TY - JOUR
T1 - Ritonavir/Lopinavir and Its Potential Interactions With Psychiatric Medications
T2 - A COVID-19 Perspective
AU - Mansuri, Zeeshan
AU - Shah, Bhumika
AU - Adnan, Mahwish
AU - Chaudhari, Gaurav
AU - Jolly, Taranjeet
N1 - Publisher Copyright:
© 2020.
PY - 2020
Y1 - 2020
N2 - The coronavirus disease 2019 (COVID-19) pandemic is a global catastrophe. One of the medications being proposed for the treatment of COVID-19 is the antiretroviral drug combination of ritonavir and lopinavir.1 Ritonavir is a potent cytochrome P450 (CYP) 2D6, 3A4, and 1A2 inhibitor and a CYP2B6, CYP2C19, and glucuronidation inducer.1 It is also an inducer and inhibitor of p-glycoprotein (a transmembrane drug efflux pump that extrudes toxins and hence protects organs).2 It is also a CYP2D6 and CYP3A4 substrate. CYP inhibition of ritonavir rises with increased dose, and it affects CYP2D6 more than other CYP enzymes. Lopinavir is primarily metabolized by CYP3A4. Lopinavir, when combined with a low dose of ritonavir, inhibits its own metabolism and thus augments its effect.3 Psychotropics are metabolized by the CYP enzymes and have a multitude of drug interactions with this antiretroviral combination.1.
AB - The coronavirus disease 2019 (COVID-19) pandemic is a global catastrophe. One of the medications being proposed for the treatment of COVID-19 is the antiretroviral drug combination of ritonavir and lopinavir.1 Ritonavir is a potent cytochrome P450 (CYP) 2D6, 3A4, and 1A2 inhibitor and a CYP2B6, CYP2C19, and glucuronidation inducer.1 It is also an inducer and inhibitor of p-glycoprotein (a transmembrane drug efflux pump that extrudes toxins and hence protects organs).2 It is also a CYP2D6 and CYP3A4 substrate. CYP inhibition of ritonavir rises with increased dose, and it affects CYP2D6 more than other CYP enzymes. Lopinavir is primarily metabolized by CYP3A4. Lopinavir, when combined with a low dose of ritonavir, inhibits its own metabolism and thus augments its effect.3 Psychotropics are metabolized by the CYP enzymes and have a multitude of drug interactions with this antiretroviral combination.1.
UR - http://www.scopus.com/inward/record.url?scp=85086916957&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086916957&partnerID=8YFLogxK
U2 - 10.4088/PCC.20com02677
DO - 10.4088/PCC.20com02677
M3 - Article
C2 - 32569450
AN - SCOPUS:85086916957
SN - 1523-5998
VL - 22
JO - The primary care companion for CNS disorders
JF - The primary care companion for CNS disorders
IS - 3
M1 - 20COM02677
ER -