Nirmatrelvir in Combination with Ritonavir Against COVID-19: Guidelines from French Society of Pharmacology and Therapeutics (SFPT)

The French Society of Pharmacology and Therapeutics (SFPT) released guidelines for managing drug-drug interactions with nirmatrelvir in patients treated for COVID-19. The guidelines were developed by a team of 18 clinical pharmacologists who searched the scientific literature to provide recommendations on the use of nirmatrelvir/ritonavir in combination with other medications. The guidelines include 171 recommendations for managing interactions with nirmatrelvir/ritonavir, advising clinicians to contact their pharmacology department for specific guidance in complex situations.

Key Takeaways:

• Nirmatrelvir in combination with ritonavir is an antiviral agent targeting the 3-chymotrypsin-like cysteine protease enzyme (3C-like protease or Mpro) essential for the viral cycle of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
• The guidelines were developed by 18 clinical pharmacologists, including researchers from the University of Rennes and the French National Institute of Health and Medical Research (INSERM).
• Five distinct recommendations were issued: contra-indications, 'Paxlovid not recommended with comedication', 'Paxlovid possible after comedication discontinuation', 'Paxlovid possible only after expert advice', and 'Paxlovid possible without modification of the associated treatment'.
• The guidelines provide recommendations for managing interactions with nirmatrelvir/ritonavir, including the use of pharmacokinetic enhancers to minimize drug-drug interactions.
• The guidelines are designed to be a help for clinicians willing to prescribe nirmatrelvir/ritonavir and to prevent drug-drug interactions leading to adverse drug reactions or loss of efficacy.

Statistics:

• The guidelines cover 171 drugs/therapeutic classes.
• The research was conducted by 18 clinical pharmacologists at the University of Rennes and INSERM.
• The guidelines were developed after a thorough search of the scientific literature.
• The guidelines provide a framework for managing interactions with nirmatrelvir/ritonavir in patients treated for COVID-19.

Sources:

• Management of drug-drug interactions with nirmatrelvir/ritonavir in patients treated for Covid-19: Guidelines from the French Society of Pharmacology and Therapeutics (SFPT). Therapies, 2022.
• University of Rennes
• French National Institute of Health and Medical Research (INSERM)
• Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands.