SUMMARY

• Paxlovid™ is approved for the treatment of mildtomoderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.¹
• Paxlovid™ is a combination drug comprised of nirmatrelvir co-packaged with ritonavir, to be taken twice daily (BID) for a full 5-day treatment course.¹
• Paxlovid™ may have a potential drug interaction with the endothelin receptor antagonist bosentan, which can decrease the concentration of Paxlovid™ and increase the concentration of bosentan. The use of bosentan should be discontinued at least 36 hours prior to initiation of Paxlovid™.¹
• Clinical studies designed to investigate the potential for a drug-drug interaction between OPSUMIT and Paxlovid™ (PF-07321332/ritonavir) have not been performed.
  • Providers should exercise clinical judgement to assess risks and benefits of concomitant therapy and determine the most appropriate strategy for managing drug-drug interactions.²
• A study in healthy volunteers showed that the concomitant use of OPSUMIT with strong CYP3A4 inhibitors (e.g., ketoconazole) approximately doubles the exposure to OPSUMIT³; therefore caution should be exercised during the concomitant use of OPSUMIT and strong CYP3A4 inhibitors (e.g., ritonavir).⁴
• Paxlovid™ was studied in the EPIC-HR study. In this study prohibited medications included those that are dependent on CYP450 3A4 for clearance.^4,5
• A search of the scientific literature did not identify publications reporting on drug-drug interactions in patients receiving OPSUMIT and Paxlovid™ concomitantly. However, 2 studies were identified describing methods to predict the likelihood of drug-drug interactions among several drugs, including OPSUMIT and ritonavir,^6,7 and 1 study was found that describes the management of potential drug interactions for Paxlovid™.⁸ Please refer to the text of these studies for full details.

Literature Search

A literature search of MEDLINE®, EMBASE®, BIOSIS Previews®, DERWENT® (and/or other resources, including internal/external databases) was conducted on the 28 May 2024.