用于 COVID-19 的 Nirmatrelvir/Ritonavir 与心血管药物的相互作用:日常实践中的注意事项

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Andrea Di Lenarda, Nicola Ferri, Massimiliano Lanzafame, E. Montuori, Luciano Pacelli
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引用次数: 0

摘要

心血管疾病与重症 COVID-19 的进展有关,因此患者应尽早接受抗病毒治疗。尼马瑞韦/利托那韦复方制剂(Paxlovid®)已获美国食品药品管理局和欧洲药品管理局批准用于临床。由于心血管疾病患者通常服用多种药物,因此医生在使用奈瑞韦/利托那韦治疗 COVID-19 时需要注意潜在的药物相互作用 (DDI)。本综述为避免 DDIs 提供了指导,并强调预防和管理使用 nirmatrelvir/ritonavir 的潜在 DDIs 需要全面的评估和知识。本综述总结了奈瑞韦酯/利托那韦的临床药理学,并详细介绍了潜在的 DDIs,重点关注心血管疾病患者的日常用药。对于主要由细胞色素 P450 3A4 代谢、P-糖蛋白底物和治疗指数较窄的药物,需要给予特别关注。正确处理潜在的 DDIs,必须在尼马瑞韦/利托那韦预防严重疾病的益处与严重不良事件的风险之间取得平衡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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 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.
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来源期刊
European Cardiology Review
European Cardiology Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.40
自引率
0.00%
发文量
23
审稿时长
12 weeks
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