Table 3.

Gastrointestinal Treatment Adverse Effects of Currently Utilized COVID-19 Therapies

Medication type	Medication name	Adverse effects		Major drug–drug interactions
		Gastrointestinal	Hepatic
Antimalarial	Chloroquine Hydroxychloroquine	Nausea, vomiting, abdominal pain, and diarrhea reported; frequency not defined	Likelihood score: D (possible rare cause of clinically apparent liver injury). Description: Rare elevations in aminotransferases. Most reactions are hypersensitivity with no known cross reactivity to hepatic injury. If this occurs, reasonable to switch between chloroquine therapies.	Substrate for CYP2D6 and CYP3A4 substrate Same as above; also substrate for CYP3A5 and CYP2C8
Antiviral	Remdesivir	Not reported (limited data available)	Likelihood score: Not scored. Description: Hepatotoxicity reported; frequency not yet known.	Not a significant inducer/inhibitor of CYP enzymes
	Lopinavir/ritonavir	Nausea and vomiting: 5%–10% (higher in children: 20%) Abdominal pain: 1%–10% Diarrhea: 10%–30% + dose-dependent Other: dysguesia in adults <2%, children: 25%, increased serum amylase, lipase: 3%–8%.	Likelihood score: D (possible, rare cause of clinically apparent liver injury). Description: Hepatotoxicity ranges from mild elevations in aminotransferases to acute liver failure. Recovery takes 1–2 mo. Re-challenging may lead to recurrence and should be avoided if possible.	Substrate for: CYP3A4, CYP2D6 P-gp Inducer for: CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, UGT1A1 Inhibitor for: CYP3A4
	Favipiravir	Nausea/vomiting: 5%–15% Diarrhea: 5% Limited data available	Likelihood score: Not scored Description: 3% prevalence, but few data available.	Inhibitor for: CYP2C8 and aldehyde oxidase Metabolized by xanthine oxidase and aldehyde oxidase