Paxlovid (Nirmatrelvir and Ritonavir)
Nirmatrelvir in combination with another medicine called ritonavir is used for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.
Nirmatrelvir and ritonavir may also be used for purposes not listed in this medication guide.
warnings
What is the most important information I should know about Paxlovid (Nirmatrelvir and Ritonavir)?
You should not use nirmatrelvir and ritonavir if you are allergic to it.
Some drugs should not be used with nirmatrelvir and ritonavir. Your treatment plan may change if you also use:
- sildenafil (Revatio) when used to treat pulmonary arterial hypertension (PAH);
- lumacaftor, ivacaftor;
- bosentan;
- alfuzosin, colchicine;
- tolvaptan;
- naloxegol;
- finerenone;
- flibanserin;
- lomitapide;
- voclosporin;
- rifampin, rifapentine;
- St. John's Wort;
- heart medicine--ivabradine, amiodarone, eplerenone, dronedarone, flecainide, propafenone, quinidine, ranolazine;
- prostate medicine--silodosin;
- antipsychotic medicine--lurasidone, pimozide;
- ergot medicines--dihydroergotamine, ergotamine, methylergonovine;
- migraine headache medicine--eletriptan, ubrogepant;
- cholesterol-lowering medicine--lovastatin, simvastatin;
- a sedative--triazolam, oral midazolam;
- a cancer medicine--apalutamide, enzalutamide; or
- seizure medicine--primidone, carbamazepine, phenobarbital, phenytoin.
Tell your doctor if:
- you have an HIV-1 infection;
- kidney disease (or if you are on dialysis); or
- you have liver problems or a liver disease such as hepatitis.
It is not known if nirmatrelvir and ritonavir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Nirmatrelvir and ritonavir can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, or contraceptive sponge.
Ask a doctor if it is safe to breastfeed while using this medicine.
Side Effects
What are the side effects of Paxlovid (Nirmatrelvir and Ritonavir)?
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Call your doctor at once if you have:
- liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Common side effects may include:
- changes in your sense of taste; or
- diarrhea.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Pregnancy & Breastfeeding
Can I take Paxlovid (Nirmatrelvir and Ritonavir) if I’m pregnant or breastfeeding?
It is not known if nirmatrelvir and ritonavir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Nirmatrelvir and ritonavir can make hormonal birth control less effective, including birth control pills, injections, implants, skin patches, and vaginal rings. Use barrier birth control to prevent pregnancy: condom, diaphragm, cervical cap, or contraceptive sponge.
Ask a doctor if it is safe to breastfeed while using this medicine.
Interactions
What drugs and food should I avoid while taking Paxlovid (Nirmatrelvir and Ritonavir)?
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Dosage Guidelines & Tips
How to take Paxlovid (Nirmatrelvir and Ritonavir)?
Use Paxlovid (Nirmatrelvir and Ritonavir) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Take nirmatrelvir together with ritonavir twice a day for 5 days.
Your kidney function will need to be tested and your dose or medication schedule may be changed based on the results.
Ask your doctor before stopping this medicine.
Tell your doctor if you do not feel better or if you feel worse after 5 days.
You may take nirmatrelvir and ritonavir with or without food.
Swallow the tablets whole and do not crush, chew, or break them.
You may need frequent blood tests to check your liver function.
Store at room temperature away from moisture and heat.
Use the medicine as soon as you can, but skip the missed dose if you are more than 8 hours late for the dose. Do not use two doses at one time.