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

Catia Marzolini; Daniel R Kuritzkes; Fiona Marra; Alison Boyle; Sara Gibbons; Charles Flexner; Anton Pozniak; Marta Boffito; Laura Waters; David Burger; David Back; Saye Khoo

doi:10.7326/M22-0281

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

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

Authors

Catia Marzolini¹, Daniel R Kuritzkes², Fiona Marra³, Alison Boyle³, Sara Gibbons⁴, Charles Flexner⁵, Anton Pozniak⁶, Marta Boffito⁷, Laura Waters⁸, David Burger⁹, David Back⁴, Saye Khoo⁴

Affiliations

¹ Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital of Basel and University of Basel, Basel, Switzerland, and Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom (C.M.).
² Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (D.R.K.).
³ Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, and Department of Pharmacy, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom (F.M., A.B.).
⁴ Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom (S.G., D.Back, S.K.).
⁵ Divisions of Clinical Pharmacology and Infectious Diseases, School of Medicine, and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (C.F.).
⁶ Chelsea and Westminster Hospital NHS Foundation Trust and London School of Hygiene and Tropical Medicine, London, United Kingdom (A.P.).
⁷ Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom (M.B.).
⁸ Mortimer Market Centre, Central and North West London, NHS Foundation Trust, London, United Kingdom (L.W.).
⁹ Department of Pharmacy, Radboud University Medical Center, Nijmegen, and Global DDI Solutions, Utrecht, the Netherlands (D.Burger).

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.

Publication types

Editorial
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Drug Interactions
Humans
Ritonavir* / therapeutic use
SARS-CoV-2

Substances

Ritonavir

Abstract

Publication types

MeSH terms

Substances

Grants and funding