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Table 1 Current medications used in Covid-19 infection and potential side effects in cardiomyopathies (CMP) and ion channel diseases (ICD)

From: COVID-19 pandemia and inherited cardiomyopathies and channelopathies: a short term and long term perspective

DRUGSIDE EFFECTSUSE in CMP and ICD
HydroxychloroquineaQT prolongation (drug effect plus CYP3A4 inhibition)Potentially harmful in LQTs, HCM or other CMPs associated with LQT, acquired QT status
Caution in: hypokaliemia status, severe hypoglicemia, renal or epatic failure; digoxin, antiepilectics or ciclosporin therapy; patients with G6PDH and porfiria
AzitromicinaQT prolongation (drug effect plus mild CYP3A4 inhibition)Potentially harmful in LQTs, HCM or other structural disease associated with LQT, acquired QT status
RitonavirQT prolongation (CYP3A4 inhibition)
Bradyarrhythmias/AV blocks
Hypertension, angioedema, maculopapular rash, respiratory tract infection, peripheral neuropathy, hypercholesterolemia, hypertriglyceridemia, increased glucose, increased uric acid, increased transaminases and creatine kinase, decreased CrCl, neutropenia, anemia
Rare: ketoacidosis, insulin resistance, anorexia, hyperlactatemia, rhabdomyolysis
Potentially harmful in LQTs, HCM or other structural disease associated with LQT, acquired QT status
Caution in patients with congenital, inherited (i.e. SCN5A), or structural (i.e. Lamin A/C, desmin, mitchocondrial) AV blocks
Caution in patients with previous renal and hepatic diseases and/or previous peripheral neuropathy (i.e. Amyloidosis, Fabry disease), hypertension, familial hypercolesterolemia, uncompensated DM, mitochondrial or metabolic disorders, syndromes associated with anemia or neutropenia (i.e. Barth synfrome)
Caution in patients taking sildenafil (i.e. pulmonary hypertension), sinvastatin, amiodaron, midazolam
LopinavirQT prolongation (CYP3A4 inhibition)
Bradyarrhythmias/AV blocks
Hypertension, angioedema, maculopapular rash, respiratory tract infection, peripheral neuropathy, hypercholesterolemia, hypertriglyceridemia, increased glucose, increased uric acid, increased transaminases and creatine kinase, decreased CrCl, neutropenia, anemia
Rare: ketoacidosis, insulin resistance, anorexia, hyperlactatemia, rhabdomyolysis
Potentially harmful in LQTs, HCM or other structural disease associated with LQT, acquired QT status
Caution in patients with congenital, inherited (i.e. SCN5A), or structural (i.e. Lamin A/C, desmin, mitchocondrial) AV blocks
Caution in patients with previous renal and hepatic diseases and/or previous peripheral neuropathy (i.e. Amyloidosis, Fabry disease), hypertension, familial hypercolesterolemia, uncompensated DM, mitochondrial or metabolic disorders, syndromes associated with anemia or neutropenia (i.e. Barth synfrome)
Caution in patients taking sildenafil (i.e. pulmonary hypertension), sinvastatin, amiodaron, midazolam
RemdesivirNo definite effect on cardiac electrical activityLiver enzyme increase
TocilizumabNo definite effect on cardiac electrical activity
Drug idiosyncrasy, hypertension, hypercolesterolemia, respiratory tract or other infections, increased transaminase, reduced CrCl,
Caution in patients with previous renal and hepatic diseases, hypertension, familial hypercolesterolemia
Caution in patients taking other immunosoppressive drugs (i.e. cortisone, ciclosporin), simvastatin/atorvastatin, amlodipin, teofillin, warfarin, temazepam
Low molecular weight EparinNo definite effect on cardiac electrical activity
Uncontrolled bleeding
Heparin induced thrombocytopenia
Elevated liver enzymes
Caution in patients with splenomegaly status (i.e. Gaucher disease, amyloidosis, sarcoidosis)
Caution in patients with previous thrombocytopenia or coagulation factors deficits (i.e. Rasopathies: Noonan syndrome)
Caution in patients with severe renal and hepatic diseases
Caution in patients taking high dose diuretics, captopril, abciximab, clopidogrel, digoxin
  1. aIn absence of clear benefit and safety data from well designed, randomized, controlled clinical trials, the WHO and many national authorities have issued specific warnings for the use of hydroxychloroquine, particularly in association with azitromicin (https://www.who.int/emergencies/diseases/novel-coronavirus-2019/coronavirus-disease-answers?query=hydroxychloroquine)