Suggestions on the use of drugs for COVID-19 infection in organ transplant recipients (2023)

doi:10.3877/cma.j.issn.1674-3903.2023.01.003

Abstract

National Alliance of Transplant Pharmacists, Zhejiang Hospital Pharmacy Management Quality Control Center. Suggestions on the use of drugs for COVID-19 infection in organ transplant recipients (2023)[J]. Chinese Journal of Transplantation(Electronic Edition), 2023, 17(01): 17-31.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhyzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3903.2023.01.003

https://zhyzzz.cma-cmc.com.cn/EN/Y2023/V17/I01/17

Figures/Tables 3

References 97

1	Hammond J, Leister-Tebbe H, Gardner A, et al. Oral nirmatrelvir for high-risk, nonhospitalized adults with Covid-19[J]. N Engl J Med，2022，386(15)：1397-1408.
2	Najjar-Debbiny R, Gronich N, Weber G, et al. Effectiveness of Paxlovid in reducing severe COVID-19 and mortality in high risk patients[J]. Clin Infect Dis, 2022. [Epub ahead of print]
3	Update to living WHO guideline on drugs for covid-19[J]. BMJ, 2022，378：o2224.
4	Hedvat J, Lange NW, Salerno DM, et al. COVID-19 therapeutics and outcomes among solid organ transplant recipients during the Omicron BA.1 era[J]. Am J Transplant, 2022，22(11)：2682-2688.
5	Salerno DM, Jennings DL, Lange NW, et al. Early clinical experience with nirmatrelvir/ritonavir for the treatment of COVID-19 in solid organ transplant recipients[J]. Am J Transplant, 2022，22(8)：2083-2088.
6	Devresse A, Briol Sébastien, De Greef J, et al. Safety, efficacy, and relapse of nirmatrelvir ritonavir in kidney transplant recipients infected with SARS-CoV-2[J]. Kidney Int Rep, 2022，7(11)：2356-2363.
7	浙江省医院药事管理质控中心. 浙江省新型冠状病毒感染临床用药建议(第一期)[EB/OL]. (2023-1-8)[2023-01-16]. URL
8	Pfizer. Pfizer shares top-line results from phase 2/3 Epic-Pep Study of Paxlovid™ for post-exposure prophylactic use[EB/OL]. (2022-04-29) [2022-12-02]. URL
9	奈玛特韦片/利托那韦片组合包装说明书[EB/OL]. (2022-11-18) [2023-01-02]. URL
10	Lingscheid T, Kinzig M, Krüger A, et al. Pharmacokinetics of nirmatrelvir and ritonavir in COVID-19 patients with end-stage renal disease on intermittent hemodialysis[J]. Antimicrob Agents Chemother, 2022，66(11)：e0122922.
11	Hiremath S, McGuinty M, Argyropoulos C, et al. Prescribing nirmatrelvir/ritonavir for COVID-19 in advanced CKD[J]. Clin J Am Soc Nephrol, 2022，17(8)：1247-1250.
12	Lemaitre F, Budde K, Van Gelder T, et al. Therapeutic drug monitoring and dosage adjustments of immunosuppressive drugs when combined with nirmatrelvir/ritonavir in patients with COVID-19[J]. Ther Drug Monit, 2022. [Epub ahead of print]
13	Badri P, Dutta S, Coakley E, et al. Pharmacokinetics and dose recommendations for cyclosporine and tacrolimus when coadministered with ABT-450, ombitasvir, and dasabuvir[J]. Am J Transplant, 2015，15(5): 1313-1322.
14	Krown SE, Roy D, Lee JY, et al. Rapamycin with antiretroviral therapy in AIDS-associated Kaposi sarcoma: an AIDS Malignancy Consortium study[J]. J Acquir Immune Defic Syndr, 2012，59(5): 447-454.
15	MAGICapp. Safety and efficacy of molnupiravir compared to standard care/placebo[EB/OL]．[2023-01-16]. URL
16	Butler CC, Hobbs FDR, Gbinigie OA, et al. Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial[J]. Lancet. 2022. [Epub ahead of print]
17	Poznański P, Augustyniak-Bartosik H, Magiera-Z·ak A, et al. Molnupiravir when used alone seems to be safe and effective as outpatient COVID-19 therapy for hemodialyzed patients and kidney transplant recipients[J]. Viruses, 2022，14(10)：2224.
92	Danieli MG, Piga MA, Paladini A, et al. Intravenous immunoglobulin as an important adjunct in the prevention and therapy of coronavirus 2019 disease[J]. Scand J Immunol, 2021, 94(5): e13101.
93	Al-Ani F, Chehade S, Lazo-Langner A. Thrombosis risk associated with COVID-19 infection. A scoping review[J]. Thromb Res, 2020，192：152-160.
94	Kareva L, Mironska K, Stavric K, et al. Adverse reactions to intravenous immunoglobulins - our experience[J]. Open Access Maced J Med Sci, 2018，6(12): 2359-2362.
95	Jordan SC, Kucher K, Bagger M, et al. Intravenous immunoglobulin significantly reduces exposure of concomitantly administered anti-C5 monoclonal antibody tesidolumab[J]. Am J Transplant, 2020，20(9)：2581-2588.
96	Salerno SN, Deng R, Kakkar T. Physiologically-based pharmacokinetic modeling of immunoglobulin and antibody coadministration in patients with primary human immunodeficiency[J]. CPT Pharmacometrics Syst Pharmacol, 2022, 11(10)：1316-1327.
97	Vo AA, Choi J, Kim I, et al. A phase I/II trial of the interleukin-6 receptor-specific humanized monoclonal (Tocilizumab) ＋ intravenous immunoglobulin in difficult to desensitize patients[J]. Transplantation, 2015，99(11)：2356-2363.
18	Villamarín M, Márquez-Algaba E, Esperalba J, et al. Preliminary clinical experience of molnupiravir to prevent progression of COVID-19 in kidney transplant recipients[J]. Transplantation, 2022，106(11)：2200-2204.
19	Kneidinger N, Hecker M, Bessa V, et al. Outcome of lung transplant recipients infected with SARS-CoV-2/Omicron/B.1.1.529: a Nationwide German study[J]. Infection, 2022：1-9.
20	Radcliffe C, Palacios CF, Azar MM, et al. Real-world experience with available, outpatient COVID-19 therapies in solid organ transplant recipients during the omicron surge[J]. Am J Transplant, 2022，22(10)：2458-2463.
21	莫诺拉韦胶囊说明书[EB/OL]. (2022-12-29) [2023-01-02]. URL
22	National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines[EB/OL]. [2023-01-03]. URL
23	Wong GL, Yip TC, Lai MS, et al. Incidence of viral rebound after treatment with nirmatrelvir-ritonavir and molnupiravir[J]. JAMA Netw Open, 2022，5(12)：e2245086.
24	COVID-19 Drug Interactions[DB/OL]. The University of Liverpool. [2023-01-16]. URL
25	Ren Z, Luo H, Yu Z, et al. A randomized, open-label, controlled clinical trial of azvudine tablets in the treatment of mild and common COVID-19, a pilot study[J]. Adv Sci (Weinh), 2020，7(19)：e2001435.
26	Study on Safety and Clinical Efficacy of AZVUDINE in Initial Stage COVID-19 Patients (SARS-CoV-2 Infected)[EB/OL]. [2023-01-16]. URL
27	Study on Safety and Clinical Efficacy of AZVUDINE in COVID-19 Patients (SARS-CoV-2 Infected) [EB/OL]. [2023-01-16]. URL
28	中华人民共和国国家卫生健康委员会. 新型冠状病毒感染诊疗方案(试行第十版)[EB/OL]. (2023-01-07) [2023-01-16]. URL
29	阿兹夫定片(捷倍安)药品说明书[EB/OL]. (2022-07-28) [2023-01-02]. URL
30	广东省药学会. 新型冠状病毒肺炎抗病毒治疗临床药学指引(更新版)[EB/OL]. (2022-12-17) [2023-01-16]. URL
31	Zhou T, Wang L, Misasi J, et al. Structural basis for potent antibody neutralization of SARS-CoV-2 variants including B．1.1.529[J]. Science, 2022，376(6591)：eabn8897.
32	Ji Y, Zhang Q, Cheng L, et al. Preclinical characterization of amubarvimab and romlusevimab, a pair of non-competing neutralizing monoclonal antibody cocktail, against SARS-CoV-2[J]. Front Immunol, 2022，13：980435.
33	Vita S, Rosati S, Ascoli Bartoli T, et al. Monoclonal antibodies for pre- and postexposure prophylaxis of COVID-19: review of the literature[J]. Pathogens, 2022，11(8)：882.
34	Qin S, Cui M, Sun S, et al. Genome characterization and potential risk assessment of the novel SARS-CoV-2 variant Omicron (B.1.1.529) [J]. Zoonoses, 2021，1(1)：1-5.
35	Wu MY, Carr EJ, Harvey R, et al. WHO's Therapeutics and COVID-19 Living Guideline on mAbs needs to be reassessed[J]. Lancet, 2023，400(10369)：2193-2196.
36	Ling Z, Yi C, Sun X, et al. Broad strategies for neutralizing SARS-CoV-2 and other human coronaviruses with monoclonal antibodies[J]. Sci China Life Sci, 2022：1-21.
37	Hoy SM. Amubarvimab/romlusevimab: first approval[J]. Drugs, 2022，82(12)：1327-1331.
38	ACTIV-3/Therapeutics for Inpatients with COVID-19 (TICO) Study Group. Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): a randomised controlled trial[J]. Lancet Infect Dis, 2022，22(5)：622-635.
39	安巴韦单抗注射液说明书[EB/OL]. (2021-12-08) [2023-01-02]. URL
40	罗米司韦单抗注射液说明书[EB/OL]. (2021-12-08) [2023-01-02]. URL
41	Tixagevimab and cilgavimab (Evusheld) for pre-exposure prophylaxis of COVID-19[J]. JAMA, 2022，327(4)：384-385.
42	RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in hospitalized patients with COVID-19[J]. N Engl J Med, 2021，384(8)：693-704.
43	Buehrle DJ, Sutton RR, McCann EL, et al. A review of treatment and prevention of coronavirus disease 2019 among solid organ transplant recipients[J]. Viruses, 2021，13(9)：1706.
44	Sigler R, Chen V, Law N. Evolution of clinical care in COVID-infected solid organ transplant recipients[J]. Curr Transplant Rep, 2022，9(3)：185-198.
45	Marchese V, Crosato V, Gulletta M, et al. Strongyloides infection manifested during immunosuppressive therapy for SARS-CoV-2 pneumonia[J]. Infection, 2021，49(3)：539-542.
46	Matsuyama S, Kawase M, Nao N, et al. The inhaled steroid ciclesonide blocks SARS-CoV-2 RNA replication by targeting the viral replication-transcription complex in cultured cells[J]. J Virol, 2020，95(1)：e01648-20.
47	Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19[J]. Clin Infect Dis, 2020: ciaa478.
48	Yu LM, Bafadhel M, Dorward J, et al. Inhaled budesonide for COVID-19 in people at high risk of complications in the community in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial[J]. Lancet, 2021，398(10303)：843-855.
49	British Society Transplantation. Guidance on the management of transplant recipients diagnosed with or suspected of having COVID19[EB/OL]. (2022-01-27) [2023-01-16]. URL
50	López V, Mazuecos A, Villanego F, et al. Update of the recommendations on the management of the SARS-CoV-2 coronavirus pandemic (COVID-19) in kidney transplant patients[J]. Nefrologia, 2022. [Epub ahead of print]
51	Johnson KM, Belfer JJ, Peterson GR, et al. Managing COVID-19 in renal transplant recipients: a review of recent literature and case supporting corticosteroid-sparing immunosuppression[J]. Pharmacotherapy, 2020，40(6)：517-524.
52	Alfano G, Damiano F, Fontana F, et al. Immunosuppressive therapy reduction and early post-infection graft function in kidney transplant recipients with COVID-19[J]. G Ital Nefrol, 2021，38(6)：2021-vol6.
53	Lier AJ, Tuan JJ, Davis MW, et al. Case report: disseminated strongyloidiasis in a patient with COVID-19[J]. Am J Trop Med Hyg, 2020，103(4)：1590-1592.
54	RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial[J]. Lancet. 2021；397(10285)：1637-1645.
55	WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group, Shankar-Hari M, Vale CL, et al. Association between administration of IL-6 antagonists and mortality among patients hospitalized for COVID-19: a meta-analysis[J]. JAMA, 2021，326(6): 499-518.
56	Abidi E, El Nekidy WS, Alefishat E, et al. Tocilizumab and COVID-19: timing of administration and efficacy[J]. Front Pharmacol, 2022，13：825749.
57	Yamani AH, Alraddadi BM, Almaghrabi RS, et al. Early use of tocilizumab in solid organ transplant recipients with COVID-19: a retrospective cohort study in Saudi Arabia[J]. Immun Inflamm Dis, 2022，10(3)：e587.
58	Coll E, Fernández-Ruiz M, Sánchez-Álvarez JE, et al. COVID-19 in transplant recipients: the Spanish experience[J]. Am J Transplant, 2021，21(5)：1825-1837.
59	Pereira MR, Mohan S, Cohen DJ, et al. COVID-19 in solid organ transplant recipients: initial report from the US epicenter[J]. Am J Transplant, 2020，20(7)：1800-1808.
60	Matthay MA, Luetkemeyer AF. IL-6 receptor antagonist therapy for patients hospitalized for COVID-19: who, when, and how？[J]. JAMA, 2021，326(6)：483-485.
61	National Health Service. Interleukin-6 inhibitors (tocilizumab or sarilumab) for hospitalised patients with COVID-19 pneumonia (adults) [EB/OL]. (2021-02-17) [2023-01-03]. URL
62	Galván-Román JM, Rodríguez-García SC, Roy-Vallejo E, et al. IL-6 serum levels predict severity and response to tocilizumab in COVID-19: an observational study[J]. J Allergy Clin Immunol, 2021，147(1)：72-80.
63	Mohzari YA, Alamer A, Alattas M, et al. Tocilizumab effectiveness in mechanically ventilated COVID-19 patients (T-MVC-19 Study): a multicenter real-world evidence[J]. Expert Rev Anti Infect Ther, 2022，20(7)：1037-1047.
64	Perrone F, Piccirillo MC, Ascierto PA, et al. Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial[J]. J Transl Med, 2020，18(1)：405.
65	托珠单抗注射液说明书[EB/OL]. (2022-07-07) [2023-01-02]. URL
66	Kewan T, Covut F, Al-Jaghbeer MJ, et al. Tocilizumab for treatment of patients with severe COVID-19: a retrospective cohort study[J]. EClinicalMedicine, 2020，24: 100418.
67	Vu CA, DeRonde KJ, Vega AD, et al. Effects of tocilizumab in COVID-19 patients: a cohort study[J]. BMC Infect Dis, 2020，20(1)：964.
68	Rosas IO, BrÄu N, Waters M, et al. Tocilizumab in hospitalized patients with severe covid-19 pneumonia[J]. N Engl J Med, 2021，384(16)：1503-1516.
69	Ashley C, Dunleavy A. The Renal Drug Handbook[M]. 5th ed. Boca Raton: CRC Press, 2017.
70	Gupta S, Madhyastha R, Hamed F, et al. Tocilizumab use in a chronic hemodialysis patient for the management of COVID-19-associated pneumonia and acute respiratory distress syndrome[J]. Case Rep Nephrol, 2020：8829309.
71	Faour WH, Choaib A, Issa E, et al. Mechanisms of COVID-19-induced kidney injury and current pharmacotherapies[J]. Inflamm Res, 2022，71(1)：39-56.
72	Ely EW, Ramanan AV, Kartman CE, et al. Efficacy and safety of baricitinib plus standard of care for the treatment of critically ill hospitalised adults with COVID-19 on invasive mechanical ventilation or extracorporeal membrane oxygenation: an exploratory, randomised, placebo-controlled trial[J]. Lancet Respir Med, 2022，10(4): 327-336.
73	Wolfe CR, Tomashek KM, Patterson TF, et al. Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial[J]. Lancet Respir Med, 2022，10(9)：888-899.
74	RECOVERY Collaborative Group. Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis[J]. Lancet, 2022，400(10349): 359-368.
75	巴瑞替尼片说明书[EB/OL]. (2021-05-10) [2023-01-03]. URL
76	Veeravalli V, Dash RP, Thomas JA, et al. Critical assessment of pharmacokinetic drug-drug interaction potential of tofacitinib, baricitinib and upadacitinib, the three approved Janus kinase inhibitors for Rrheumatoid arthritis treatment[J]. Drug Saf, 2020，43(8)：711-725.
77	Reid NK, Joyner KR, Lewis-Wolfson TD. Baricitinib versus tocilizumab for the treatment of moderate to severe COVID-19[J]. Ann Pharmacother, 2022. [Epub ahead of print]
78	Karampitsakos T, Papaioannou O, Tsiri P, et al. Tocilizumab versus baricitinib in hospitalized patients with severe COVID-19: an open label, randomized controlled trial[J]. Clin Microbiol Infect, 2022. [Epub ahead of print]
79	Karolyi M, Gruebl A, Omid S, et al. Tocilizumab vs. baricitinib in hospitalized severe COVID-19 patients: results from a real-world cohort[J]. Infection, 2022：1-8.
80	Niu J, Lin Z, He Z, et al. Janus kinases inhibitors for coronavirus disease-2019: a pairwise and Bayesian network meta-analysis[J]. Front Med (Lausanne), 2022，9: 973688.
81	Arumugham VB, Rayi A. Intravenous Immunoglobulin (IVIG)[M/OL]. Treasure Island (FL): StatPearls Publishing, 2022[2023-01-02]. URL
82	Dézsi L, Horváth Z, Vécsei L. Intravenous immunoglobulin: pharmacological properties and use in polyneuropathies[J]. Expert Opin Drug Metab Toxicol, 2016, 12(11)：1343-1358.
83	Shao Z, Feng Y, Zhong L, et al. Clinical efficacy of intravenous immunoglobulin therapy in critical ill patients with COVID-19: a multicenter retrospective cohort study[J]. Clin Transl Immunology, 2020, 9(10)：e1192.
84	Mazeraud A, Jamme M, Mancusi RL, et al. Intravenous immunoglobulins in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome (ICAR): multicentre, double-blind, placebo-controlled, phase 3 trial[J]. Lancet Respir Med, 2022，10(2)：158-166.
85	Lai CC, Chen WC, Chen CY, et al. The effect of intravenous immunoglobulins on the outcomes of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials[J]. Expert Rev Anti Infect Ther, 2022，20(10): 1333-1340.
86	中华医学会呼吸病学分会，中国医师协会呼吸医师分会危重症医学专家组. 奥密克戎变异株所致重症新型冠状病毒感染临床救治专家推荐意见[J]. 中华结核和呼吸杂志. 2023. [Epub ahead of print]
87	Wang T, Qiu T, Yuan Y, et al. Summary report of seven cases of COVID-19 infection in renal transplant recipients[J]. Transpl Immunol, 2021，69：101445.
88	潘频华，张丽娜，黄燕，等. 中南大学湘雅医院新型冠状病毒感染诊疗方案(试行)[EB/OL]. (2023-01-02) [2023-01-03]. URL
89	Kaplan B, Bonagura VR. Secondary hypogammaglobulinemia: an increasingly recognized complication of treatment with immunomodulators and after solid organ transplantation[J]. Immunol Allergy Clin North Am, 2019, 39(1): 31-47.
90	Hoang J, Krisl J, Moaddab M, et al. Intravenous immunoglobulin in heart transplant recipients with mild to moderate hypogammaglobulinemia and infection[J]. Clin Transplant, 2022，36(4)：e14571.
91	Jordan SC, Toyoda M, Kahwaji J, et al. Clinical aspects of intravenous immunoglobulin use in solid organ transplant recipients[J]. Am J Transplant, 2011, 11(2): 196-202.

肾功能	剂量调整建议
eGFR >60～90 mL·min^－1·(1.73 m²)^－1	无需调整剂量：奈玛特韦300 mg＋利托那韦100 mg，每12小时1次
eGFR 30～60 mL·min^－1·(1.73 m²)^－1	奈玛特韦150 mg＋利托那韦100 mg，每12小时1次，连续5 d
eGFR <30 mL·min^－1·(1.73 m²)^－1，未透析	药品说明书不推荐使用文献推荐：第1天，奈玛特韦300 mg＋利托那韦100 mg，1次/d；第2～5天，奈玛特韦150 mg＋利托那韦100 mg，1次/d
透析	药品说明书不推荐使用文献推荐：第1天，奈玛特韦300 mg＋利托那韦100 mg，1次/d；第2～5天，奈玛特韦150 mg＋利托那韦100 mg，透析后给药，1次/d 体质量≤40 kg者可考虑奈玛特韦150 mg＋利托那韦100 mg，每48小时1次

肾功能	剂量调整建议
eGFR >60～90 mL·min^－1·(1.73 m²)^－1	无需调整剂量：奈玛特韦300 mg＋利托那韦100 mg，每12小时1次
eGFR 30～60 mL·min^－1·(1.73 m²)^－1	奈玛特韦150 mg＋利托那韦100 mg，每12小时1次，连续5 d
eGFR <30 mL·min^－1·(1.73 m²)^－1，未透析	药品说明书不推荐使用文献推荐：第1天，奈玛特韦300 mg＋利托那韦100 mg，1次/d；第2～5天，奈玛特韦150 mg＋利托那韦100 mg，1次/d
透析	药品说明书不推荐使用文献推荐：第1天，奈玛特韦300 mg＋利托那韦100 mg，1次/d；第2～5天，奈玛特韦150 mg＋利托那韦100 mg，透析后给药，1次/d 体质量≤40 kg者可考虑奈玛特韦150 mg＋利托那韦100 mg，每48小时1次

免疫抑制剂	调整建议	启用建议
他克莫司	奈玛特韦/利托那韦使用前12 h暂停使用	第6天或第7天检测他克莫司血药浓度，此后每2～4天复查；超过治疗目标浓度，继续停用；在治疗目标浓度范围内，以基线剂量的25%～50%重新启用；低于治疗目标浓度，以基线剂量的25%～75%重新启用
环孢素	剂量减至原来的20%，同时改为每日1次服用	第6天开始逐步重新启用
西罗莫司	奈玛特韦/利托那韦使用前12 h停用	可在第7天以原剂量的20%重新启用，每日剂量增加20%
霉酚酸类药物	奈玛特韦/利托那韦与麦考酚钠相互作用较小，可根据COVID-19严重程度考虑不调整、减量或停用
糖皮质激素	奈玛特韦/利托那韦与泼尼松相互作用较小，可根据COVID-19严重程度，使用不同剂量糖皮质激素

免疫抑制剂	调整建议	启用建议
他克莫司	奈玛特韦/利托那韦使用前12 h暂停使用	第6天或第7天检测他克莫司血药浓度，此后每2～4天复查；超过治疗目标浓度，继续停用；在治疗目标浓度范围内，以基线剂量的25%～50%重新启用；低于治疗目标浓度，以基线剂量的25%～75%重新启用
环孢素	剂量减至原来的20%，同时改为每日1次服用	第6天开始逐步重新启用
西罗莫司	奈玛特韦/利托那韦使用前12 h停用	可在第7天以原剂量的20%重新启用，每日剂量增加20%
霉酚酸类药物	奈玛特韦/利托那韦与麦考酚钠相互作用较小，可根据COVID-19严重程度考虑不调整、减量或停用
糖皮质激素	奈玛特韦/利托那韦与泼尼松相互作用较小，可根据COVID-19严重程度，使用不同剂量糖皮质激素

肾功能	剂量和用法
eGFR >60 mL·min^－1·(1.73 m²)^－1	原剂量：5 mg，1次/d
eGFR 30～60 mL·min^－1·(1.73 m²)^－1	3 mg，1次/d
eGFR 15～<30 mL·min^－1·(1.73 m²)^－1	慎用
血液透析	持续6 h以上的血液透析患者，全剂量维持，建议透析后给药
CRRT	推测可按正常剂量使用

Please choose a citation manager

Content to export

Suggestions on the use of drugs for COVID-19 infection in organ transplant recipients (2023)

RichHTML

PDF (PC)

Knowledge

Cited

Abstract

Cite this article

share this article

Figures/Tables 3

References 97

Related Articles 0

Recommended Articles

Metrics

Comments

模态框（Modal）标题

Please choose a citation manager

Content to export

Suggestions on the use of drugs for COVID-19 infection in organ transplant recipients (2023)

RichHTML

PDF (PC)

Knowledge

Cited

Abstract

Cite this article

share this article

Figures/Tables 3

References 97

Related Articles 0

Recommended Articles

Metrics

Comments