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. 2022 Aug;35(4):357-361.
doi: 10.37201/req/054.2022. Epub 2022 Jul 13.

Interactions listed in the Paxlovid fact sheet, classified according to risks, pharmacological groups, and consequences

J R Azanza  1 , J Mensa, J González Del Castillo, M Linares Rufo, J M Molero, N Madero Valle, J Barberán
Affiliations

Interactions listed in the Paxlovid fact sheet, classified according to risks, pharmacological groups, and consequences

J R Azanza et al. Rev Esp Quimioter. 2022 Aug.

Abstract
in English, Spanish

Paxlovid (nirmatrelvir plus ritonavir) is a new oral antiviral therapeutic for the treatment and post-exposure prophylaxis of COVID-19. Nirmatrelvir is an inhibitor of SARS-CoV-2 main protease, while ritonavir is used as a CYP3A inhibitor in low doses to slow the metabolism of nirmatrelvir, thus enhancing their therapeutic effect. The isoenzyme CYP3A4 is responsible for at least part of the oxidative metabolism of approximately 60% of available medications and ritonavir is therefore a significant source of drug interactions. We describe here the drugs that are contraindicated or should be used with or without precautions when Paxlovid (nirmaltrevir plus ritonavir) should be administered according to each fact sheet in force at the Spanish Agency for Medicines and Health Products.

Paxlovid (nirmatrelvir más ritonavir) es un nuevo tratamiento antivírico oral para la COVID-19. Nirmatrelvir es un inhibidor de la principal proteasa del SARS-CoV-2, mientras que ritonavir es usado como un inhibidor de la CYP3A a baja dosis para reducir el metabolismo de nirmatrelvir, potenciando así su efecto terapéutico. La isoenzima CYP3A4 es responsable de al menos una parte del metabolismo oxidativo de aproximada-mente el 60% de los medicamentos disponibles, por lo que el ritonavir es una fuente importante de interacciones farmacológicas. Describimos los fármacos cuyo uso está contraindicado o deben utilizarse con precauciones o sin ella cuando debe administrase Paxlovid (nirmaltrevir más ritonavir), de acuerdo con cada ficha técnica vigente en la Agencia Española de Medicamentos y Productos Sanitarios

Keywords: COVID-19; Drug interactions; Nirmatrelvir; Paxlovid; Ritonavir; SARS-CoV-2.

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Conflict of interest statement

The authors declare no conflicts of interest.

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