Table 2

Relevant pro-arrhythmic drug interactions involving the most commonly used COVID-19 medications.34

COVID-19 drugsCardiovascular effectsDrugs to be avoided
Chloroquine (hydroxychloroquine)- QT prologation
- Cardiotoxicity
Amiodarone
Flecainide
Mexiletine
Ziprasidone
Drugs to use with caution
Anti-COVID-19 drugs:
Lopinavir/ritonavir
Anaesthetics:
Propofol
Sevoflurane
Antiarrhythmics:
Digoxine
Disopyramide
Dofetilide
Ivabradine
Metoprolol
Nebivolol
Propafenone
Propranolol
Quinidine
Ranolazine
Timolol
Anticonvulsivants:
Chlorpromazine
Clozapine
Haloperidol
Iloperidone
Lovomepromazine
Fluphenazine
Quetiapine
Perphenazine
Pimozide
Risperidone
Sulpride
Thioridazine
Tiapride
Zotepine
Zuclopenthixol
Antimicrobials:
Azithromycin
Clarithromycin
Erythromycin
Levofloxacin
Ofloxacin
Moxifloxacin
Antidepressants:
Citalopram
Escitalopram
Lithium
Lopinavir/ritonavir- AV (atrio-ventricular) block
- QT prolongation
- Increased amiodarone and dronedarone plasma concentration
Amiodarone
Disopyramide
Dofetilide
Flecainide
Ivabradine
Ranolazine
Lercanidipine
Sildenafil
Pimozide
Quetiapine
Ziprasidone
Midazolam
Triazolam
Drugs to use with caution
Anti-COVID19 drugs:
Chloriquine/hydroxychloroquine
Antidepressants:
Citalopram
Escitalopram
Lithium
Lipid-lowering agents:
Atorvastatina
Lovastatina
Rosuvastatina
Steroids and immunosuppressants:
Sirolimus
Tacrolimus
Ciclosporin
Antiarrhythmics:
Lidocaine
Quinidine
Mexiletine
Propafenone
Digoxine
Atenolol
Bisoprolol
Carvedilol
Metoprolol
Nebivolol
Oxprenolol
Pindolol
Propranolol
Timolol
Amlodipine
Diltiazem
Verapamil
Nicardipine
Nifedipine
Labetalol
Anticonvulsivants:
Chlorpromazine
Clozapine
Haloperidol
Iloperidone
Lovomepromazine
Fluphenazine
Perphenazine
Pimozide
Risperidone
Sulpride
Thioridazine
Tiapride
Zotepine
Zuclopenthixol
RemdesivirCardiovascular effectsDrugs to be avoided
No known proven effects//
Drugs to use with caution
//
Favipiravir *Cardiovascular effectsDrugs to be avoided
No known proven effects//
Drugs to use with caution
//
TocilizumabCardiovascular effectsDrugs to be avoided
Fluid retention//
Drugs to use with caution
Drugs that are CYP450 substrates
SarilumabCardiovascular effectsDrugs to be avoided
Increased triglycerides and low-density lipoprotein-cholesterol//
Drugs to use with caution
Drugs that are CYP450 substrates
AnakinraCardiovascular effectsDrugs to be avoided
No known proven effects//
Drugs to use with caution
//
  • *This drug is currently not approved in USA and UE. COVID-19, coronavirus disease of 2019; CYP450, cytochrome P450.