The need to manage the risk of thromboembolism in COVID-19 patients

doi:10.1016/j.jvs.2020.05.015

PMC full text:

J Vasc Surg. 2020 Sep; 72(3): 799–804.

Published online 2020 May 14. doi: 10.1016/j.jvs.2020.05.015

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Table II

Drug interactions in COVID-19

	Class	Subtype	Drug	Atazanavir^a	Lop/Rv	Remdesivir^b	Favipiravir^b	CLQ	HCLQ	Ribavirin^b	Tocilizumab^c	IFN-β
Antiplatelets	Thromboxane inhibitor		Aspirin	↔	↔	↔	↔	↔	↔	↔	↔	↔
			Dipyridamole	↑↑	↓↓	↔	↔	↔	↔	↔	↔	↔
	ADP receptor/P2Y₁₂ inhibitors	Thienopyridines	Clopidogrel	↓↓↓	↓↓↓	↔	↔	↔	↔	↔	↓	↔
			Prasugrel	↔	↔	↔	↔	↔	↔	↔	↓	↔
		Nucleotide analogues	Ticagrelor	↑↑↑	↑↑↑	↔	↔	↔	↔	↔	↓	↔
Anticoagulants	Vitamin K antagonist		Acenocoumarol	↔	↓↓	↔	↔	↔	↔	↔	↓	↔
			Phenprocoumon	↑↑	↑↓	↔	↔	↔	↔	↔	↓	↔
			Warfarin	↑↑	↓↓	↔	↔	↔	↔	↓↓	↓	↔
	Factor Xa inhibitors	Heparin/glycosaminoglycans	Dalteparin	↔	↔	↔	↔	↔	↔	↔	↔	↔
			Enoxaparin	↔	↔	↔	↔	↔	↔	↔	↔	↔
			Fondaparinux	↔	↔	↔	↔	↔	↔	↔	↔	↔
			Heparin	↔	↔	↔	↔	↔	↔	↔	↔	↔
		Direct Xa inhibitor	Apixaban	↑↑↑	↑↑↑	↔	↔	↑	↑	↔	↓	↔
			Betrixaban	↑↑	↑↑	↔	↔	↑↑	↑↑	↔	↔	↔
			Edoxaban	↑↑	↑↑	↔	↔	↑↑	↑↑	↔	↔	↔
			Rivaroxaban	↑↑↑	↑↑↑	↔	↔	↑	↑	↔	↓	↔
	Direct thrombin (IIa) inhibitor		Argatroban	↔	↔	↔	↔	↔	↔	↔	↔	↔
			Dabigatran	↑↑↑	↓↓	↔	↔	↑↑	↑↑	↔	↔	↔

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ADP, Adenosine diphosphate; CLQ, chloroquine (antimalarial); HCLQ, hydroxychloroquine (antimalarial and used in rheumatoid arthritis and lupus); IFN-β, interferon β; Lop/Rv, loprinovir/ritonavir (combination treatment for HIV/AIDS).

Upward arrow (↑) indicates an increased risk of interaction. Downward arrow (↓) indicates a reduced risk of interaction. Single arrow (↓/↑)denotes potential interaction, likely to be of weak intensity—dose adjustment is unlikely. Double arrows (↑↑/↓↓)indicate possible interaction that may require dose adjustment or close monitoring. Triple arrows (↑↑↑/↓↓↓) indicate that these two drugs should not be coadministered. Horizontal arrow (↔) indicates no significant interaction reported.

^aSecond-generation protease inhibitor.

^bAntiviral.

^cImmunosuppressant.