{"doi":"10.1093/jac/dkaa340","title":"Drug interactions: a review of the unseen danger of experimental COVID-19 therapies","abstract":"As global health services respond to the coronavirus pandemic, many prescribers are turning to experimental drugs. This review aims to assess the risk of drug-drug interactions in the severely ill COVID-19 patient. Experimental therapies were identified by searching ClinicalTrials.gov for 'COVID-19', '2019-nCoV', '2019 novel coronavirus' and 'SARS-CoV-2'. The last search was performed on 30 June 2020. Herbal medicines, blood-derived products and in vitro studies were excluded. We identified comorbidities by searching PubMed for the MeSH terms 'COVID-19', 'Comorbidity' and 'Epidemiological Factors'. Potential drug-drug interactions were evaluated according to known pharmacokinetics, overlapping toxicities and QT risk. Drug-drug interactions were graded GREEN and YELLOW: no clinically significant interaction; AMBER: caution; RED: serious risk. A total of 2378 records were retrieved from ClinicalTrials.gov, which yielded 249 drugs that met inclusion criteria. Thirteen primary compounds were screened against 512 comedications. A full database of these interactions is available at www.covid19-druginteractions.org. Experimental therapies for COVID-19 present a risk of drug-drug interactions, with lopinavir/ritonavir (10% RED, 41% AMBER; mainly a perpetrator of pharmacokinetic interactions but also risk of QT prolongation particularly when given with concomitant drugs that can prolong QT), chloroquine and hydroxychloroquine (both 7% RED and 27% AMBER, victims of some interactions due to metabolic profile but also perpetrators of QT prolongation) posing the greatest risk. With management, these risks can be mitigated. We have published a drug-drug interaction resource to facilitate medication review for the critically ill patient.","journal":"Journal of Antimicrobial Chemotherapy","year":2020,"id":93835,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":39,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9574,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":468055,"name":"Fiona Marra","orcid":"0000-0003-1326-1149","position":1,"is_corresponding":false},{"id":459821,"name":"Catia Marzolini","orcid":"0000-0002-2312-7050","position":2,"is_corresponding":false},{"id":468056,"name":"Alison Boyle","orcid":"0000-0003-1365-9755","position":3,"is_corresponding":false},{"id":468748,"name":"Sara Gibbons","orcid":null,"position":4,"is_corresponding":false},{"id":468057,"name":"Marco Siccardi","orcid":"0000-0002-3539-7867","position":5,"is_corresponding":false},{"id":468058,"name":"David M. Burger","orcid":"0000-0001-7279-2818","position":6,"is_corresponding":false},{"id":254198,"name":"David Back","orcid":"0000-0002-7381-4799","position":7,"is_corresponding":false},{"id":254199,"name":"Saye Khoo","orcid":"0000-0002-2769-0967","position":8,"is_corresponding":false},{"id":468054,"name":"Daryl Hodge","orcid":"0000-0003-2288-7020","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-18T22:31:34.149524Z","pmid":"32750131","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}