NIRMATRELVIR WITH RITONAVIR

Nirmatrelvir is a peptidomimetic inhibitor of corona virus 3C-like protease which prevents multiplication of SARS-CoV-2.

Ritonavir inhibits CYP3A mediated metabolism of nirmatrelvir there by increasing the plasma concentration of nirmatrelvir

Dosage Forms

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Tablet

150mg/100mg tablets

Uses

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  • Covid-19 disease

Dose and Duration

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COVID-19 inpatients who do not require oxygen supplementation and are at an increased risk of severe COVID-19 infection

By mouth

Adult: 300mg(two pink tablets) and 100mg (one white tablet)twice daily for 5 days. To be initiated as soon as possible after SARS-CoV-2 positive result and within 5 days of symptom onset.

For each dose, nirmatrelvir (pink tablets)and ritonavir(white tablet)to be taken together

Side Effects

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  • Diarrhoea
  • Vomiting
  • Taste alteration

Contra-indications

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  • Uncontrolled or undiagnosed HIV infection
  • Renal impairment with eGFR less than 30mL/minute/1.73m²

Pregnancy

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  • Do not use

Breast-feeding

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  • Avoid during treatment and for 7days after last treatment.

⚠️ Caution

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  • Hepatitis
  • liver enzyme abnormalities
  • As nirmatrelvir is co-administered with ritonavir there maybe a risk of developing resistance to HIV protease inhibitors in patients with uncontrolled or undiagnosed HIV infection.
  • Effectiveness of combined hormonal contraceptives maybe reduced - alternative contraceptive methods or an additional barrier method is recommended during treatment and until completion of one menstrual cycle after stopping treatment