E important drug interaction may possibly occur between alpha and beta antagonists with sofosbuvir/RBV regimen during HCV therapy that close monitoring is required.42 The study conducted by Ramanathan et al.43 has not demonstrated a pharmacokinetic interactionbetweentenofovirandRBV.ThedetailsofRBVdruginteractions are shown in Table 1.The helpful pharmacotherapy can reduce the mortality and morbidity of COVID-19.12 Studies are NK1 web advised many mixture therapy with chloroquine, lopinavir/ritonavir (Kaletra), ribavirin (RBV)andtocilizumab(TCZ)forthetreatmentofCOVID-19.13OnMay2,2020,FDAapprovesemergencyuseofremdesivir(RDV)for COVID-19. One of the most important complications in pharmacotherapy is drug-drug interaction (DDI) which could significantly enhance the adverse effects of drug. The present write-up focuses on reviewing DDIsofchloroquine,RBV,Kaletra,TCZ,andRDVtoreducesideeffects of COVID-19 treatment.2 | R I BAV I R I NRibavirin (Virazole, as a broad-spectrum antiviral drug, was approvedbyFDAin1986andadministeredasanaerosolforinfants with respiratory syncytial virus infection.17RBVisanucleos(t)ideanalogue polymerase inhibitor that is utilized for the treatment of hepatitis C virus infection in combination with sofosbuvir and pegylated interferon alpha-2b.18,three | C H LO RO QU I N EChloroquine, a 4-aminoquinolone derivative, is utilized in the prophylaxis and remedy of uncomplicated malaria. It’s also successful in systemic lupus erythematosus and rheumatoid arthritis.446 The critical unwanted effects related with chloroquine are retinopathy, ototoxicity, and myopathy.470 Chloroquine can inhibit organic anion transporting polypeptide 1A2 that the inhibition of this transporter is linked with retinopathy.51 Chloroquine can induce psoriasis in patient as exfoliative erythroderma and pustular psoriasis. 52 The National Well being Commission of your People’s Republic of China for tentative treatment of COVID-19 (version 6) recommends chloroquine for the treatment of COVID-19 at doses of 500 mg oral twice daily for 10 days that could shorten the recovery period and enhance pulmonary complication findings in imaging.53 In sufferers with CrCl 10 ml/min, the advisable dose of chloroquine is 50 standard dose.16,53,54 Chloroquine is fully absorbed just after oral administration and it’s distributed widely in tissues that incorporate kidney, liver, lung and spleen.54 About 60 of chloroquine is bound to plasma proteins.ItismetabolizedbyCYP2C8andCYP3A4enzymesinthe liver and ULK2 site converted into active metabolites (desethylchloroquine and bisdesethylchloroquine).54,55 The mechanism of action of chloroquine is inhibition with the polymerization of heme which heme accumulate as toxic agent inside the parasite.54 The concomitant administration of chloroquine and paracetamol cautiously.56 The absorption of chloroquine might lower by antto lessen the threat of drug interaction.57,58 A controlled study was performed by Ette et al.59 for analysis of interaction among cimetidine and chloroquine. The outcomes showed that cimetidine may lower the metabolism of chloroquine and boost its volume of distribution. The study performed by Ette et al.60 showed no substantial pharmacokinetic interaction in between ranitidine and chloroquine. As a result, ranitidine will be the H2 blocker of choice for ulcer patients getting chloroquine. A number of clinical studies indicate that chloroquine could boost the metformin-induced cell apoptosis and considerably enhance the metformin-induced inhibition of c.