Drug-Drug Interactions between COVID-19 and Tuberculosis Medications: A Comprehensive Review of CYP450 and Transporter-Mediated Effects.

English summary

This review examines potential drug-drug interactions (DDIs) between COVID-19 and tuberculosis (TB) treatments through the roles of CYP450 enzymes and drug transporters. It considers pathways involved in absorption, distribution, metabolism, elimination, and pharmacokinetics to clarify how coadministration may lead to subtherapeutic or excessive exposure to COVID-19 medications, with the aim of informing safer medication management in patients with co-infection.

Key points

• Most medications are metabolized and eliminated through CYP450 enzymes, while uptake and efflux transporters also contribute substantially to drug elimination in various organs.
• Interactions may occur when multiple drugs share CYP450- and transporter-mediated pathways, requiring clinical management tailored to the type of interaction.
• The review describes interactions between COVID-19 and TB drugs in terms of the effects of CYP450 enzymes and transporters on drug absorption, distribution, metabolism, elimination, and pharmacokinetics.

Audience

The content is intended for clinicians, pharmacology researchers, and advanced students examining drug interactions, pharmacokinetics, and precision pharmacotherapy in COVID-19 and tuberculosis coinfection.

Scope and limitations

The supplied source text summarizes the review’s purpose and thematic scope but does not provide specific drug pairs, effect sizes, study designs, or clinical results. This summary is therefore limited to the mechanistic scope and significance stated in the source.

Research context

The topic aligns thematically with research on precision pharmacotherapy for infectious diseases based on drug-metabolizing enzymes, transporters, and pharmacokinetic interactions.