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J Int Med Res . The interaction between nirmatrelvir/ritonavir and sirolimus: a case report of a kidney recipient with renal insufficiency and COVI

tetano

Editor, Senior Moderator
J Int Med Res


. 2025 Jan;53(1):3000605241307845.
doi: 10.1177/03000605241307845. The interaction between nirmatrelvir/ritonavir and sirolimus: a case report of a kidney recipient with renal insufficiency and COVID-19

Yinhua Gong[SUP] 1 [/SUP], Dan Shen[SUP] 2 [/SUP], Jinfang Shi[SUP] 1 [/SUP], Ye Jiang[SUP] 1 3 [/SUP], Jie Gao[SUP] 1 [/SUP]



Affiliations
Abstract

Nirmatrelvir/ritonavir is a novel drug combination authorized by the US Food and Drug Administration for the treatment of coronavirus disease 2019 (COVID-19). This report describes the case of a patient with a prior history of kidney transplantation who received nirmatrelvir/ritonavir. In this case, sirolimus use was successfully stopped before nirmatrelvir/ritonavir treatment, and the nirmatrelvir/ritonavir trough concentration was determined. During nirmatrelvir/ritonavir treatment, the sirolimus trough concentration remained stable. This case highlights the risk associated with the concomitant administration of sirolimus and nirmatrelvir/ritonavir. Providers should therefore be cautious when prescribing nirmatrelvir/ritonavir to kidney transplant recipients currently receiving sirolimus, with caution exercised based on creatinine clearance.

Keywords: COVID-19; Nirmatrelvir/ritonavir; drug–drug interaction; immunosuppression; kidney transplantation; sirolimus.

 
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