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Editorial
. 2022 May;175(5):744-746.
doi: 10.7326/M22-0281. Epub 2022 Mar 1.

Prescribing Nirmatrelvir-Ritonavir: How to Recognize and Manage Drug-Drug Interactions

Catia Marzolini  1 , Daniel R Kuritzkes  2 , Fiona Marra  3 , Alison Boyle  3 , Sara Gibbons  4 , Charles Flexner  5 , Anton Pozniak  6 , Marta Boffito  7 , Laura Waters  8 , David Burger  9 , David Back  4 , Saye Khoo  4
Affiliations
Editorial

Prescribing Nirmatrelvir-Ritonavir: How to Recognize and Manage Drug-Drug Interactions

Catia Marzolini et al. Ann Intern Med. 2022 May.

Abstract

Nirmatrelvir–ritonavir (NMV/r) is now being used to treat high-risk patients with mild to moderate COVID-19. This article provides advice to clinicians regarding recognition of medications likely to interact with NMV/r and suggests approaches to managing such drug–drug interactions. An algorithm is provided to assist in decision making.

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Conflict of interest statement

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0281.

Figures

Figure.
Figure.. Flow diagram to assess management of nirmatrelvir–ritonavir DDIs.
The inhibitory effect of ritonavir takes several days to resolve. Thus, paused comedication therapy should be restarted 3 d after the last dose of nirmatrelvir–ritonavir. The same timeline applies for comedications whose dosage has been adjusted during nirmatrelvir–ritonavir treatment. CYP = cytochrome; DDI = drug–drug interaction; NTI = narrow therapeutic index; P-gp = P-glycoprotein.
See this image and copyright information in PMC

References

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