Uses
What is Paxlovid used for?
Paxlovid (nirmatrelvir and ritonavir) is commonly used to treat mild to moderate coronavirus disease 2019 (COVID-19) if you are at high risk of progression to severe COVID-19.
Paxlovid may also be used for other conditions as determined by your healthcare provider.
How does Paxlovid work (mechanism of action)?
Paxlovid contains two medicines, nirmatrelvir and ritonavir. Nirmatrelvir is a medicine used against the virus that causes COVID-19. It works by preventing the virus from making more copies of itself. When used together, ritonavir is a medicine that works to increase the amount of nirmatrelvir in your body.
How is Paxlovid supplied (dosage forms)?
Paxlovid is available in the following dosage forms that are taken by mouth.
- 150 mg and 100 mg oral tablets dose pack
- 300 mg and 100 mg oral tablets dose pack
How should I store Paxlovid?
Paxlovid should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Do not remove the tablets from the blister cards and store in a different container (such as a pill organizer) for future use. Make sure your hands are dry when handling the tablets.
Side Effects
What are the most common side effects of Paxlovid?
The most common side effects of Paxlovid are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Change in how things taste
- Diarrhea
- Headache
- Nausea and vomiting
- Stomach pain
- High blood pressure
- Overall unwell feeling
There may be other side effects of Paxlovid that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Paxlovid?
While less common, the most serious side effects of Paxlovid are described below, along with what to do if they happen.
Severe Allergic Reactions. Paxlovid may cause allergic reactions, which can be serious. Stop taking Paxlovid and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Severe Skin Reactions. Paxlovid can cause severe skin reactions called Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) that can lead to death if not treated. If you develop a rash, stop Paxlovid and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.
- Painful red or purple skin that looks burned and peels off
- Flat red rash or blisters on your skin, mouth, nose, and genitals
- Red, painful, watery eyes
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking Paxlovid. Call your healthcare provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Warnings & Precautions
Who should not use Paxlovid?
Allergies to Ingredients. People who are allergic to any of the following should not take Paxlovid.
- Paxlovid
- Nirmatrelvir
- Ritonavir
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Paxlovid.
Drug Interactions. Paxlovid should not be taken while you are using certain other medicines. Before taking Paxlovid, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Kidney Problems. Paxlovid should not be used if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your healthcare provider may do tests to determine if they are working well enough to take this medicine.
Liver Problems. Paxlovid should not be used if your liver is not working as well as it should be. If there is a concern about the health of your liver, your healthcare provider may do tests to determine if it is working well enough to take this medicine.
What should I know about Paxlovid before using it?
Do not take Paxlovid unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share Paxlovid with other people, even if they have the same condition as you. It may harm them.
Keep Paxlovid out of the reach of children.
Both medicines in Paxlovid (nirmatrelvir and ritonavir) should be taken at the same time, two times each day.
Do not take Paxlovid if you do not have COVID-19.
Do not chew, cut, or crush Paxlovid.
What should I tell my healthcare provider before using Paxlovid?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Paxlovid is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Liver problems
- Kidney problems
- HIV infection
Pregnancy. It is not known if or how Paxlovid could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take Paxlovid while you are pregnant or trying to get pregnant.
Breastfeeding. It is not known if Paxlovid passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take Paxlovid while breastfeeding.
How can I get more information about Paxlovid?
For more information about Paxlovid, you can visit the manufacturer’s website at www.paxlovid.com or call them at 800-438-1985.
Interactions
Does Paxlovid interact with foods or drinks?
There are no known interactions between Paxlovid and foods or drinks.
It is unknown if drinking alcohol will affect Paxlovid.
Does Paxlovid interact with other medicines (drug interactions)?
Paxlovid interacts with many other medicines. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking Paxlovid.
- Alfuzosin or silodosin, which is a medicine commonly used for a large prostate
- Colchicine, which is a medicine commonly used for gout
- Ranolazine, which is a medicine commonly used for chest pain
- Amiodarone, dronedarone, flecainide, propafenone, quinidine (and others), which is a medicine used for an irregular heart rhythm
- Eplerenone and finerenone, which is a medicine for the heart or blood pressure
- Lurasidone or pimozide, which is a medicine for certain mental health conditions
- Lovastatin, simvastatin, or lomitapide (and others), which is a medicine used to lower cholesterol
- Eletriptan or ubrogepant, which is a medicine commonly used for migraine
- An ergot, such as ergotamine (Ergomar), dihydroergotamine (Migranal or Trudhesa) or methylergonovine, which is a medicine used to treat migraine
- Carbamazepine or phenytoin, which is a medicine to control seizures
- A barbiturate, such as phenobarbital or primidone, which is a medicine that may be used to treat insomnia, migraine, or seizures
- Naloxegol, which is a medicine to block opioids
- Midazolam (oral) or triazolam, which is a medicine commonly used for sleep or anxiety
- Flibanserin, which is a medicine used for low sexual desire in women
- Lumacaftor/ivacaftor, which is a medicine used for cystic fibrosis
- Rifampin or rifapentine, which is a medicine used to treat an infection called tuberculosis
- A type of medicine called a phosphodiesterase-5 (PDE-5) inhibitor, such as sildenafil (Viagra, Revatio, and others), which is used for erectile dysfunction and pulmonary arterial hypertension (PAH)
- Voclosporin, which is a medicine to suppress your immune system
- Apalutamide, which is a medicine used to treat cancer
- A birth control pill, patch, or ring
- Tolvaptan, which is a medicine for your heart or kidneys
- Ivabradine, which is a medicine for your heart
- St. John’s wort, which is a supplement that may be used to treat depression
Paxlovid may alter the blood levels of many other medicines, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with Paxlovid. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Paxlovid?
If you or someone else has used too much Paxlovid, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Paxlovid?
If you miss a dose of Paxlovid, take it as soon as you remember, if it is within 8 hours. If you remember after 8 hours, skip the missed dose and only take the next dose. Do not take double or extra doses.
It is important to complete your prescribed course of Paxlovid, even if your symptoms get better or go away.
Are you currently using Paxlovid (nirmatrelvir and ritonavir)?
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