Paxlovid Resources

Paxlovid Prescribing Clinical Steps:

1. Patient meets eligibility criteria as per Science Table grid

3. Patient is within the 5-day window from onset of symptoms

4. Patient has a positive COVID test (PCR or RAT)

5. Patient has adequate kidney function:

   1. Recent creatinine, ideally within the past 3 months

   2. Renal dosing:

      1. if eGFR > 60, full dose

      2. if eGFR between 30 and 60, decrease dose of nirmatrelvir component (pink tab) to one tab bid (instead of two). Ritonavir component (white tab) does not change

      3. if eGFR < 30, Paxlovid is contraindicated

6. Patient has adequate liver function. Severe hepatic impairment = contraindication

7. Assess for drug-drug interactions. There are many; check carefully

8. Write a script

   1. 1. “Paxlovid pack as directed” for usual dosing. The drug is blister packed by the manufacturer with very obvious and straight forward instructions.

      2. If using altered dosing because of poor renal function, must write out components and doses, “nirmatrelvir 150mg po bid and ritonavir 100mg po bid” for 5 days.