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. 2022 Sep 22;12(10):889. doi: 10.3390/metabo12100889

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© 2022 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Depiction of the interaction between antiviral medicaments and antiplatelet drugs on CYP3A4 metabolism. In the marked red box, antiviral agents are represented. Lopinavir and ritonavir drive an inhibitory action on the cytochrome. This activity may increase the exposure of ticagrelor (marked yellow box), leading to a dysregulation of hemostasis (highlighted in the picture being the only depicted potential effect). Conversely, remdesivir (marked red box) is an inducer of CYP3A4 function. Differently from ticagrelor, prasugrel (marked yellow box) is metabolized by several cytochromes (2C19, 2C9, 3A4/3A5, 2B6, and 2D6), thus its effects seem to be unmodified by ritonavir or lopinavir interaction. Abbreviations: CYP3A4: cytochrome P450 3A4, ADP P2Y12 receptor: adenosine 5′diphosphate P2Y12 receptor.