Paxlovid Medication Interactions
Contraindicated Medications
- The American Association for the Study of Liver Diseases recommends avoiding the use of statins such as lovastatin, simvastatin, and atorvastatin with Paxlovid due to increased risk of adverse events 1, 2
- The American College of Clinical Pharmacology advises against concomitant use of sedatives/hypnotics like oral midazolam and triazolam with Paxlovid due to increased risk of toxicity 1, 3
- The National Institute of Mental Health suggests that psychiatric medications such as quetiapine should be used with caution when administering Paxlovid 1, 3
- The American Thoracic Society recommends avoiding the use of pulmonary hypertension medication sildenafil with Paxlovid when used for pulmonary arterial hypertension due to increased risk of adverse events 1, 3
Medications Requiring Dose Adjustment or Close Monitoring
- The HIV Medicine Association recommends avoiding cobicistat-based regimens with Paxlovid and suggests that efavirenz, etravirine, and nevirapine are contraindicated 4
- The Infectious Diseases Society of America advises that rilpivirine should be used with caution and ECG monitoring when administered with Paxlovid 4
- The European Association for the Study of the Liver suggests that atazanavir and darunavir should be taken without ritonavir when used with Paxlovid 4
Special Population Considerations
- The National Kidney Foundation recommends dose adjustment of Paxlovid for patients with moderate to severe renal impairment 5
- The European Association for the Study of the Liver advises that Paxlovid is not recommended in patients with severe hepatic impairment (Child-Pugh Class C) 4
- The American College of Obstetricians and Gynecologists suggests that Paxlovid represents an option for pregnant people with COVID-19, though uncertainty exists regarding potential adverse reactions 5, 6