Vaskulárna medicína 1/2023

Pharmacological aspects of COVID-19 antivirals from the perspective of drug-drug interactions with antithrombotic treatment

The COVID-19 pandemic has caused enormous consequences worldwide. Although nowadays favorable epidemiological situation, this disease is still a serious risk for certain groups of the population. The consensus defines as risk population, among others, patients in advanced age, with chronic metabolic and cardiovascular diseases, oncological and patients with various type sof immunosupression. Currently, three antiviral drugs are available for the early stages of infection wich have demonstrated clinical benefit in non-hospitalized patients at high risk of disease progression to severe COVID-19: remdesivir, molnupiravir, and nirmatrelvir/ritonavir. The combination of nirmatrelvir with ritonavir, which plays the role of pharmacokinetics booster, significantly increases the potential for drug-drug interactions. Considering the comorbidities and polypharmacy present in the target group of patients, it is necessary to take consideration on drug-drug interactions with chronic pharmacotherapy. This article focuses on the drug interactions of antiviral drugs used in the prevention of a severe course of the COVID-19 infection and drugs used as antiplatelets and anticoagulants.

Keywords: remdesivir, molnupiravir, nirmatrelvir/ritonavir, drug-drug interactions, antiplatelets, anticoagulants