Nirmatrelvir-ritonavir: Difference between revisions
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== Background == |
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* Indicated for mild to moderate [[COVID-19]] infection |
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* Combination medication includes: [[nirmatrelvir]], a protease inhibitor that interferes with viral replication, and [[ritonavir]], which boosts levels of [[nirmatrelvir]] by interfering with CYP3A-mediated drug metabolism |
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== Dosing == |
== Dosing == |
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* COVID-19: |
* Mild-to-moderate [[COVID-19]] (within 5 days of symptom onset): nirmatrelvir/ritonavir 300 mg/100 mg p.o. bid for 5 days |
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=== Renal Dosing === |
=== Renal Dosing === |
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* eGFR 30-59 mL/min: 150 mg/100 mg p.o. bid |
* eGFR 30-59 mL/min: 150 mg/100 mg p.o. bid |
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* eGFR <30 mL/min: 300 mg/100 mg load on day 1, followed by 150 mg/100 mg p.o daily for 4 more days |
* eGFR <30 mL/min: 300 mg/100 mg load on day 1, followed by 150 mg/100 mg p.o daily for 4 more days |
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* Dialysis: |
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* |
** Weight ≥40 kg: 300 mg/100 mg load on day 1, followed by 150 mg/100 mg p.o daily for 4 more days |
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** Weight <40 kg: 150 mg/100 mg every 48 hours for 3 doses |
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** Give after dialysis on dialysis days |
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=== Hepatic Dosing === |
=== Hepatic Dosing === |
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* [[Child-Pugh classification|Child-Pugh]] class C: contraindicated |
* [[Child-Pugh classification|Child-Pugh]] class C: contraindicated |
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== Safety == |
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=== Contraindications === |
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* Hypersensitivity reaction |
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* Severe liver disease ([[Child-Pugh classification|Child-Pugh]] Class C) |
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* Drug-drug interactions (check [https://www.covid19-druginteractions.org/checker Liverpool site]) |
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[[Category:Medications]] |
[[Category:Medications]] |
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Latest revision as of 14:42, 6 May 2025
Background
- Indicated for mild to moderate COVID-19 infection
- Combination medication includes: nirmatrelvir, a protease inhibitor that interferes with viral replication, and ritonavir, which boosts levels of nirmatrelvir by interfering with CYP3A-mediated drug metabolism
Dosing
- Mild-to-moderate COVID-19 (within 5 days of symptom onset): nirmatrelvir/ritonavir 300 mg/100 mg p.o. bid for 5 days
Renal Dosing
- eGFR ≥60 mL/min: no adjustment
- eGFR 30-59 mL/min: 150 mg/100 mg p.o. bid
- eGFR <30 mL/min: 300 mg/100 mg load on day 1, followed by 150 mg/100 mg p.o daily for 4 more days
- Dialysis:
- Weight ≥40 kg: 300 mg/100 mg load on day 1, followed by 150 mg/100 mg p.o daily for 4 more days
- Weight <40 kg: 150 mg/100 mg every 48 hours for 3 doses
- Give after dialysis on dialysis days
Hepatic Dosing
- Child-Pugh class C: contraindicated
Safety
Contraindications
- Hypersensitivity reaction
- Severe liver disease (Child-Pugh Class C)
- Drug-drug interactions (check Liverpool site)
