Results
After removing duplicates, in total of 62 severe DDI pairs of LPV/RTV were identified from the FDA and Liverpool COVID-19 interaction resources predicted to cause clinically significant life-threatening ADRs, as shown in Figure 1. Of these, seven unique DDI pairs were identified from the FDA only whereas 45 unique DDI pairs were identified from the Liverpool COVID-19 drug interactions resource. Interestingly, only 10 DDI pairs were recognized by both of these drug interaction resources. The lists of all interacting drugs as identified from these two DDI resources are shown in Table 1.
Systematic cross-comparison between these two well-recognized evidenced-based DDI resources indicated that discrepancies were existed in between these two resources for enlisting contraindicated drugs potentially causing life-threatening ADRs of LPV/RTV.
Severe DDI pairs that were not enlisted by the Liverpool COVID-19 DDI resource and the potential life-threatening ADRs are tabulated in Table 2 as identified from the FDA prescribing information of LPV/RTV. Notable life-threatening ADRs due DDIs of LPV/RTV with these drugs were cardiac arrhythmias, vasospasm, ischemia and hypotension.
Severe DDI pairs that were recognized by both the FDA and the Liverpool COVID-19 DDI resource and the potential life-threatening ADRs are tabulated in Table 3. Notable life-threatening ADRs due DDIs of LPV/RTV with these drugs were cardiac arrhythmias, myopathy, rhabdomyolysis, respiratory depression, risk of alanine transaminase (ALT) elevations, hypotension and risk of reduced virologic response.
In summary, Liverpool COVID-19 DDI resource was more effective in enlisting contraindicated drugs of LPV/RTV potentially causing life-threatening ADRs, however, clinicians should not entirely rely on this resource for checking DDIs of LPV/RTV since it didn’t enlist several important contraindicated drugs of LPV/RTV predicted to cause life-threatening ADRs.