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Common Drugs That May Confer Higher Risk For COVID-19

4 years, 3 months ago

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Posted on Mar 17, 2020, 3 p.m.

It is known [1] that coronaviruses bind to target cells via angiotensin converting enzyme 2. COVID-19 attaches and binds to target cells through ACE2 protein sites on cells of the lung, intestine, kidneys and blood vessels. 

Angiotensin converting enzyme 2 sites are increased [2] by Ibuprofen, antihypertensive medications such as ACE inhibitors, ARBS, Thiazolidedinones, as well as type 1 and type 2 diabetes. 

The most frequent comorbidities include diabetes, hypertension, coronary artery disease, and cerebrovascular diseases that have been reported thus far in those with COVID-19, and these are typically treated with ACE inhibitors, although this was not mentioned in the studies. 

The higher level of angiotensin converting enzyme 2 may increase infection with COVID-19 and consequently may also increase the risks for both severe and fatal infection of the COVID-19 virus. However, antihypertensive calcium channel blockers [3] don’t increase ACE2, and should be taken into consideration as a possible alternative drug and may be worth having a conversation with your prescribing physician about.

Examples of angiotensin converting enzyme ACE inhibitors include: 

  • Captopril (Capoten),
  • Enalapril (Vasotec),
  • Fosinopril (Monopril),
  • Lisinopril (Prinivil, Zestril),
  • Moexipril (Univasc)
  • Perindopril (Aceon),
  • Quinapril (Accupril),
  • Ramipril (Altace), 
  • Trandolapril (Mavik),
  • Benazepril (Lotensin, Lotensin Hct).

Examples of (ARBs) angiotensin II receptor blockers include:

  • Azilsartan (Edarbi)
  • Candesartan (Atacand)
  • Eprosartan
  • Irbesartan (Avapro)
  • Losartan (Cozaar)
  • Olmesartan (Benicar)
  • Telmisartan (Micardis)
  • Valsartan (Diovan)

Examples of Thiazolidnediones include:

  • Rosiglitazone (Avandia)
  • Pioglitazone (Actos)

Examples of calcium channel blockers include:

  • Norvasc (amlodipine)
  • Plendil (felodipine)
  • DynaCirc (isradipine)
  • Cardene (nicardipine)
  • Procardia XL, Adalat (nifedipine)
  • Cardizem, Dilacor, Tiazac, Diltia XL (diltiazem)
  • Sular (Nisoldipine)
  • Isoptin, Calan, Verelan, Covera-HS (verapamil) 

This article is not diagnosing disease or recommending treatment of disease, rather sharing information for you to discuss with your physician who can determine what nutrition, disease and injury treatment or regimen will best suit your personal needs.

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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement

[1] Wan Y et al. Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS. J Virology. 2020; (published online Jan 29). DOI:10.1128/JVI.00127-20

[2] Li XC et al. The vasoprotective axes of the renin-angiotensin system: physiological relevance and therapeutic implications in cardiovascular, hypertensive and kidney diseases. Pharmacol Res. 2017; 125: 21-38

[3] Fang L, et al. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respiratory Medicine. March 11, 2020. 

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