Probable QT Prolongation between Chloroquine/Hydroxychloroquine in Treatment of COVID-19 Infection and other Medications

Drug-drug interactions (DDI) occur when the effects of one drug are changed by the presence of another substance such as drugs, herbal products, and complementary medicines. Clinically significant DDIs are potentially life-threatening; therefore, it is essential to have a clear understanding and attention regarding the health care professionals towards DDIs and identify a proper management strategy. In late December 2019, early reports predicted the onset of a potential Coronavirus outbreak in China, given the estimate of a reproduction number for the 2019 Novel Coronavirus (COVID-19, named by WHO on Feb 11, 2020). In a short period, the virus spread has occurred in many countries such as Italy and Iran (2). Currently, no effective antiviral treatment or vaccine is available for COVID-19 except for the old antimalaria medications, which are shown to have significant efficacy and safety against COVID-19 associated pneumonia in multicenter clinical trials conducted in China (3). Also, a group of Korean physicians with experience in treating SARS-CoV-2 infected patients have developed recommendations for the treatment of COVID-19. They have mentioned that treatment with lopinavir 400 mg daily; ritonavir 100 mg daily; chloroquine 1000 mg daily or hydroxychloroquine 400 mg daily (where chloroquine is unavailable) should be considered for use in older patients or patients with underlying conditions and serious symptoms.