Nirmatrelvir and ritonavir (Paxlovid®)

Nirmatrelvir plus ritonavir (Paxlovid^®) is recommended as an option for treating COVID‑19 in adults, only if they:

are within 5 days of symptoms onset and
do not need supplemental oxygen for COVID‑19 and
are at an increased risk for progression to severe COVID‑19, as defined in section 5 of NICE's technology appraisal guidance (TA878) on nirmatrelvir plus ritonavir, sotrovimab and tocilizumab. The list of eligible conditions can also be found in this document

Dosing

The recommended dosage is 300 mg nirmatrelvir (two 150 mg tablets) with 100 mg ritonavir (one 100 mg tablet) all taken together orally twice daily for 5 days. Paxlovid^® should be given as soon as possible after positive results of direct SARS-CoV-2 viral testing and within 5 days of onset of symptoms.

Posology, contraindications and cautions

Renal impairment

In patients with moderate renal impairment (CKD stage 3), the dose of nirmatrelvir/ritonavir should be reduced to nirmatrelvir/ritonavir 150 mg/100 mg (1 tablet of each) twice daily for 5 days:

Moderate renal impairment (eGFR 30 to 59 mL/min): Half dose: nirmatrelvir 150mg (ONE tablet instead of TWO with full dose ritonavir)
Severe renal impairment (eGFR <30mL/min): Not recommended

For full prescribing information including contraindications and cautions please see SmPC and BNF.

Please note that Paxlovid^® can interact with many other medications. It is therefore vital that a drug-drug interaction check is undertaken prior to prescribing Paxlovid®. A useful interaction checker can be found at: https://covid19-druginteractions.org/checker

TRAK shortcode

\PAXLOVID

This is the Trak short code to be used to document the use of Paxlovid.