atazanavir CLQ Chloroquine  These drugs should not be coadministered LPV/r Lopinavir/ritonavir HCLQ Hydroxychloroquine  Potential interaction - may require close monitoring, alteration of drug dosage or timing of administration RDV Remdesivir RBV Ribavirin Potential interaction likely to be of weak intensity. FAVI Favipiravir TCZ Tocilizumab Additional action/monitoring or dosage adjustment is unlikely to be required IFN-β Interferon beta  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 Therapies

Charts updated 3 April 2020 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

- - ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN 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   Eltrombopag  Fluvoxamine   Enoxaparin  Imipramine  Fondaparinux  Lithium  Heparin  Maprotiline  Phenprocoumon   Mianserin   Prasugrel   Milnacipran  Rivaroxaban     Mirtazapine  Streptokinase  Nefazodone  Ticagrelor   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  Exanatide  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 

Charts updated 3 April 2020 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

- - ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN Antifungals Antivirals - Covid Amphotericin B  Atazanavir     Anidulafungin  Lopinavir/ritonavir    Caspofungin  Remdesivir    Fluconazole    Favipiravir    Flucytosine  Chloroquine     Griseofulvin  Hydroxychloroquine     Isavuconazole    Ribavirin    Itraconazole    Tocilizumab    Ketoconazole    Interferon beta   Micafungin  Antivirals - HCV DAAs Miconazole  Elbasvir/Grazoprevir  Nystatin  Glecaprevir/Pibrentasvir  Posaconazole    Ledipasvir/Sofosbuvir   Terbinafine   Ombitasvir/Paritaprevir/r  Voriconazole    Ombitasvir/Paritaprevir/r + Dasabuvir  Antipsychotics/Neuroleptics Sofosbuvir   Amisulpride  Sofosbuvir/Velpatasvir   Aripiprazole Sofosbuvir/Velpatasvir/Voxilaprevir  Asenapine  Antivirals - others Chlorpromazine  Oseltamivir          Clozapine  Anxiolytics/Hypnotics/Sedatives Fluphenazine  Alprazolam  Haloperidol  Bromazepam   Iloperidone  Buspirone  Levomepromazine  Chlordiazepoxide  Olanzapine  Clobazam  Paliperidone   Clorazepate  Perazine  Diazepam  Periciazine  Estazolam  Perphenazine  Flunitrazepam  Pimozide  Flurazepam  Pipotiazine  Hydroxyzine  Quetiapine  Lorazepam  Risperidone  Lormetazepam  Sulpiride  Midazolam (oral)  Thioridazine  Midazolam (parenteral)  Tiapride  Oxazepam  Ziprasidone  Temazepam  Zotepine  Triazolam  Zuclopenthixol  Zaleplon   Zolpidem  Zopiclone 

 ATV and LPV/r are not intended to be combined for the treatment of COVID-19

Charts updated 3 April 2020 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

- - ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN Beta Blockers Contraceptives/HRT Atenolol  Desogestrel (COC)   Bisoprolol  Desogestrel (POP)    Carvedilol  Drospirenone (COC)   Metoprolol  Drospirenone (HRT)  Nebivolol  Dydrogesterone (HRT)   Oxprenolol  Estradiol   Pindolol  Ethinylestradiol   Propranolol  Etonogestrel (implant)    Timolol  Etonogestrel (vaginal ring)   Bronchodilators Gestodene (COC)   Aclidinium bromide  Levonorgestrel (COC)   Aminophylline   Levonorgestrel (emergency contrac.)    Formoterol  Levonorgestrel (HRT)   Glycopyrronium bromide  Levonorgestrel (implant)    Indacaterol  Levonorgestrel (IUD)  Ipratropium bromide  Levonorgestrel (POP)    Montelukast    Medroxyprogesterone (depot inj.)  Olodaterol   Medroxyprogesterone (oral)   Roflumilast   Norelgestromin (patch)   Salbutamol  Norethisterone (COC)   Salmeterol  Norethisterone (HRT)   Theophylline   Norethisterone (IM depot)   Tiotropium bromide  Norethisterone(POP)    Umeclidinium bromide     Norgestimate (COC)   Vilanterol   Norgestrel (COC)   Calcium Channel Blockers Norgestrel (HRT)   Amlodipine  Ulipristal    Diltiazem  Gastrointestinal Agents Felodipine  Alosetron  Nicardipine  Antacids  Nifedipine  Bisacodyl  Nisoldipine  Cimetidine  Nitrendipine  Cisapride  Verapamil    Esomeprazole  Famotidine  Lactulose  Lansoprazole  Loperamide  Mesalazine  Omeprazole  Pantoprazole  Prucalopride  Rabeprazole  Ranitidine  Senna  Gastrointestinal Agents (anti-emetics) Aprepitant  Dolasetron  Domperidone  Dronabinol   Granisetron  Metoclopramide  Ondansetron  Prochlorperazine 

Charts updated 3 April 2020 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

- - ATV LPV/r RDV FAVI CLQ HCLQ RBV TCZ IFN ATV LPV/r RDV FAVI CLQ HCLQ RBV IFN TCZ 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 Digoxin  Adrenaline (Epinephrine)  Dopamine  Dobutamine  Doxazosin  Noradrenaline  Enalapril  Vasopressin  Eplerenone  Lipid Lowering Agents Epoprostenol  Atorvastatin  Eprosartan  Bezafibrate  Fosinopril   Clofibrate  Furosemide  Evolocumab  Hydralazine  Ezetimibe  Hydrochlorothiazide  Fenofibrate  Iloprost  Fish oils  Indapamide  Fluvastatin  Irbesartan   Gemfibrozil   Isosorbide dinitrate  Lovastatin  Ivabradine  Pitavastatin  Labetalol  Pravastatin  Lacidipine  Rosuvastatin  Lercanidipine  Simvastatin  Lisinopril  Steroids Losartan   Beclometasone  Macitentan  Betamethasone  Methyldopa  Budesonide  Metolazone  Ciclesonide  Moxonidine  Clobetasol  Olmesartan  Dexamethasone  Perindopril  Fludrocortisone  Prazosin  Flunisolide  Quinapril  Fluocinolone  Ramipril  Fluticasone  Ranolazine  Hydrocortisone (oral)  Riociguat  Hydrocortisone (topical)  Sacubitril  Megestrol acetate  Selexipag  Methylprednisolone  Sildenafil (PAH)  Mometasone  Sodium nitroprusside  Nandrolone  Spironolactone  Oxandrolone  Tadalafil (PAH)  Prednisolone  Telmisartan  Prednisone  Terazosin  Stanazolol  Torasemide   Testosterone  Trandolapril  Triamcinolone  Treprostinil  Valsartan  Xipamide 