Side Effects of lopinavir and ritonavir: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Main Research Findings

Lopinavir/ritonavir, a drug combination widely used in HIV treatment, has also been studied for its potential as a COVID-19 treatment. Research into its use as a COVID-19 treatment has revealed several significant findings regarding its side effects. For instance, a study comparing lopinavir/ritonavir with atazanavir/ritonavir ( 17 ) found that the lopinavir/ritonavir group experienced a higher incidence of arrhythmias. Another study ( 16 ) suggests that lopinavir/ritonavir could potentially cause liver damage. A study on HIV-infected individuals ( 2 ) indicates that lopinavir/ritonavir can cause gastrointestinal side effects. A study using zebrafish ( 10 ) suggests that lopinavir can damage hair cells in the inner ear. Lastly, another study ( 20 ) suggests that lopinavir/ritonavir may contribute to environmental issues. These studies indicate that lopinavir/ritonavir might cause a range of side effects. It is crucial to note that these studies are all observational and do not definitively prove that lopinavir/ritonavir is the cause of the observed side effects.

Reasons for Side Effects

Lopinavir/ritonavir is known to inhibit the activity of an enzyme called CYP2C9. CYP2C9 is involved in the metabolism of many medications, and its inhibition can lead to increased drug levels in the blood, potentially causing adverse effects ( 7 ). Lopinavir/ritonavir can also interact with other medications, potentially leading to side effects ( 5 ). Furthermore, lopinavir/ritonavir might place a strain on the liver, potentially resulting in liver damage ( 16 ).

Common Side Effects

Arrhythmias

Lopinavir/ritonavir can cause arrhythmias ( 17 ).

Liver Damage

Lopinavir/ritonavir can cause liver damage ( 16 , 7 ).

Gastrointestinal Side Effects

Lopinavir/ritonavir can cause gastrointestinal side effects ( 2 ).

Inner Ear Hair Cell Damage

Lopinavir can damage hair cells in the inner ear ( 10 ).

Environmental Issues

Lopinavir/ritonavir may contribute to environmental issues ( 20 ).

Side Effect Management

Arrhythmias

If you suspect arrhythmias related to lopinavir/ritonavir, consult your doctor.

Liver Damage

If you suspect liver damage related to lopinavir/ritonavir, consult your doctor. Regular liver function tests are recommended ( 16 ).

Gastrointestinal Side Effects

If you suspect gastrointestinal side effects related to lopinavir/ritonavir, consult your doctor. Dietary and medication therapies might be helpful.

Inner Ear Hair Cell Damage

If you suspect inner ear hair cell damage related to lopinavir, consult your doctor. Regular check-ups, including hearing tests, are recommended ( 10 ).

Environmental Issues

Dispose of lopinavir/ritonavir in a manner that minimizes environmental impact ( 20 ).

Comparison Across Studies

Commonalities

Multiple studies indicate that lopinavir/ritonavir has the potential to cause a variety of side effects. However, these studies are all observational, and they do not definitively prove that lopinavir/ritonavir is the cause of the observed side effects.

Differences

Each study has different patient populations and methodologies, making direct comparison of results challenging. For example, one study ( 17 ) compares lopinavir/ritonavir with atazanavir/ritonavir, while another study ( 16 ) explores the side effects of lopinavir/ritonavir alone.

Real-World Application Considerations

Lopinavir/ritonavir should be taken only under the guidance of a physician. Self-medication is dangerous. If you experience any unusual symptoms while taking lopinavir/ritonavir, consult your doctor immediately.

Limitations of Current Research

Research on the side effects of lopinavir/ritonavir is still insufficient. Further investigation is needed.

Future Research Directions

Research is needed to elucidate the mechanisms of lopinavir/ritonavir side effects and to develop drug therapies and dietary interventions to mitigate these effects.

Conclusion

Lopinavir/ritonavir is a potentially effective medication, but it carries a risk of various side effects. If you are taking lopinavir/ritonavir, be sure to do so under the guidance of a physician and be aware of potential side effects.

Literature analysis of 20 papers
Positive Content
13
Neutral Content
1
Negative Content
6
Article Type
1
0
0
9
20
1.

The influence of Microgynon and Diane-35, two sub-fifty ovulation inhibitors, on voice function in women.

Author: WendlerJ, SiegertC, SchelhornP, KlingerG, GurrS, KaufmannJ, AydinlikS, BraunschweigT

The study investigated the potential voice-related side effects of two oral contraceptives, Diane-35 and Microgynon, in 91 patients over a year. No significant side effects on voice function were observed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Side effects and tolerability of post-exposure prophylaxis with zidovudine, lamivudine, and lopinavir/ritonavir: a comparative study with HIV/AIDS patients.

Author: CaiJuan, XiaoJiang, ZhangQiang

HIV prevention

This study looked at the safety and tolerability of a combination of three antiretroviral drugs (zidovudine, lamivudine, and lopinavir/ritonavir) in healthcare workers who were exposed to HIV. The study found that the combination was well tolerated and safe.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Lopinavir/ritonavir vs. indinavir/ritonavir in antiretroviral naive HIV-infected patients: immunovirological outcome and side effects.

Author: BongiovanniMarco, BiniTeresa, ChiesaElisabetta, CicconiPaola, AdorniFulvio, Monforte d'ArminioAntonella

Improved immunovirological outcomes
Drug discontinuation
Increased total cholesterol

This study compared the effectiveness and toxicity of two antiretroviral treatments, LPV/r and IDV/r, in HIV-1 patients. Both treatments achieved viral suppression, but IDV/r was less effective and had a higher risk of discontinuation due to toxicity.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Evaluation of the efficacy and safety of oral N-acetylcysteine in patients with COVID-19 receiving the routine antiviral and hydroxychloroquine protocol: A randomized controlled clinical trial.

Author: AtefiNajmolsadat, GoodarziAzadeh, RiahiTaghi, KhodabandehlooNiloofar, Talebi TaherMahshid, Najar NobariNiloufar, SeirafianpourFarnoosh, MahdiZeinab, BaghestaniAmir, ValizadehRohollah

COVID-19 treatment

This randomized controlled trial evaluated the efficacy and safety of N-acetylcysteine (NAC) as adjuvant therapy for hospitalized Iranian patients with COVID-19.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Potential drug-drug interactions in a multi-center study of death cases of COVID-19: The significance of appropriate drug choice.

Author: EsmaeiliAyda, NiazkhaniZahra, MakhdoomiKhadijeh, MohebbiIraj, Aghazadeh-AttariJavad, HassaniEbrahim, MousaviSeyed Jalil, GharebaghiNaser, NejadrahimRahim, Mirza-AghzadehMohammad, EsmaeiliAysan, CheshmekaboodiMojgan, Nader-BabaeiYasaman, PirnejadHabibollah

Polypharmacy
QTc prolongation

Drug-drug interactions (DDIs) were prevalent in deceased COVID-19 patients, with 27.2% of interactions involving COVID drugs. Polypharmacy was associated with a higher risk of DDIs. Careful drug selection and close monitoring are crucial for reducing DDIs and their adverse effects in patients with COVID-19.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Role of Cytochrome P450 2C9 in COVID-19 Treatment: Current Status and Future Directions.

Author: LimSharoen Yu Ming, Al BishtawiBasel, LimWillone

COVID-19 recovery
Combination therapy
Bleeding
CYP2C9 variability
Drug-drug interactions
Hepatotoxicity
Thromboembolism

This article discusses the impact of COVID-19 infection on the activity of cytochrome P450 (CYP) enzymes, which are important for drug metabolism in the liver. The downregulation of CYP enzymes during COVID-19 infection can lead to drug-drug interactions and potentially worsen the disease condition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Pharmacovigilance follow-up of patients in the context of the COVID-19 pandemic.

Author: GrandvuilleminAurélie, RocherFanny, Valnet-RabierMarie Blanche, DriciMilou-Daniel, DautricheAnne,

ADR monitoring

A national pharmacovigilance survey was conducted in the context of the COVID-19 pandemic to monitor adverse drug reactions (ADRs) in patients with COVID-19. The survey aims to monitor ADRs related to drugs used in COVID-19 treatment and other drugs administered to these patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Antivirals and the Potential Benefits of Orally Inhaled Drug Administration in COVID-19 Treatment.

Author: SahinGokben, Akbal-DagistanOzlem, CulhaMeltem, ErturkAybige, BasarirNur Sena, SancarSerap, Yildiz-PekozAyca

COVID-19 treatment

This review article examines the potential for inhaled antiviral drugs in the treatment of COVID-19. The article discusses the advantages of inhaled drug delivery, such as higher drug concentrations in the pulmonary system and reduced systemic side effects. The article reviews commonly used antiviral drugs and discusses current studies on inhalation therapy for COVID-19, advocating for inhaled antivirals as a potential treatment option.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Safety profile of COVID-19 drugs in a real clinical setting.

Author: ChiuMei Nee, BhardwajMaitry, SahSangeeta Pilkhwal

Adverse events

This review highlights the associated adverse events related to drugs used in a real COVID-19 setting, including their relevant mechanisms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases.

Author: LawMan Fai, HoRita, LawKimmy Wan Tung, CheungCarmen Ka Man

COVID-19 treatment
COVID-19 vaccine
GI symptoms
Liver dysfunction

This review examines various medications and vaccines being investigated for COVID-19 treatment and prevention. It discusses potential gastrointestinal and liver complications associated with the disease and treatment, as well as the safety of COVID-19 vaccination in patients with chronic liver disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Comparing Outcomes of Two Antiviral Therapy Combinations among COVID-19 Patients.

Author: MazaherpourHossein, SofianMasoomeh, FarahaniElham, AbdiAlireza, MazaherpourSakine, BavandAnahita, RamezaniAmitis

COVID-19 treatment
Arrhythmia
Hyperbilirubinemia

This study compared the outcomes of two combination therapies, atazanavir/ritonavir (ATV/r) and lopinavir/ritonavir (LPV/r) plus hydroxychloroquine, in patients with COVID-19. Both therapies showed similar clinical outcomes, but ATV/r was associated with increased bilirubin levels, and LPV/r was associated with increased arrhythmias.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Effectiveness of Remdesivir, Lopinavir/Ritonavir, and Favipiravir for COVID-19 Treatment: A Systematic Review.

Author: QomaraWindi Fresha, PrimanissaDelya Nur, AmaliaSalma Hasni, PurwadiFebby V, ZakiyahNeily

Inhibition of virus spreading

This study reviews the potential antiviral therapies for COVID-19, focusing on the use of antiviral drugs like remdesivir, favipiravir, and lopinavir/ritonavir. While research on these treatments is ongoing, studies suggest they may effectively inhibit the spread of the virus.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Candidate antiviral drugs for COVID-19 and their environmental implications: a comprehensive analysis.

Author: BiswasPartha, HasanMohammad Mehedi, DeyDipta, Dos Santos CostaAna Carla, PolashShakil Ahmed, BibiShabana, FerdousNadim, KaiumMd Abu, RahmanM D Hasanur, JeetFardin Kamal, PapadakosStavros, IslamKhairul, UddinMd Sahab

COVID-19 treatment
Side effects

This review summarizes the current pharmaceutical perspective on COVID-19 treatment, emphasizing the efficiency of known agents and their side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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