Recently, with the increase in patients infected with the new coronavirus, the number of severely ill patients admitted to hospitals has also increased sharply. In some hospitals, it is even hard to find a bed in the intensive care unit , which makes many people think of the new coronavirus specific drug Nematvir/ritonavir tablets (Paxlovid, Paxlovid)!
Why is Paclovir tablets recognized worldwide as a specific drug for COVID-19?
Due to the dynamic zero-blocking policy, the number of infections was controlled at a relatively low level and there were fewer severe patients. Coupled with the high price of Parklovi, its widespread application was limited. But now that the number of severely ill patients is rising as the number of infections increases, this drug has become a life-saving straw for many critically ill patients.
The FDA authorizes Paxlovid for use only in adults and pediatric patients 12 years of age and older and weighing at least 40 kilograms who test positive for the new coronavirus and have high-risk factors for progression to severe disease. This means you must have certain underlying conditions (including cancer, diabetes, obesity or other conditions) or be over 60 (more than 81% of COVID-19 deaths have occurred in this group). According to the CDC, the more underlying medical conditions a person has, the higher their risk of developing a severe case of COVID-19.
There is no doubt about the efficacy of Paclovir. Studies have shown that use of the drug within 3 days of symptom onset can quickly reduce viral load , and use within 5 days can reduce the risk of hospitalization or death by 88%. But what we want to talk about today is not the efficacy of the drug, but the issue of how to use the drug safely in patients with cardiovascular disease.
Paclovir interacts with cardiovascular drugs
The reason why patients with cardiovascular disease are mentioned is, first of all, because this group of people with underlying diseases are at high risk of infection with the new coronavirus, and they are also the group with the highest risk of severe illness after infection. Many of them must need to take Paclovir after infection. Secondly, there are interactions between Paclovir and many cardiovascular drugs.
Because there are two ingredients in Paclovir, one is called nematvir, which is the main ingredient that inhibits the new coronavirus; the other, ritonavir, does not have the effect of inhibiting the new coronavirus itself, but it can enhance the efficacy of nematvir and is equivalent to a synergist. The effect of ritonavir is achieved by inhibiting the metabolizing enzyme of nematvir in the liver, thereby slowing down the metabolism of nematvir. However, this enzyme is also a key enzyme in the metabolism of many cardiovascular disease drugs, so Paclovir interacts with cardiovascular drugs, which many patients are unaware of.
How can cardiovascular patients use the drug safely while taking Paclovir?
There are many types of cardiovascular drugs, and it is very difficult to explain them clearly in the short space of this article. Here are some commonly used cardiovascular drugs for explanation.
1. Antiplatelet or anticoagulant drugs
Antiplatelet and anticoagulant drugs are commonly used drugs after PCI, coronary heart disease and atrial fibrillation patients. Representative drugs mainly include aspirin, clopidogrel and warfarin. The good news is that research has found that there is no obvious interaction between paclovir and aspirin, so you can continue to use aspirin while taking paclovir. However, there is a certain interaction between clopidogrel and warfarin, so it is recommended that cardiovascular patients switch to prasugrel, and warfarin needs to be monitored more closely INR.
2. The antihypertensive drug
Paclovir can be safely used in combination with diuretic and antihypertensive drugs, but it can double the blood concentration of amlodipine. Therefore, patients taking amlodipine for antihypertensive treatment should pay attention to reducing the dose. In terms of ARBs, Paclovir has no significant interactions with candesartan, olmesartan and telmisartan, but it can increase the drug concentrations of Losartan and Valsartan and reduce Irbesartan . In addition, Paclovir can be safely combined with metoprolol.
3. The lipid-lowering drug
Paclovir is prohibited from being used in combination with lovastatin and simvastatin . It can also increase the drug concentration of atorvastatin and rosuvastatin, so attention should be paid to adjusting the dose. In addition to the above statin drugs , Paclovir can be used in combination with pravastatin, fluvastatin and pitavastatin .
There are many types of cardiovascular drugs, and it is difficult to explain them all at once. In fact, you only need to remember one thing, that is, when you go to the hospital, when the doctor prescribes Paxil, you must truthfully inform the doctor of all the drugs you are taking. The doctor will judge which drugs interact with Paxil and give professional guidance to ensure the safety of your life!
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