摘要
洛匹那韦/利托那韦主要用于人类免疫缺陷(艾滋病)病毒感染的治疗,临床上超说明书用于新型冠状病毒感染的治疗。临床发现使用该药后易引发多种不良反应,主要包括胃肠道反应、肝损伤、代谢紊乱、心血管和神经毒性不良反应。洛匹那韦/利托那韦不良反应机制可能与内质网应激、氧化应激、线粒体应激、细胞凋亡等有关,具有剂量相关性,剂量越高则不良反应越大,主要由肝脏CYP3A代谢,当其与某些具有较强CYP3A4抑制作用的药物共同使用时,往往会加重其不良反应。综述了洛匹那韦/利托那韦片的不良反应及其发生机制,为临床安全、合理用药提供参考。
Lopinavir/ritonavir is mainly used in treatment of HIV/AIDS infection,and it has also been reported that off-label use in COVID-19 clinical research.A variety of adverse reactions of lopinavir/ritonavir were caused after clinical use,mainly including gastrointestinal reaction,liver injury,metabolic disorder,cardiovascular and neurotoxicity,and so on.The adverse reaction mechanism of lopinavir/ritonavir may be related to endoplasmic reticulum stress,oxidative stress,mitochondrial stress,cell apoptosis,etc.Lopinavir/ritonavir has a dose-dependent relationship,and the higher the dose,the greater the adverse reaction.Lopinavir/ritonavir is mainly metabolized by liver CYP3A.When used together with some drugs with strong CYP3A4 inhibition,it often aggravates its adverse reactions.This article reviews the adverse reactions of lopinavir/ritonavir and their mechanisms,providing reference for clinical safe and rational use of drugs.
作者
王丹
张艳
吴新玉
徐永寿
邓艳
成蕾
唐富山
叶林虎
WANG Dan;ZHANG Yan;WU Xin-yu;XU Yong-shou;DENG Yan;CHENG Lei;TANG Fu-shan;YE Lin-hu(Department of Clinical Pharmacy,School of Pharmacy,Zunyi Medical University,Zunyi 563000,China;Department of Pharmacy,The First People’s Hospital of Bijie,Bijie 551700,China;The Fourth People’s Hospital of Guiyang,Guiyang 550000,China;The Sixth Affiliated Hospital of South China University of Technology,Foshan 528225,China)
出处
《现代药物与临床》
CAS
2023年第4期1014-1020,共7页
Drugs & Clinic
基金
毕节市应急计划项目(毕科合字[2022]01号)
毕节市联合基金项目(毕科联合字sy[2022]10号)
毕节市个体化用药人才团队项目。
关键词
洛匹那韦/利托那韦
不良反应
胃肠道反应
肝损伤
代谢紊乱
内质网应激
氧化应激
lopinavir/ritonavir
adverse drug reaction
gastrointestinal reaction
liver injury
metabolic disorder
endoplasmic reticulum stress
oxidative stress
