This list is primarily based on the most common medication searches by U.S. Box 1 includes commonly prescribed medications that are not expected to have clinically relevant interactions with ritonavir-boosted nirmatrelvir.īecause ritonavir-boosted nirmatrelvir is the only highly effective oral antiviral for the treatment of COVID-19, drug interactions that can be safely managed should not preclude the use of this medication. Clinicians should be aware that many commonly used medications can be safely coadministered with ritonavir-boosted nirmatrelvir despite its drug-drug interaction potential. Clinicians should consider the potential benefits of treatment with ritonavir-boosted nirmatrelvir, the potential risks of drug-drug interactions, and whether any risks related to drug-drug interactions can be safely managed. The Food and Drug Administration (FDA) prescribing information and Emergency Use Authorization (EUA) fact sheet include a boxed warning about significant drug-drug interactions between ritonavir-boosted nirmatrelvir (Paxlovid) and other medications.īefore prescribing ritonavir-boosted nirmatrelvir to treat patients with mild to moderate COVID-19, carefully review the patient’s concomitant medications, including over-the-counter medicines, herbal supplements, and recreational drugs. Ritonavir may also increase blood concentrations of certain concomitant medications. Ritonavir, a strong cytochrome P450 (CYP) 3A4 inhibitor and a P-glycoprotein (P-gp) inhibitor, is coadministered with nirmatrelvir to increase the blood concentration of nirmatrelvir, thereby making it effective against SARS-CoV-2.

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