Covid-19 patients with a history of cardiovascular disease are at higher risk of developing severe disease and may benefit most from the Covid-19 treatment Paxlovid, but there are pitfalls.
Paxlovid may have dangerous interactions with some of the most common drugs for cardiovascular disease, including certain statins and heart failure medications, a new paper warns.
A review article published Wednesday in the Journal of the American College of Cardiology lists dozens of cardiovascular drugs and whether they are safe to take with Paxlovid or they may interact. It lists whether
According to the paper, some drugs, such as aspirin, can be safely taken with paxlobid, but other drugs can interact, so doses should be adjusted while patients are taking paxlobid. , should be temporarily discontinued.
When President Joe Biden tested positive for Covid-19 and started Pax Rovid in July, his doctor, Dr. Kevin O’Connor temporarily took him off Crestor and Eliquis, two heart drugs the President takes for his chronic illness. Doctors say there are no short-term risks from stopping these drugs.
A review article states that interactions between paxlobid and certain blood thinners may increase the risk of bleeding.Interactions between paxlobid and some cholesterol drugs, such as statins, are toxic to the liver. Interactions between paxlovid and certain blood pressure medications can cause low blood pressure, flushing, and swelling.
“There are some drugs you simply can’t stop and your doctor has to make a decision. This is a risk-benefit analysis,” said Piedmont Hospital/Healthcare in Atlanta, which was not involved in the new paper.
Regarding cardiovascular drugs that patients can stop taking Paxlovid, Morgan said Covid-19 treatment is a five-day regimen.
“You have to make a diagnosis, then stop the meds, and get it all done in time for the five-day window,” Morgan said, adding that people should talk to their doctors about what’s best for them. He added that there is..
“Awareness is the key”
Authors of new paper — from Lahey Hospital and Medical Center, Harvard Medical School and other US institutions — say Paxlovid should be avoided if potentially interacting cardiovascular drugs cannot be “safely discontinued” I wrote.
Paxlovid, an oral antiviral drug, was approved in December for the treatment of mild to moderate Covid-19 in people over the age of 12 who are at high risk of serious illness, hospitalization, or death.
“It is important to recognize the existence of drug-drug interactions between paxlobid and common cardiovascular drugs. ,” said senior author Sarju Ganatra, Ph.D. He is Director of the Cardiac Oncology Program at Lahey Hospital and Medical Center in Massachusetts.
“Paxlobid prescriptions can be incorporated into an order set that allows physicians, whether primary care physicians or cardiologists, to consciously rule out contraindications to the paxlobid combination. Consultation with members, especially pharmacists, could prove very valuable,” Ganatra said. “However, a basic understanding by health care providers of drug-drug interactions with cardiovascular drugs is key.”
“It’s not just a free pass”
Interactions between paxlovid and common heart drugs are well known, said Dan Baloch, Ph.D., director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, involved in the new paper. said no.
“Drug interactions have been reported, but paxlobid is so widely prescribed that I think some doctors and patients may not be as harmonious as they should be.
Paxlovid consists of two antiviral drugs, nilmatrelvir and ritonavir.
“The second drug, ritonavir, is a non-specific drug that inhibits metabolism and increases the dose of other drugs. However, ritonavir in paxlovid may also inhibit metabolism of other drugs. So you have to be really careful when prescribing paxlobide to people who are taking certain blood thinners, cardiotonic drugs, statins and other medications,” Barouch said. “So it’s not just a free pass.”
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