SHM Converge Scientific Abstract ePoster Gallery-Drug Interactions With Antivirals for Covid-19 Among Us Hospitalized Patients

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This retrospective study examined potential drug-drug interactions (DDIs) between COVID-19 antivirals and medications given to hospitalized US patients. Using the PINC AI Healthcare Database, researchers analyzed 788,238 hospitalizations for primary COVID-19 from May 2020 to December 2022.<br /><br />The main goal was to estimate how often patients were taking drugs that could interact with nirmatrelvir/ritonavir, remdesivir, or molnupiravir. Interaction lists were based on EUA fact sheets and prescribing information. The study also looked at higher-risk subgroups: patients aged 65 or older, those with Charlson Comorbidity Index (CCI) 3, and patients with CDC-defined high-risk underlying conditions.<br /><br />Key findings showed that DDIs were very common with nirmatrelvir/ritonavir: 93% of hospitalized patients were receiving at least one medication with potential for interaction. About 52% had medications that could be clinically problematic, including 11% with contraindicated drugs and 41% with drugs to avoid using together. The most common contraindicated medications were amiodarone, simvastatin, and colchicine. Common “avoid concomitant use” drugs included atorvastatin, tamsulosin, clopidogrel, rosuvastatin, and rivaroxaban. Many patients also received drugs requiring dose adjustment or monitoring, such as dexamethasone, amlodipine, methylprednisolone, and apixaban.<br /><br />Potential DDIs with remdesivir were rare, affecting only 1%–2% of patients, and no DDIs were identified for molnupiravir.<br /><br />DDI risk was even higher in older, more comorbid, and high-risk patients. The authors conclude that careful screening for DDIs is essential when selecting antiviral therapy for COVID-19, especially in hospitalized patients with polypharmacy and multiple comorbidities.

Asset Subtitle

Essy Mozaffari

Meta Tag

Author List Aastha Chandak, Alpesh N. Amin, Andrew Ustianowski, Christina G. Rivera, Essy Mozaffari, Heng Jiang, Jason F. Okulicz, Mark Berry, Neera Ahuja

Category Research

Concept Drug-Drug Interaction

Concept Nirmatrelvir/Ritonavir

Concept Polypharmacy

Concept Remdesivir

Concept Molnupiravir

Distinguished Non-Finalist

Presenter Organization Gilead Sciences, Foster City, California

Presenting Author Essy Mozaffari

Track Patient Safety

Keywords

COVID-19 antivirals

drug-drug interactions

nirmatrelvir/ritonavir

remdesivir

molnupiravir

hospitalized patients

polypharmacy

contraindicated medications

PINC AI Healthcare Database

retrospective study

Drug-Drug Interaction

Nirmatrelvir/Ritonavir

Polypharmacy

Remdesivir

Molnupiravir