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Management of Drug Interactions With Nirmatrelvir/Ritonavir (Paxlovid®): Resource for Clinicians - IDSA

Mary Wilson

Well-known member
Last Updated: May 6, 2022- Version 1.1*

Nirmatrelvir/ritonavir has FDA Emergency Use Authorization to treat mild-to-moderate COVID-19 in patients at high risk of progression to severe disease who are ≥12 years of age and weigh ≥40 kg.

In such patients, IDSA guidelines suggest nirmatrelvir/ritonavir be initiated within 5 days of symptom onset. Patients with mild-to-moderate COVID-19 who are at high risk of progression to severe disease admitted to the hospital for reasons other than COVID-19 may also receive nirmatrelvir/ritonavir. NIH guidelines also suggest nirmatrelvir/ritonavir for nonhospitalized patients with mild-to-moderate COVID-19 who are at high risk of disease progression.

Given coformulation with ritonavir as a pharmacokinetic booster, there is potential for drug interactions.
The following steps can be taken to minimize the risk of drug interactions for those who are eligible and would benefit from nirmatrelvir/ritonavir treatment: ...

... Among the top 100 prescribed drugs, only two have interactions so severe that nirmatrelvir/ ritonavir should be avoided altogether: rivaroxaban and salmeterol. ...

https://www.idsociety.org/globalass...id-drug-interactions-resource-5-6-22-v1.1.pdf
 
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