Table 2: Important drug-drug interactions of COVID-19 treatments with immunosuppressive drugs. (H)CQ = (hydroxy)chloroquine; QTc = corrected QT-interval.
|
|
Remdesivir
|
(H)CQ
|
Lopinavir/ritonavir |
Ribavirin |
Tocilizumab
|
|
Tacrolimus |
no interaction expected |
QTc prolongation |
neuropsychiatric effects in tacrolimus intoxication reduce tacrolimus to 0.5-1.0 mg/week |
no interaction expected |
unchanged, or increase tacrolimus with close monitoring |
|
Cyclosporin |
no interaction expected |
QTc prolongation Consider dose reduction to 25 mg every 1-2 days |
|
no interaction expected |
unchanged, or increase cyclosporin with close monitoring |
|
Sirolimus |
no interaction expected |
QTc prolongation
|
reduce sirolimus, close monitoring, strong drug-drug interaction expected with high sirolimus levels |
no interaction expected |
unchanged, or increase sirolimus with close monitoring |
|
Mycophenolate |
generally, discontinue or decrease dosage with close monitoring MMF concentrations |
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|
Prednisolone |
generally, continue or increase if other immunosuppressive drugs are discontinued, no routine monitoring of drug concentrations |
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