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Important Safety Information WARNING: SIGNIFICANT DRUG INTERACTIONS WITH PAXLOVID
  • PAXLOVID includes ritonavir, a strong CYP3A inhibitor, which may lead to greater exposure of certain concomitant medications, resulting in potentially severe, life-threatening, and/or fatal events
  • Prior to prescribing PAXLOVID: 1) Review all medications taken by the patient to assess for potential drug-drug interactions with a strong CYP3A inhibitor like PAXLOVID and 2) Determine if concomitant medications require a dose adjustment, interruption, and/or additional monitoring
  • Consider the benefit of PAXLOVID treatment in reducing hospitalization and death, and whether the risk of potential drug-drug interactions for an individual patient can be appropriately managed
PAXLOVID is contraindicated in patients with a history of clinically significant hypersensitivity reactions (eg, toxic epidermal necrolysis or Stevens-Johnson syndrome) to its active ingredients (nirmatrelvir or ritonavir) or any other components of the product. If signs and symptoms of a clinically significant hypersensitivity reaction or anaphylaxis occur, immediately discontinue PAXLOVID and initiate appropriate medications and/or supportive care. PAXLOVID is contraindicated with drugs that are primarily metabolized by CYP3A and for which elevated concentrations are associated with serious and/or life-threatening reactions and drugs that are strong CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance. There are certain other drugs for which concomitant use with PAXLOVID should be avoided and/or dose adjustment, interruption, or therapeutic monitoring is recommended. Drugs listed here are a guide and not considered a comprehensive list of all drugs that may be contraindicated with PAXLOVID. The healthcare provider should consult other appropriate resources such as the prescribing information for the interacting drug for comprehensive information on dosing or monitoring with concomitant use of a strong CYP3A inhibitor like PAXLOVID. Drugs that are primarily metabolized by CYP3A for which elevated concentrations are associated with serious and/or life-threatening reactions:
  • Alpha 1-adrenoreceptor antagonist: alfuzosin
  • Antianginal: ranolazine
  • Antiarrhythmic: amiodarone, dronedarone, flecainide, propafenone, quinidine
  • Anti-gout: colchicine (in patients with renal and/or hepatic impairment)
  • Antipsychotics: lurasidone, pimozide
  • Benign prostatic hyperplasia agents: silodosin
  • Cardiovascular agents: eplerenone, ivabradine
  • Ergot derivatives: dihydroergotamine, ergotamine, methylergonovine
  • HMG-CoA reductase inhibitors: lovastatin, simvastatin (these drugs can be temporarily discontinued to allow PAXLOVID use)
  • Immunosuppressants: voclosporin
  • Microsomal triglyceride transfer protein inhibitor: lomitapide
  • Migraine medications: eletriptan, ubrogepant
  • Mineralocorticoid receptor antagonists: finerenone
  • Opioid antagonists: naloxegol
  • PDE5 inhibitor: sildenafil (Revatio®) when used for pulmonary arterial hypertension
  • Sedative/hypnotics: triazolam, oral midazolam
  • Serotonin receptor 1A agonist/serotonin receptor 2A antagonist: flibanserin
  • Vasopressin receptor antagonists: tolvaptan

Drugs that are strong CYP3A inducers: PAXLOVID cannot be started immediately after discontinuation of any of the following medications due to the delayed offset of the recently discontinued CYP3A inducer:

  • Anticancer drugs: apalutamide
  • Anticonvulsant: carbamazepine, phenobarbital, primidone, phenytoin
  • Antimycobacterials: rifampin, rifapentine
  • Cystic fibrosis transmembrane conductance regulator potentiators: lumacaftor/ivacaftor
  • Herbal Products: St. John’s Wort (hypericum perforatum)
 Risk of Serious Adverse Reactions Due to Drug Interactions: Initiation of PAXLOVID, which contains ritonavir, a strong CYP3A inhibitor, in patients receiving medications metabolized by CYP3A or initiation of medications metabolized by CYP3A in patients already receiving PAXLOVID, may increase plasma concentrations of medications metabolized by CYP3A. Medications that induce CYP3A may decrease concentrations of PAXLOVID. These interactions may lead to:
  • Clinically significant adverse reactions, potentially leading to severe, life-threatening, or fatal events from greater exposures of concomitant medications
  • Loss of therapeutic effect of PAXLOVID and possible development of viral resistance
Severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with PAXLOVID. The most commonly reported concomitant medications resulting in serious adverse reactions were calcineurin inhibitors (eg, tacrolimus, cyclosporine), followed by calcium channel blockers. Hepatotoxicity: Hepatic transaminase elevations, clinical hepatitis, and jaundice have occurred in patients receiving ritonavir. Therefore, caution should be exercised when administering PAXLOVID to patients with pre-existing liver diseases, liver enzyme abnormalities, or hepatitis. Because nirmatrelvir is coadministered with ritonavir, there may be a risk of HIV-1 developing resistance to HIV protease inhibitors in individuals with uncontrolled or undiagnosed HIV-1 infection. The most common adverse reactionsin the PAXLOVID group (≥1%) that occurred at a greater frequency than in the placebo group were dysgeusia (5% and <1%, respectively) and diarrhea (3% and 2%, respectively). The following adverse reactions have been identified during use of PAXLOVID under Emergency Use Authorization: Immune System Disorders: Anaphylaxis, hypersensitivity reactions Skin and Subcutaneous Tissue Disorders: Toxic epidermal necrolysis, Stevens-Johnson syndrome Nervous System Disorders: Headache Vascular Disorders: Hypertension Gastrointestinal Disorders: Abdominal pain, nausea, vomiting General Disorders and Administration Site Conditions: Malaise PAXLOVID is a strong inhibitor of CYP3A, and an inhibitor of CYP2D6, P-gp, and OATP1B1. Coadministration of PAXLOVID with drugs that are primarily metabolized by CYP3A and CYP2D6 or are transported by P-gp or OATP1B1 may result in increased plasma concentrations of such drugs and increase the risk of adverse events. Coadministration with other CYP3A substrates may require a dose adjustment or additional monitoring.Pregnancy: Available data on the use of nirmatrelvir during pregnancy are insufficient to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Published observational studies on ritonavir use in pregnant women have not identified an increase in the risk of major birth defects. Published studies with ritonavir are insufficient to identify a drug-associated risk of miscarriage. There are maternal and fetal risks associated with untreated COVID-19 in pregnancy.Lactation: There are no available data on the presence of nirmatrelvir in human or animal milk, the effects on the breastfed infant, or the effects on milk production. A transient decrease in body weight was observed in the nursing offspring of rats administered nirmatrelvir. Limited published data report that ritonavir is present in human milk. There is no information on the effects of ritonavir on the breastfed infant or the effects of the drug on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for PAXLOVID and any potential adverse effects on the breastfed infant from PAXLOVID or from the underlying maternal condition.Contraception: Use of ritonavir may reduce the efficacy of combined hormonal contraceptives. Advise patients using combined hormonal contraceptives to use an effective alternative contraceptive method or an additional barrier method of contraception. Pediatrics: The optimal dose of PAXLOVID has not been established in pediatric patients. Systemic exposure of nirmatrelvir increases in renally impaired patients with increase in the severity of renal impairment. No dosage adjustment is recommended in patients with mild renal impairment. Reduce the dose of PAXLOVID in patients with moderate renal impairment (eGFR ≥30 to <60 mL/min). PAXLOVID is not recommended in patients with severe renal impairment (eGFR <30 mL/min) or in patients with end-stage renal disease (eGFR <15 mL/min). PAXLOVID is not recommended for use in patients with severe hepatic impairment (Child-Pugh Class C). Please see FullPrescribing Information, including BOXED WARNING and Patient Information INDICATIONPAXLOVID is indicated for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.Limitations of UsePAXLOVID is not approved for use as pre-exposure or post-exposure prophylaxis for prevention of COVID-19.Please see FullPrescribing Information, including BOXED WARNING and Patient Information

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Before you prescribe, understand potential DDIs
WARNING: SIGNIFICANT DRUG INTERACTIONS WITH PAXLOVID1
  • PAXLOVID includes ritonavir, a strong CYP3A inhibitor, which may lead to greater exposure of certain concomitant medications, resulting in potentially severe, life-threatening, or fatal events.
  • Prior to prescribing PAXLOVID: 1) Review all medications taken by the patient to assess potential drug-drug interactions with a strong CYP3A inhibitor like PAXLOVID and 2) Determine if concomitant medications require a dose adjustment, interruption, and/or additional monitoring.
  • Consider the benefit of PAXLOVID treatment in reducing hospitalization and death, and whether the risk of potential drug-drug interactions for an individual patient can be appropriately managed.
Contraindications due to drug interactions1

PAXLOVID is contraindicated with drugs that are primarily metabolized by CYP3A and for which elevated concentrations are associated with serious and/or life-threatening reactions and drugs that are strong CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance. There are certain other drugs for which concomitant use with PAXLOVID should be avoided and/or dose adjustment, interruption, or therapeutic monitoring is recommended. Drugs listed in this section are a guide and not considered a comprehensive list of all drugs that may be contraindicated with PAXLOVID. The healthcare provider should consult other appropriate resources such as the prescribing information for the interacting drug for comprehensive information on dosing or monitoring with concomitant use of a strong CYP3A inhibitor like PAXLOVID.

Drugs that are primarily metabolized by CYP3A for which elevated concentrations are associated with serious and/or life-threatening reactions:

  • Alpha1-adrenoreceptor antagonist: alfuzosin
     
  • Antianginal: ranolazine
     
  • Antiarrhythmic: amiodarone, dronedarone, flecainide, propafenone, quinidine
     
  • Anti-gout: colchicine (in patients with renal and/or hepatic impairment)
     
  • Antipsychotics: lurasidone, pimozide
     
  • Benign prostatic hyperplasia agents: silodosin
     
  • Cardiovascular agents: eplerenone, ivabradine
     
  • Ergot derivatives: dihydroergotamine, ergotamine, methylergonovine
     
  • HMG-CoA reductase inhibitors: lovastatin, simvastatin (these drugs can be temporarily discontinued to allow PAXLOVID use
     
  • Immunosuppressants: voclosporin
     
  • Microsomal triglyceride transfer protein inhibitor: lomitapide
     
  • Migraine medications: eletriptan, ubrogepant
     
  • Mineralocorticoid receptor antagonists: finerenone
     
  • Opioid antagonists: naloxegol
     
  • PDE5 inhibitor: sildenafil (Revatio®) when used for pulmonary arterial hypertension (PAH)
     
  • Sedative/hypnotics: triazolam, oral midazolam
     
  • Serotonin receptor 1A agonist/serotonin receptor 2A antagonist: flibanserin
     
  • Vasopressin receptor antagonists: tolvaptan

Drugs that are strong CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance. PAXLOVID cannot be started immediately after discontinuation of any of the following medications due to the delayed offset of the recently discontinued CYP3A inducer.

  • Anticancer drugs: apalutamide
     
  • Anticonvulsant: carbamazepine, phenobarbital, primidone, phenytoin
     
  • Antimycobacterials: rifampin, rifapentine
     
  • Cystic fibrosis transmembrane conductance regulator potentiators: lumacaftor/ivacaftor
     
  • Herbal products: St. John’s Wort (hypericum perforatum)
Warnings and precautions1

Initiation of PAXLOVID, which contains ritonavir, a strong CYP3A inhibitor, in patients receiving medications metabolized by CYP3A or initiation of medications metabolized by CYP3A in patients already receiving PAXLOVID, may increase plasma concentrations of medications metabolized by CYP3A. Medications that induce CYP3A may decrease concentrations of PAXLOVID.

These interactions may lead to:

  • Clinically significant adverse reactions, potentially leading to severe, life-threatening, or fatal events from greater exposures of concomitant medications
     
  • Loss of therapeutic effect of PAXLOVID and possible development of viral resistance


Severe, life-threatening, and/or fatal adverse reactions due to drug interactions have been reported in patients treated with PAXLOVID. The most commonly reported concomitant medications resulting in serious adverse reactions were calcineurin inhibitors (eg, tacrolimus, cyclosporine), followed by calcium channel blockers.

Prior to prescribing PAXLOVID, review all medications taken by the patient to assess potential drug-drug interactions and determine if concomitant medications require a dose adjustment, interruption, and/or additional monitoring (eg, calcineurin inhibitors). See Table 1 below for clinically significant drug interactions, including contraindicated drugs. Drugs listed in Table 1 are a guide and not considered a comprehensive list of all possible drugs that may interact with PAXLOVID.

Consider the benefit of PAXLOVID treatment in reducing hospitalization and death, and whether the risk of potential drug-drug interactions for an individual patient can be appropriately managed.

The concomitant use of PAXLOVID and certain other drugs may result in potentially significant drug interactions1Coadministration of PAXLOVID can alter the plasma concentrations of other drugs
  • PAXLOVID (nirmatrelvir co-packaged with ritonavir) is a strong inhibitor of CYP3A and an inhibitor of CYP2D6, P-gp, and OATP1B1. Coadministration of PAXLOVID with drugs that are primarily metabolized by CYP3A and CYP2D6 or are transported by P-gp or OATP1B1 may result in increased plasma concentrations of such drugs and increase the risk of adverse events
  • Coadministration of PAXLOVID with drugs highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life‑threatening events is contraindicated
  • Coadministration with other CYP3A substrates may require a dose adjustment or additional monitoring, as described in Table 1 below
Other drugs can alter the plasma concentration of PAXLOVID
  • Nirmatrelvir and ritonavir are CYP3A substrates; therefore, drugs that induce CYP3A may decrease nirmatrelvir and ritonavir plasma concentrations and reduce PAXLOVID therapeutic effect
Considerations before prescribing1
  • Identify any drugs your patient may be taking, including over-the-counter medications, vitamins, and herbal supplements
  • Consider management strategies. Some potential drug interactions for commonly prescribed drugs may be managed with strategies that include dose adjustment, monitoring, or temporary discontinuation. Not all drug interactions can be managed, and alternative therapy may need to be considered
  • Consult the table below for clinical comments on managing commonly prescribed drug classes, such as anticoagulants (including warfarin) and HMG-CoA reductase inhibitors (including statins)
Ritonavir has been used in combination with other protease inhibitors to similarly inhibit CYP3A4 metabolism, so certain healthcare providers may have experience managing its associated drug interactions2CYP3A4=cytochrome P450 3A4; DDI=drug-drug interaction; HMG-CoA=3-hydroxy-3-methylglutaryl coenzyme A; OATP1B1=organic anion transporting polypeptide 1B1; PDE5=phosphodiesterase type 5; P-gp=P-glycoprotein.
Table 1: Established and Other Potentially Significant Drug Interactions1
Alpha1-adrenoreceptor antagonist
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Drugs within Class Effect on
Concentration		 Clinical Comments
alfuzosin ↑ alfuzosin Coadministration contraindicated due to potential hypotension [see Contraindications (4)].
tamsulosin ↑ tamsulosin Avoid concomitant use with PAXLOVID.
Antianginal
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Drugs within Class Effect on
Concentration		 Clinical Comments
ranolazine ↑ ranolazine Coadministration contraindicated due to potential for serious and/or life-threatening reactions [see Contraindications (4)].
Antiarrhythmics
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Drugs within Class Effect on
Concentration		 Clinical Comments
amiodarone, 
dronedarone, 
flecainide, 
propafenone, 
quinidine		 ↑ antiarrhythmic  Coadministration contraindicated due to potential for cardiac arrhythmias [see Contraindications (4)].
lidocaine (systemic), disopyramide ↑ antiarrhythmic  Caution is warranted and therapeutic concentration monitoring is recommended for antiarrhythmics if available. 
Anticancer drugs
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Drugs within Class Effect on
Concentration		 Clinical Comments
apalutamide ↓ nirmatrelvir/ritonavir Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
abemaciclib,
ceritinib,
dasatinib,
encorafenib,
ibrutinib,
ivosidenib,
neratinib,
nilotinib,
venetoclax,
vinblastine,
vincristine		 ↑ anticancer drug Avoid coadministration of encorafenib or ivosidenib due to potential risk of serious adverse events such as QT interval prolongation. Avoid use of neratinib, venetoclax or ibrutinib.

Coadministration of vincristine and vinblastine may lead to significant hematologic or gastrointestinal side effects.

For further information, refer to individual product label for anticancer drug.
Anticoagulants 
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Drugs within Class Effect on
Concentration		 Clinical Comments
warfarin ↑↓ warfarin Closely monitor international normalized ratio (INR) if coadministration with warfarin is necessary.
rivaroxaban ↑ rivaroxaban Increased bleeding risk with rivaroxaban. Avoid concomitant use.
dabigatrana ↑ dabigatran Increased bleeding risk with dabigatran. Depending on dabigatran indication and renal function, reduce dose of dabigatran or avoid concomitant use. Refer to the dabigatran product label for further information. 
apixaban ↑ apixaban Combined P-gp and strong CYP3A inhibitors increase blood levels of apixaban and increase the risk of bleeding. Dosing recommendations for coadministration of apixaban with PAXLOVID depend on the apixaban dose. Refer to the apixaban product label for more information.
Antifungals
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Drugs within Class Effect on
Concentration		 Clinical Comments
voriconazole ↓ voriconazole Avoid concomitant use of voriconazole.
ketoconazole, 
isavuconazonium sulfate,
itraconazolea 		↑ ketoconazole
↑ isavuconazonium sulfate
↑ itraconazole		 Refer to ketoconazole, isavuconazonium sulfate, and itraconazole product labels for further information.
  ↑ nirmatrelvir/
ritonavir		 A nirmatrelvir/ritonavir dose reduction is not needed.
Anticonvulsants
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Drugs within Class Effect on
Concentration		 Clinical Comments
carbamazepinea, 
phenobarbital, 
primidone, 
phenytoin		 ↓ nirmatrelvir/
ritonavir		 Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
clonazepam ↑ anticonvulsant A dose decrease may be needed for clonazepam when coadministered with PAXLOVID and clinical monitoring is recommended.
Antidepressants
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Drugs within Class Effect on
Concentration		 Clinical Comments
bupropion ↓ bupropion and active metabolite hydroxybupropion Monitor for an adequate clinical response to bupropion. 
trazodone ↑ trazodone  Adverse reactions of nausea, dizziness, hypotension, and syncope have been observed following coadministration of trazodone and ritonavir. A lower dose of trazodone should be considered. Refer to trazodone product label for further information.
Anti-gout
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Drugs within Class Effect on
Concentration		 Clinical Comments
colchicine ↑ colchicine Coadministration contraindicated due to potential for serious and/or life-threatening reactions in patients with renal and/or hepatic impairment [see Contraindications (4)].
Anti-HIV protease inhibitors
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Drugs within Class Effect on
Concentration		 Clinical Comments
atazanavir,
darunavir,
tipranavir		 ↑ protease inhibitor For further information, refer to the respective protease inhibitors’ prescribing information.

Patients on ritonavir- or 
cobicistat-containing HIV regimens should continue their treatment as indicated. Monitor for increased PAXLOVID or protease inhibitor adverse events.
Anti-HIV
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Drugs within Class Effect on
Concentration		 Clinical Comments
efavirenz ↑ efavirenz For further information, refer to the respective anti-HIV drugs prescribing information.
maraviroc ↑ maraviroc
nevirapine ↑ nevirapine
zidovudine ↓ zidovudine
bictegravir ↑ bictegravir
emtricitabine ←→ emtricitabine
tenofovir ↑ tenofovir
Anti-infective
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Drugs within Class Effect on
Concentration		 Clinical Comments
clarithromycin ↑ clarithromycin  Refer to the respective prescribing information for anti-infective dose adjustment.
erythromycin ↑ erythromycin
Antimycobacterial
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Drugs within Class Effect on
Concentration		 Clinical Comments
rifampin,
rifapentine		 ↓ nirmatrelvir/
ritonavir		 Coadministration contraindicated due to potential loss of virologic response and possible resistance.

Alternate antimycobacterial drugs such as rifabutin should be considered [see Contraindications (4)].
bedaquiline ↑ bedaquiline Refer to the bedaquiline product label for further information.
rifabutin ↑ rifabutin Refer to rifabutin product label for further information on rifabutin dose reduction.
Antipsychotics
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Drugs within Class Effect on
Concentration		 Clinical Comments
lurasidone ↑ lurasidone Coadministration contraindicated due to serious and/or life-threatening reactions such as cardiac arrhythmias [see Contraindications (4)].
pimozide ↑ pimozide
quetiapine ↑ quetiapine If coadministration is necessary, reduce quetiapine dose and monitor for quetiapine-associated adverse reactions. Refer to the quetiapine prescribing information for recommendations.
clozapine ↑ clozapine If coadministration is necessary, consider reducing the clozapine dose and monitor for adverse reactions.
Benign prostatic hyperplasia agents
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Drugs within Class Effect on
Concentration		 Clinical Comments
silodosin ↑ silodosin Coadministration contraindicated due to potential for postural hypotension [see Contraindications (4)].
Calcium channel blockers
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Drugs within Class Effect on
Concentration		 Clinical Comments
amlodipine, 
diltiazem,
felodipine,
nicardipine,
nifedipine,
verapamil		 ↑ calcium channel      
blocker		 Caution is warranted and clinical monitoring of patients is recommended. A dose decrease may be needed for these drugs when coadministered with PAXLOVID. 

If coadministered, refer to individual product label for calcium channel blocker for further information.
Cardiac glycosides
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Drugs within Class Effect on
Concentration		 Clinical Comments
digoxin ↑ digoxin Caution should be exercised when coadministering PAXLOVID with digoxin, with appropriate monitoring of serum digoxin levels. 

Refer to the digoxin product label for further information.
Cardiovascular agents
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Drugs within Class Effect on
Concentration		 Clinical Comments
eplerenone ↑ eplerenone Coadministration with eplerenone is contraindicated due to potential for hyperkalemia [see Contraindications (4)].
ivabradine ↑ ivabradine Coadministration with ivabradine is contraindicated due to potential for bradycardia or conduction disturbances [see Contraindications (4)].
aliskiren ↑ aliskiren Avoid concomitant use with PAXLOVID.
ticagrelor ↑ ticagrelor
vorapaxar ↑ vorapaxar
clopidogrel ↓ clopidogrel active metabolite
cilostazol ↑ cilostazol Dosage adjustment of cilostazol is recommended. Refer to the cilostazol product label for more information.
Corticosteroids primarily metabolized by CYP3A
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Drugs within Class Effect on
Concentration		 Clinical Comments
betamethasone
budesonide
ciclesonide
dexamethasone
fluticasone
methylprednisolone
mometasone
triamcinolone		 ↑ corticosteroid Coadministration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing’s syndrome and adrenal suppression. However, the risk of Cushing’s syndrome and adrenal suppression associated with short-term use of a strong CYP3A inhibitor is low.

Alternative corticosteroids including beclomethasone, prednisone, and prednisolone should be considered.
Cystic fibrosis transmembrane conductance regulator potentiators
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Drugs within Class Effect on
Concentration		 Clinical Comments
lumacaftor/ivacaftor ↓ nirmatrelvir/
ritonavir		 Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
ivacaftor ↑ ivacaftor Reduce dosage when coadministered with PAXLOVID. Refer to individual product labels for more information.
elexacaftor/tezacaftor/ivacaftor ↑elexacaftor/
tezacaftor/ivacaftor
tezacaftor/ivacaftor ↑ tezacaftor/
ivacaftor
Dipeptidyl peptidase 4 (DPP4) inhibitors
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Drugs within Class Effect on
Concentration		 Clinical Comments
saxagliptin ↑ saxagliptin Dosage adjustment of saxagliptin is recommended. Refer to the saxagliptin product label for more information. 
Endothelin receptor antagonists
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Drugs within Class Effect on
Concentration		 Clinical Comments
bosentan ↑ bosentan
↓ nirmatrelvir/
ritonavir		 Discontinue use of bosentan at least 36 hours prior to initiation of PAXLOVID.

Refer to the bosentan product label for further information.
Ergot derivatives
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Drugs within Class Effect on
Concentration		 Clinical Comments
dihydroergotamine
ergotamine
methylergonovine		 ↑ dihydroergotamine 

↑ ergotamine
↑ methylergonovine		 Coadministration contraindicated due to potential for acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues including the central nervous system [see Contraindications (4)].
Hepatitis C direct-acting antivirals
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Drugs within Class Effect on
Concentration		 Clinical Comments
elbasvir/grazoprevir ↑ antiviral  Increased grazoprevir concentrations can result in alanine transaminase (ALT) elevations.
glecaprevir/pibrentasvir ↑ antiviral  Avoid concomitant use of glecaprevir/pibrentasvir with PAXLOVID.
ombitasvir/paritaprevir/
ritonavir and dasabuvir		 ↑ antiviral  Refer to the ombitasvir/paritaprevir/ritonavir and dasabuvir label for further information.

Patients on ritonavir-containing HCV regimens should continue their treatment as indicated. Monitor for increased PAXLOVID or HCV drug adverse events with concomitant use.
sofosbuvir/velpatasvir​/voxilaprevir ↑ antiviral  Refer to the sofosbuvir/velpatasvir/voxilaprevir product label for further information.
Herbal products
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Drugs within Class Effect on
Concentration		 Clinical Comments
St. John’s Wort (hypericum perforatum) ↓ nirmatrelvir/
ritonavir		 Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
HMG-CoA reductase inhibitors 
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Drugs within Class Effect on
Concentration		 Clinical Comments
lovastatin,
simvastatin		 ↑ lovastatin
↑ simvastatin		 Coadministration contraindicated due to potential for myopathy including rhabdomyolysis [see Contraindications (4)].

If treatment with PAXLOVID is considered medically necessary, discontinue use of lovastatin and simvastatin at least 12 hours prior to initiation of PAXLOVID, during the 5 days of PAXLOVID treatment, and for 5 days after completing PAXLOVID.
atorvastatin,
rosuvastatin		 ↑ atorvastatin
↑ rosuvastatin		 Consider temporary discontinuation of atorvastatin and rosuvastatin during treatment with PAXLOVID. Atorvastatin and rosuvastatin do not need to be withheld prior to or after completing PAXLOVID.
Hormonal contraceptive
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Drugs within Class Effect on
Concentration		 Clinical Comments
ethinyl estradiol ↓ ethinyl estradiol An additional, nonhormonal method of contraception should be considered during the 5 days of PAXLOVID treatment and until one menstrual cycle after stopping PAXLOVID.
Immunosuppressants
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Drugs within Class Effect on
Concentration		 Clinical Comments
voclosporin ↑ voclosporin Coadministration contraindicated due to potential for acute and/or chronic nephrotoxicity [see Contraindications (4)].
calcineurin inhibitors:
cyclosporine
tacrolimus		 ↑ cyclosporine
↑ tacrolimus		 Avoid concomitant use of calcineurin inhibitors with PAXLOVID when close monitoring of immunosuppressant concentrations is not feasible. If co-administered, dose adjustment of the immunosuppressant and close and regular monitoring for immunosuppressant concentrations and adverse reactions are recommended during and after treatment with PAXLOVID. Obtain expert consultation to appropriately manage the complexity of this coadministration [see Warnings and Precautions (5.1)].
mTOR inhibitors:
everolimus
sirolimus		 ↑ everolimus
↑ sirolimus		 Avoid concomitant use of everolimus and sirolimus and PAXLOVID.
Refer to the individual immunosuppressant product label and latest guidelines for further information.
Janus kinase (JAK) inhibitors 
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Drugs within Class Effect on
Concentration		 Clinical Comments
tofacitinib ↑ tofacitinib Dosage adjustment of tofacitinib is recommended. Refer to the tofacitinib product label for more information.
upadacitinib ↑ upadacitinib Dosing recommendations for coadministration of upadacitinib with PAXLOVID depends on the upadacitinib indication. Refer to the upadacitinib product label for more information.
Long-acting beta-adrenoceptor agonist
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Drugs within Class Effect on
Concentration		 Clinical Comments
salmeterol ↑ salmeterol Avoid concomitant use with PAXLOVID. The combination may result in increased risk of cardiovascular adverse events associated with salmeterol, including QT prolongation, palpitations, and sinus tachycardia.
Microsomal triglyceride transfer protein (MTTP) inhibitor
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Drugs within Class Effect on
Concentration		 Clinical Comments
lomitapide ↑ lomitapide Coadministration contraindicated due to potential for hepatotoxicity and gastrointestinal adverse reactions [see Contraindications (4)].
Migraine medications
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Drugs within Class Effect on
Concentration		 Clinical Comments
eletriptan ↑ eletriptan Coadministration of eletriptan within at least 72 hours of PAXLOVID is contraindicated due to potential for serious adverse reactions including cardiovascular and cerebrovascular events [see Contraindications (4)].
ubrogepant ↑ ubrogepant Coadministration of ubrogepant with PAXLOVID is contraindicated due to potential for serious adverse reactions [see Contraindications (4)].
rimegepant ↑ rimegepant Avoid concomitant use with PAXLOVID.
Mineralocorticoid receptor antagonists
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Drugs within Class Effect on
Concentration		 Clinical Comments
finerenone ↑ finerenone Coadministration contraindicated due to potential for serious adverse reactions including hyperkalemia, hypotension, and hyponatremia [see Contraindications (4)].
Muscarinic receptor antagonists
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
darifenacin ↑ darifenacin The darifenacin daily dose should not exceed 7.5 mg when coadministered with PAXLOVID. Refer to the darifenacin product label for more information.
Narcotic analgesics
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
fentanyl ↑ fentanyl Careful monitoring of therapeutic and adverse effects (including potentially fatal respiratory depression) is recommended when fentanyl, hydrocodone, oxycodone, or meperidine is concomitantly administered with PAXLOVID. If concomitant use with PAXLOVID is necessary, consider a dosage reduction of the narcotic analgesic and monitor patients closely at frequent intervals. Refer to the individual product label for more information.
hydrocodone ↑ hydrocodone
oxycodone ↑ oxycodone
meperidine ↑ meperidine
methadone ↓ methadone Monitor methadone-maintained patients closely for evidence of withdrawal effects and adjust the methadone dose accordingly.
Neuropsychiatric agents
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
suvorexant ↑ suvorexant Avoid concomitant use of suvorexant with PAXLOVID.

Dosage adjustment of aripiprazole, brexpiprazole, cariprazine, iloperidone, lumateperone, and pimavanserin is recommended. Refer to individual product label for more information.
aripiprazole ↑ aripiprazole
brexpiprazole ↑ brexpiprazole
cariprazine ↑ cariprazine
iloperidone ↑ iloperidone
lumateperone ↑ lumateperone
pimavanserin ↑ pimavanserin
Opioid antagonists
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
naloxegol ↑ naloxegol Coadministration contraindicated due to the potential for opioid withdrawal symptoms [see Contraindications (4)].
Pulmonary hypertension agents (PDE5 inhibitors)
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
sildenafil (Revatio®) ↑ sildenafil Coadministration of sildenafil with PAXLOVID is contraindicated for use in pulmonary hypertension due to the potential for sildenafil associated adverse events, including visual abnormalities hypotension, prolonged erection, and syncope [see Contraindications (4)].
tadalafil (Adcirca®) ↑ tadalafil Avoid concomitant use of tadalafil with PAXLOVID for pulmonary hypertension.
Pulmonary hypertension agents (sGC stimulators)
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
riociguat ↑ riociguat Dosage adjustment is recommended for riociguat when used for pulmonary hypertension. Refer to the riociguat product label for more information.
Erectile dysfunction agents (PDE5 inhibitors)
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
avanafil ↑ avanafil Do not use PAXLOVID with avanafil because a safe and effective avanafil dosage regimen has not been established.
sildenafil ↑ sildenafil Dosage adjustment is recommended for use of sildenafil, tadalafil, or vardenafil with PAXLOVID when used for erectile dysfunction. Refer to individual product label for more information.
tadalafil ↑ tadalafil
vardenafil ↑ vardenafil
Sedative/hypnotics 
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
triazolam ↑ triazolam  Coadministration contraindicated due to potential for extreme sedation and respiratory depression [see Contraindications (4)].
oral midazolama ↑ midazolam
buspirone, 
clorazepate,
diazepam,
estazolam,
flurazepam,
zolpidem 		 ↑ sedative/hypnotic A dose decrease may be needed for these drugs when coadministered with PAXLOVID and monitoring for adverse events.
midazolam 
(administered parenterally)		 ↑ midazolam Coadministration of midazolam
(parenteral) should be done in a setting which ensures close clinical monitoring and appropriate medical management in case of respiratory depression and/or prolonged sedation. Dosage reduction for midazolam should be considered, especially if more than a single dose of midazolam is administered. 

Refer to the midazolam product label for further information.
Serotonin receptor 1A agonist/serotonin receptor 2A antagonist
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
flibanserin ↑ flibanserin Coadministration contraindicated due to potential for hypotension, syncope, and CNS depression [see Contraindications (4)].
Vasopressin receptor antagonists
Scroll left to view table
Drugs within Class Effect on
Concentration		 Clinical Comments
tolvaptan ↑ tolvaptan Coadministration contraindicated due to potential for dehydration, hypovolemia, and hyperkalemia [see Contraindications (4)].

Example

aSee Pharmacokinetics, Drug Interaction Studies Conducted with Nirmatrelvir and Ritonavir (see PAXLOVID Prescribing Information section 12.3).
Alpha1-adrenoreceptor antagonist
Drugs within Class Effect on
Concentration		 Clinical Comments
alfuzosin ↑ alfuzosin Coadministration contraindicated due to potential hypotension [see Contraindications (4)].
tamsulosin ↑ tamsulosin Avoid concomitant use with PAXLOVID.
Antianginal
Drugs within Class Effect on
Concentration		 Clinical Comments
alfuzosin ↑ alfuzosin Coadministration contraindicated due to potential hypotension [see Contraindications (4)].
tamsulosin ↑ tamsulosin Avoid concomitant use with PAXLOVID.
Antiarrhythmics
Drugs within Class Effect on
Concentration		 Clinical Comments
amiodarone, 
dronedarone, 
flecainide, 
propafenone, 
quinidine		 ↑ antiarrhythmic  Coadministration contraindicated due to potential hypotension [see Contraindications (4)].
lidocaine (systemic), disopyramide ↑ antiarrhythmic  Caution is warranted and therapeutic concentration monitoring is recommended for antiarrhythmics if available. 
Anticancer drugs
Drugs within Class Effect on
Concentration		 Clinical Comments
apalutamide ↓ nirmatrelvir/ritonavir Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
abemaciclib,
ceritinib,
dasatinib,
encorafenib,
ibrutinib,
ivosidenib,
neratinib,
nilotinib,
venetoclax,
vinblastine,
vincristine		 ↑ anticancer drug Avoid coadministration of encorafenib or ivosidenib due to potential risk of serious adverse events such as QT interval prolongation. Avoid use of neratinib, venetoclax or ibrutinib.

Coadministration of vincristine and vinblastine may lead to significant hematologic or gastrointestinal side effects.

For further information, refer to individual product label for anticancer drug.
Anticoagulants 
Drugs within Class Effect on
Concentration		 Clinical Comments
warfarin ↑↓ warfarin Closely monitor international normalized ratio (INR) if coadministration with warfarin is necessary.
rivaroxaban ↑ rivaroxaban Increased bleeding risk with rivaroxaban. Avoid concomitant use.
dabigatrana ↑ dabigatran Increased bleeding risk with dabigatran. Depending on dabigatran indication and renal function, reduce dose of dabigatran or avoid concomitant use. Refer to the dabigatran product label for further information. 
apixaban ↑ apixaban Combined P-gp and strong CYP3A inhibitors increase blood levels of apixaban and increase the risk of bleeding. Dosing recommendations for coadministration of apixaban with PAXLOVID depend on the apixaban dose. Refer to the apixaban product label for more information.
Anticonvulsants
Drugs within Class Effect on
Concentration		 Clinical Comments
carbamazepinea, 
phenobarbital, 
primidone, 
phenytoin		 ↓ nirmatrelvir/ritonavir Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
clonazepam ↑ anticonvulsant A dose decrease may be needed for clonazepam when coadministered with PAXLOVID and clinical monitoring is recommended.
Antidepressants
Drugs within Class Effect on
Concentration		 Clinical Comments
bupropion ↓ bupropion and active metabolite hydroxybupropion Monitor for an adequate clinical response to bupropion. 
trazodone ↑ trazodone  Adverse reactions of nausea, dizziness, hypotension, and syncope have been observed following coadministration of trazodone and ritonavir. A lower dose of trazodone should be considered. Refer to trazodone product label for further information.
Antifungals
Drugs within Class Effect on
Concentration		 Clinical Comments
voriconazole ↓ voriconazole Avoid concomitant use of voriconazole.
ketoconazole, 
isavuconazonium sulfate,
itraconazolea		 ↑ ketoconazole
↑ isavuconazonium sulfate
↑ itraconazole		 Refer to ketoconazole, isavuconazonium sulfate, and itraconazole product labels for further information.
  ↑ nirmatrelvir/ritonavir A nirmatrelvir/ritonavir dose reduction is not needed.
Anti-gout
Drugs within Class Effect on
Concentration		 Clinical Comments
colchicine ↑ colchicine Coadministration contraindicated due to potential for serious and/or life-threatening reactions in patients with renal and/or hepatic impairment [see Contraindications (4)].
Anti-HIV protease inhibitors
Drugs within Class Effect on
Concentration		 Clinical Comments
atazanavir,
darunavir,
tipranavir		 ↑ protease inhibitor For further information, refer to the respective protease inhibitors’ prescribing information.

Patients on ritonavir- or 
cobicistat-containing HIV regimens should continue their treatment as indicated. Monitor for increased PAXLOVID or protease inhibitor adverse events.
Anti-HIV
Drugs within Class Effect on
Concentration		 Clinical Comments
atazanavir,
darunavir,
tipranavir		 ↑ protease inhibitor
↑ maraviroc 		For further information, refer to the respective protease inhibitors’ prescribing information.
maraviroc
nevirapine ↑ nevirapine
zidovudine ↓ zidovudine
bictegravir ↑ bictegravir
emtricitabine <- -> emtricitabine
tenofovir ↑ tenofovir
Anti-infective
Drugs within Class Effect on
Concentration		 Clinical Comments
clarithromycin ↑ clarithromycin  Refer to the respective prescribing information for anti-infective dose adjustment.
erythromycin ↑ erythromycin
Antimycobacterial
Drugs within Class Effect on
Concentration		 Clinical Comments
rifampin,
rifapentine		 ↓ nirmatrelvir/ritonavir Coadministration contraindicated due to potential loss of virologic response and possible resistance.

Alternate antimycobacterial drugs such as rifabutin should be considered [see Contraindications (4)].
bedaquiline ↑ bedaquiline Refer to the bedaquiline product label for further information.
rifabutin ↑ rifabutin Refer to rifabutin product label for further information on rifabutin dose reduction.
Antipsychotics
Drugs within Class Effect on
Concentration		 Clinical Comments
lurasidone ↑ lurasidone Coadministration contraindicated due to serious and/or life-threatening reactions such as cardiac arrhythmias [see Contraindications (4)].
pimozide ↑ quetiapine
clozapine ↑ clozapine If coadministration is necessary, consider reducing the clozapine dose and monitor for adverse reactions.
Antipsychotics
Drugs within Class Effect on
Concentration		 Clinical Comments
lurasidone ↑ lurasidone Coadministration contraindicated due to serious and/or life-threatening reactions such as cardiac arrhythmias [see Contraindications (4)].
pimozide ↑ quetiapine
clozapine ↑ clozapine If coadministration is necessary, consider reducing the clozapine dose and monitor for adverse reactions.
Benign prostatic hyperplasia agents
Drugs within Class Effect on
Concentration		 Clinical Comments
silodosin ↑ silodosin Coadministration contraindicated due to potential for postural hypotension [see Contraindications (4)].
Calcium channel blockers
Drugs within Class Effect on
Concentration		 Clinical Comments
amlodipine, 
diltiazem,
felodipine,
nicardipine,
nifedipine,
verapamil		 ↑ calcium channel      
blocker		 Caution is warranted and clinical monitoring of patients is recommended. A dose decrease may be needed for these drugs when coadministered with PAXLOVID. 

If coadministered, refer to individual product label for calcium channel blocker for further information.
Cardiac glycosides
Drugs within Class Effect on
Concentration		 Clinical Comments
digoxin ↑ digoxin Caution should be exercised when coadministering PAXLOVID with digoxin, with appropriate monitoring of serum digoxin levels. 

Refer to the digoxin product label for further information.
Cardiovascular agents
Drugs within Class Effect on silodosin Clinical Comments
eplerenone ↑ eplerenone Coadministration with eplerenone is contraindicated due to potential for hyperkalemia [see Contraindications (4)].
ivabradine ↑ ivabradine Coadministration with ivabradine is contraindicated due to potential for bradycardia or conduction disturbances [see Contraindications (4)].
aliskiren ↑ aliskiren Avoid concomitant use with PAXLOVID.
ticagrelor ↑ ticagrelor
vorapaxar ↑ vorapaxar
clopidogrel ↓ clopidogrel active metabolite
cilostazol ↑ cilostazol Dosage adjustment of cilostazol is recommended. Refer to the cilostazol product label for more information.
Corticosteroids primarily metabolized by CYP3A
Drugs within Class Effect on
Concentration		 Clinical Comments
digoxin ↑ corticosteroid Coadministration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing’s syndrome and adrenal suppression. However, the risk of Cushing’s syndrome and adrenal suppression associated with short-term use of a strong CYP3A inhibitor is low. Alternative corticosteroids including beclomethasone, prednisone, and prednisolone should be considered.
Cystic fibrosis transmembrane conductance regulator potentiators
Drugs within Class Effect on
Concentration		 Clinical Comments
lumacaftor/ivacaftor ↓ nirmatrelvir/ritonavir Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
ivacaftor ↑ ivacaftor Reduce dosage when coadministered with PAXLOVID. Refer to individual product labels for more information.
elexacaftor/tezacaftor/ivacaftor ↑elexacaftor/tezacaftor/ivacaftor
tezacaftor/ivacaftor ↑ tezacaftor/ivacaftor
Dipeptidyl peptidase 4 (DPP4) inhibitors
Drugs within Class Effect on
Concentration		 Clinical Comments
saxagliptin ↑ saxagliptin Dosage adjustment of saxagliptin is recommended. Refer to the saxagliptin product label for more information. 
Endothelin receptor antagonists
Drugs within Class Effect on
Concentration		 Clinical Comments
bosentan ↑ bosentan
↓ nirmatrelvir/ritonavir		 Discontinue use of bosentan at least 36 hours prior to initiation of PAXLOVID.

Refer to the bosentan product label for further information.
Ergot derivatives
Drugs within Class Effect on
Concentration		 Clinical Comments
dihydroergotamine
ergotamine
methylergonovine		 ↑ dihydroergotamine 
↑ ergotamine
↑ methylergonovine		 Coadministration contraindicated due to potential for acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues including the central nervous system [see Contraindications (4)].
Hepatitis C direct-acting antivirals
Drugs within Class Effect on Concentration Clinical Comments
elbasvir/grazoprevir ↑ antiviral  Increased grazoprevir concentrations can result in alanine transaminase (ALT) elevations.
glecaprevir/pibrentasvir ↑ antiviral  Avoid concomitant use of glecaprevir/pibrentasvir with PAXLOVID.
ombitasvir/paritaprevir/
ritonavir and dasabuvir		 ↑ antiviral  Refer to the ombitasvir/paritaprevir/ritonavir and dasabuvir label for further information.

Patients on ritonavir-containing HCV regimens should continue their treatment as indicated. Monitor for increased PAXLOVID or HCV drug adverse events with concomitant use.
sofosbuvir/velpatasvir​/voxilaprevir ↑ antiviral  Refer to the sofosbuvir/velpatasvir/voxilaprevir product label for further information.
Herbal products
Drugs within Class Effect on
Concentration		 Clinical Comments
St. John’s Wort (hypericum perforatum) ↓ nirmatrelvir/ritonavir Coadministration contraindicated due to potential loss of virologic response and possible resistance [see Contraindications (4)].
HMG-CoA reductase inhibitors 
Drugs within Class Effect on
Concentration		 Clinical Comments
lovastatin,
simvastatin		 ↑ lovastatin ↑ simvastatin Coadministration contraindicated due to potential for myopathy including rhabdomyolysis [see Contraindications (4)].

If treatment with PAXLOVID is considered medically necessary, discontinue use of lovastatin and simvastatin at least 12 hours prior to initiation of PAXLOVID, during the 5 days of PAXLOVID treatment, and for 5 days after completing PAXLOVID.
atorvastatin,
rosuvastatin		 ↑ atorvastatin
↑ rosuvastatin		 Consider temporary discontinuation of atorvastatin and rosuvastatin during treatment with PAXLOVID. Atorvastatin and rosuvastatin do not need to be withheld prior to or after completing PAXLOVID.
Hormonal contraceptive
Drugs within Class Effect on
Concentration		 Clinical Comments
ethinyl estradiol ↓ ethinyl estradiol  An additional, nonhormonal method of contraception should be considered during the 5 days of PAXLOVID treatment and until one menstrual cycle after stopping PAXLOVID.
Immunosuppressants
Drugs within Class Effect on
Concentration		 Clinical Comments
voclosporin ↑ voclosporin Coadministration contraindicated due to potential for acute and/or chronic nephrotoxicity [see Contraindications (4)].
calcineurin inhibitors:
cyclosporine
tacrolimus		 ↑ cyclosporine
↑ tacrolimus		 Avoid concomitant use of calcineurin inhibitors with PAXLOVID when close monitoring of immunosuppressant concentrations is not feasible. If co-administered, dose adjustment of the immunosuppressant and close and regular monitoring for immunosuppressant concentrations and adverse reactions are recommended during and after treatment with PAXLOVID. Obtain expert consultation to appropriately manage the complexity of this coadministration [see Warnings and Precautions (5.1)].
mTOR inhibitors:
everolimus
sirolimus		 ↑ everolimus
↑ sirolimus		 Avoid concomitant use of everolimus and sirolimus and PAXLOVID.

Refer to the individual immunosuppressant product label and latest guidelines for further information.
Janus kinase (JAK) inhibitors 
Drugs within Class Effect on
Concentration		 Clinical Comments
tofacitinib ↑ tofacitinib Dosage adjustment of tofacitinib is recommended. Refer to the tofacitinib product label for more information.
upadacitinib ↑ upadacitinib Dosing recommendations for coadministration of upadacitinib with PAXLOVID depends on the upadacitinib indication. Refer to the upadacitinib product label for more information.
Long-acting beta-adrenoceptor agonist
Drugs within Class Effect on
Concentration		 Clinical Comments
salmeterol ↑ salmeterol Avoid concomitant use with PAXLOVID. The combination may result in increased risk of cardiovascular adverse events associated with salmeterol, including QT prolongation, palpitations, and sinus tachycardia.
Microsomal triglyceride transfer protein (MTTP) inhibitor
Drugs within Class Effect on
Concentration		 Clinical Comments
lomitapide ↑ lomitapide Coadministration contraindicated due to potential for hepatotoxicity and gastrointestinal adverse reactions [see Contraindications (4)].
Migraine medications
Drugs within Class Effect on
Concentration		 Clinical Comments
eletriptan ↑ eletriptan Coadministration of eletriptan within at least 72 hours of PAXLOVID is contraindicated due to potential for serious adverse reactions including cardiovascular and cerebrovascular events [see Contraindications (4)].
ubrogepant ubrogepant Coadministration of ubrogepant with PAXLOVID is contraindicated due to potential for serious adverse reactions [see Contraindications (4)].
rimegepant ↑ rimegepant Avoid concomitant use with PAXLOVID.
Mineralocorticoid receptor antagonists
Drugs within Class Effect on
Concentration		 Clinical Comments
finerenone ↑ finerenone Coadministration contraindicated due to potential for serious adverse reactions including hyperkalemia, hypotension, and hyponatremia [see Contraindications (4)].
Muscarinic receptor antagonists
Drugs within Class Effect on
Concentration		 Clinical Comments
darifenacin ↑ darifenacin The darifenacin daily dose should not exceed 7.5 mg when coadministered with PAXLOVID. Refer to the darifenacin product label for more information.
Narcotic analgesics
Drugs within Class Effect on
Concentration		 Clinical Comments
fentanyl ↑ fentanyl Careful monitoring of therapeutic and adverse effects (including potentially fatal respiratory depression) is recommended when fentanyl, hydrocodone, oxycodone, or meperidine is concomitantly administered with PAXLOVID. If concomitant use with PAXLOVID is necessary, consider a dosage reduction of the narcotic analgesic and monitor patients closely at frequent intervals. Refer to the individual product label for more information.
     
hydrocodone ↑ hydrocodone  
oxycodone ↑ oxycodone  
meperidine ↑ meperidine  
methadone ↓ methadone Monitor methadone-maintained patients closely for evidence of withdrawal effects and adjust the methadone dose accordingly.
Neuropsychiatric agents
Drugs within Class Effect on
Concentration		 Clinical Comments
suvorexant ↑ suvorexant Avoid concomitant use of suvorexant with PAXLOVID.

Dosage adjustment of aripiprazole, brexpiprazole, cariprazine, iloperidone, lumateperone, and pimavanserin is recommended. Refer to individual product label for more information.
aripiprazole ↑ aripiprazole  
brexpiprazole ↑ brexpiprazole  
cariprazine ↑ cariprazine  
iloperidone ↑ iloperidone  
lumateperone ↑ lumateperone  
pimavanserin ↑ pimavanserin  
Opioid antagonists
Drugs within Class Effect on
Concentration		 Clinical Comments
naloxegol ↑ naloxegol Coadministration contraindicated due to the potential for opioid withdrawal symptoms [see Contraindications (4)].
Pulmonary hypertension agents (PDE5 inhibitors)
Drugs within Class Effect on
Concentration		 Clinical Comments
sildenafil (Revatio®) ↑ sildenafil Coadministration of sildenafil with PAXLOVID is contraindicated for use in pulmonary hypertension due to the potential for sildenafil associated adverse events, including visual abnormalities hypotension, prolonged erection, and syncope [see Contraindications (4)].
tadalafil (Adcirca®) ↑ tadalafil Avoid concomitant use of tadalafil with PAXLOVID for pulmonary hypertension.
Pulmonary hypertension agents (sGC stimulators)
Drugs within Class Effect on
Concentration		 Clinical Comments
riociguat ↑ riociguat Dosage adjustment is recommended for riociguat when used for pulmonary hypertension. Refer to the riociguat product label for more information.
Erectile dysfunction agents (PDE5 inhibitors)
Drugs within Class Effect on
Concentration		 Clinical Comments
avanafil ↑ avanafil Do not use PAXLOVID with avanafil because a safe and effective avanafil dosage regimen has not been established.
sildenafil ↑ sildenafil Dosage adjustment is recommended for use of sildenafil, tadalafil, or vardenafil with PAXLOVID when used for erectile dysfunction. Refer to individual product label for more information.
tadalafil ↑ tadalafil  
vardenafil vardenafil  
Sedative/hypnotics 
Drugs within Class Effect on
Concentration		 Clinical Comments
triazolam ↑ triazolam  Coadministration contraindicated due to potential for extreme sedation and respiratory depression [see Contraindications (4)].
buspirone, 
clorazepate,
diazepam,
estazolam,
flurazepam,
zolpidem 		 ↑ sedative/hypnotic Coadministration of midazolam
(parenteral) should be done in a setting which ensures close clinical monitoring and appropriate medical management in case of respiratory depression and/or prolonged sedation. Dosage reduction for midazolam should be considered, especially if more than a single dose of midazolam is administered. 

Refer to the midazolam product label for further information.
midazolam 
(administered parenterally)		 ↑ midazolam  
Serotonin receptor 1A agonist/serotonin receptor 2A antagonist
Drugs within Class Effect on
Concentration		 Clinical Comments
flibanserin ↑ flibanserin Coadministration contraindicated due to potential for hypotension, syncope, and CNS depression [see Contraindications (4)].
Vasopressin receptor antagonists
Drugs within Class Effect on
Concentration		 Clinical Comments
tolvaptan ↑ tolvaptan Coadministration contraindicated due to potential for dehydration, hypovolemia, and hyperkalemia [see Contraindications (4)].
Neuropsychiatric agents
Drugs within Class Effect on
Concentration		 Clinical Comments
suvorexant ↑ suvorexant Avoid concomitant use of suvorexant with PAXLOVID.

Dosage adjustment of aripiprazole, brexpiprazole, cariprazine, iloperidone, lumateperone, and pimavanserin is recommended. Refer to individual product label for more information.
aripiprazole ↑ aripiprazole  
brexpiprazole ↑ brexpiprazole  
cariprazine ↑ cariprazine  
iloperidone ↑ iloperidone  
lumateperone ↑ lumateperone  
pimavanserin ↑ pimavanserin  
Scroll left to view table
Table 1: Established and Other Potentially Significant Drug Interactions1
Drug Class Drugs within Class Effect on
Concentration		 Clinical Comments
Alpha1-
adrenoreceptor
antagonist		 alfuzosin ↑ alfuzosin Coadministration
contraindicated due to
potential hypotension
[see Contraindications
(4)].
Alpha1-
adrenoreceptor
antagonist		 tamsulosin ↑ tamsulosin Avoid concomitant
use with PAXLOVID.
Antianginal ranolazine ↑ ranolazine Coadministration
contraindicated due to
potential for serious
and/or life-threatening
reactions [see
Contraindications (4)].
Antiarrhythmics amiodarone,
dronedarone,
flecainide,
propafenone,
quinidine		 ↑ antiarrhythmic Coadministration
contraindicated due to
potential for cardiac
arrhythmias [see
Contraindications (4)].
Antiarrhythmics lidocaine (systemic),
disopyramide		 ↑ antiarrhythmic Caution is warranted
and therapeutic
concentration
monitoring is
recommended for
antiarrhythmics if
available.
Anticancer drugs apalutamide ↓ nirmatrelvir/
ritonavir		 Coadministration
contraindicated due to
potential loss of
virologic response and
possible resistance
[see Contraindications
(4)].
Anticancer drugs abemaciclib,
ceritinib,
dasatinib,
encorafenib,
ibrutinib,
ivosidenib,
neratinib,
nilotinib,
venetoclax,
vinblastine,
vincristine		 ↑ anticancer drug Avoid
coadministration of
encorafenib or
ivosidenib due to
potential risk of
serious adverse
events such as QT
interval prolongation.
Avoid use of
neratinib, venetoclax
or ibrutinib.

Coadministration of
vincristine and
vinblastine may lead
to significant
hematologic or
gastrointestinal side
effects.

For further
information, refer to
individual product
label for anticancer
drug.
Anticoagulants warfarin





rivaroxaban




dabigatrana












apixaban		 ↑↓ warfarin





↑ rivaroxaban




↑ dabigatran












↑ apixaban		 Closely monitor
international normalized
ratio (INR) if
coadministration with
warfarin is necessary.

Increased bleeding
risk with rivaroxaban.
Avoid concomitant
use.

Increased bleeding
risk with dabigatran.
Depending on
dabigatran indication
and renal function,
reduce dose of
dabigatran or avoid
concomitant use.
Refer to the
dabigatran product
label for further
information.

Combined P-gp and
strong CYP3A
inhibitors increase
blood levels of
apixaban and
increase the risk of
bleeding. Dosing
recommendations for
coadministration of
apixaban with
PAXLOVID depend on
the apixaban dose.
Refer to the apixaban
product label for
more information.
Anticonvulsants carbamazepinea,
phenobarbital,
primidone,
phenytoin		 ↓ nirmatrelvir/
ritonavir		 Coadministration
contraindicated due to
potential loss of
virologic response and
possible resistance
[see Contraindications
(4)].
Anticonvulsants clonazepam ↑ anticonvulsant A dose decrease may
be needed for
clonazepam when
coadministered with
PAXLOVID and clinical
monitoring is
recommended.
Antidepressants bupropion




trazodone		 ↓ bupropion and
active metabolite
hydroxybupropion


↑ trazodone		 Monitor for an
adequate clinical
response to
bupropion.

Adverse reactions of
nausea, dizziness,
hypotension, and
syncope have been
observed following
coadministration of
trazodone and
ritonavir. A lower
dose of trazodone
should be
considered. Refer to
trazadone product
label for further
information.
Antifungals voriconazole


ketoconazole,
isavuconazonium
sulfate,
itraconazolea 		↓ voriconazole


↑ ketoconazole
↑ isavuconazonium
sulfate
↑ itraconazole



↑ nirmatrelvir/
ritonavir		 Avoid concomitant
use of voriconazole.

Refer to
ketoconazole,
isavuconazonium
sulfate, and
itraconazole product
labels for further
information.

A nirmatrelvir/
ritonavir dose
reduction is not
needed.
Anti-gout colchicine ↑ colchicine Coadministration
contraindicated due to
potential for serious
and/or life-threatening
reactions in patients
with renal and/or
hepatic impairment
[see Contraindications
(4)].
Anti-HIV protease
inhibitors		 atazanavir,
darunavir,
tipranavir		 ↑ protease inhibitor For further
information, refer to
the respective
protease inhibitors’
prescribing
information.

Patients on ritonavir-
or 
cobicistat-containing
HIV regimens should
continue their
treatment as
indicated. Monitor for
increased PAXLOVID
or protease inhibitor
adverse events.
Anti-HIV efavirenz,
maraviroc,
nevirapine,
zidovudine,
bictegravir/
emtricitabine/
tenofovir		 ↑ efavirenz
↑ maraviroc
↑ nevirapine
↓ zidovudine
↑ bictegravir
←→ emtricitabine
↑ tenofovir		 For further
information, refer to
the respective anti-
HIV drugs prescribing
information.
Anti-infective clarithromycin,
erythromycin		 ↑ clarithromycin
↑ erythromycin		 Refer to the
respective
prescribing
information for anti-
infective dose
adjustment.
Antimycobacterial rifampin,
rifapentine		 ↓ nirmatrelvir/
ritonavir		 Coadministration
contraindicated due to
potential loss of
virologic response and
possible resistance.
Alternate
antimycobacterial
drugs such as rifabutin
should be considered
[see Contraindications
(4)].
Antimycobacterial bedaquiline




rifabutin		 ↑ bedaquiline




↑ rifabutin		 Refer to the
bedaquiline product
label for further
information.

Refer to rifabutin
product label for
further information on
rifabutin dose
reduction.
Antipsychotics lurasidone,
pimozide		 ↑ lurasidone
↑ pimozide		 Coadministration
contraindicated due to
serious and/or life-
threatening reactions
such as cardiac
arrhythmias [see
Contraindications (4)].
Antipsychotics quetiapine











clozapine		 ↑ quetiapine











↑ clozapine		 If coadministration is
necessary, reduce
quetiapine dose and
monitor for
quetiapine-
associated adverse
reactions. Refer to
the quetiapine
prescribing
information for
recommendations.

If coadministration is
necessary, consider
reducing the
clozapine dose and
monitor for adverse
reactions.
Benign prostatic
hyperplasia agents		 silodosin ↑ silodosin Coadministration
contraindicated due
to potential for
postural hypotension
[see
Contraindications
(4)].
Calcium channel
blockers		 amlodipine,
diltiazem,
felodipine,
nicardipine,
nifedipine,
verapamil		 ↑ calcium channel
blocker		 Caution is warranted
and clinical
monitoring of patients
is recommended. A
dose decrease may
be needed for these
drugs when
coadministered with
PAXLOVID.

If coadministered,
refer to individual
product label for
calcium channel
blocker for further
information.
Cardiac glycosides digoxin ↑ digoxin Caution should be
exercised when
coadministering
PAXLOVID with
digoxin, with
appropriate
monitoring of serum
digoxin levels.

Refer to the digoxin
product label for
further information.
Cardiovascular
agents		 eplerenone






ivabradine		 ↑ eplerenone






↑ ivabradine		 Coadministration with
eplerenone is
contraindicated due to
potential for
hyperkalemia [see
Contraindications (4)].

Coadministration with
ivabradine is
contraindicated due to
potential for
bradycardia or
conduction
disturbances [see
Contraindications (4)].
Cardiovascular
agents		 aliskiren,
ticagrelor,
vorapaxar

clopidogrel


cilostazol		 ↑ aliskiren
↑ ticagrelor
↑ vorapaxar

↓ clopidogrel active metabolite

↑ cilostazol		 Avoid concomitant
use with PAXLOVID.





Dosage adjustment of
cilostazol is
recommended. Refer
to the cilostazol
product label for
more information.
Corticosteroids
primarily metabolized
by CYP3A		 betamethasone,
budesonide,
ciclesonide,
dexamethasone,
fluticasone,
methylprednisolone,
mometasone,
triamcinolone		 ↑ corticosteroid Coadministration with
corticosteroids (all
routes of
administration) of
which exposures are
significantly
increased by strong
CYP3A inhibitors can
increase the risk for
Cushing’s syndrome
and adrenal
suppression.
However, the risk of
Cushing’s syndrome
and adrenal
suppression
associated with
short-term use of a
strong CYP3A
inhibitor is low.

Alternative
corticosteroids
including
beclomethasone,
prednisone, and
prednisolone should
be considered.
Cystic fibrosis
transmembrane
conductance
regulator potentiators		 lumacaftor/ivacaftor ↓ nirmatrelvir/
ritonavir		 Coadministration
contraindicated due to
potential loss of
virologic response and
possible resistance
[see Contraindications
(4)].
Cystic fibrosis
transmembrane
conductance
regulator potentiators		 ivacaftor

elexacaftor/tezacaftor/
ivacaftor

tezacaftor/ivacaftor		 ↑ ivacaftor

↑ elexacaftor/
tezacaftor/ivacaftor

↑ tezacaftor/
ivacaftor		 Reduce dosage when
coadministered with
PAXLOVID. Refer to
individual product
labels for more
information.
Dipeptidyl peptidase
4 (DPP4) inhibitors		 saxagliptin ↑ saxagliptin Dosage adjustment of
saxagliptin is
recommended. Refer
to the saxagliptin
product label for
more information.
Endothelin receptor
antagonists		 bosentan ↑ bosentan
↓ nirmatrelvir/
ritonavir		 Discontinue use of
bosentan at least 36
hours prior to
initiation of
PAXLOVID.

Refer to the bosentan
product label for
further information.
Ergot derivatives dihydroergotamine,
ergotamine,
methylergonovine		 ↑ dihydroergotamine
↑ ergotamine
↑ methylergonovine		 Coadministration
contraindicated due
to potential for acute
ergot toxicity
characterized by
vasospasm and
ischemia of the
extremities and other
tissues including the
central nervous
system [see
Contraindications (4)].
Hepatitis C
direct-acting antivirals		 elbasvir/grazoprevir





glecaprevir/
pibrentasvir



ombitasvir/
paritaprevir/
ritonavir and
dasabuvir



sofosbuvir/
velpatasvir/
voxilaprevir		 ↑ antiviral Increased grazoprevir
concentrations can
result in alanine
transaminase (ALT)
elevations.

Avoid concomitant
use of glecaprevir/
pibrentasvir with
PAXLOVID.

Refer to the
ombitasvir/
paritaprevir/ritonavir
and dasabuvir label
for further
information.

Refer to the sofosbuvir/velpatasvir/voxilaprevir product label for further information.

Patients on ritonavir-
containing HCV
regimens should
continue their
treatment as
indicated. Monitor for
increased PAXLOVID
or HCV drug adverse
events with
concomitant use.
Herbal products St. John’s Wort
(hypericum perforatum)		 ↓ nirmatrelvir/
ritonavir		 Coadministration
contraindicated due to
potential loss of
virologic response and
possible resistance
[see Contraindications (4)].
HMG-CoA
reductase
inhibitors		 lovastatin,
simvastatin		 ↑ lovastatin
↑ simvastatin		 Coadministration
contraindicated due to
potential for myopathy
including
rhabdomyolysis [see
Contraindications (4)].

If treatment with
PAXLOVID is
considered medically
necessary, discontinue
use of lovastatin and
simvastatin at least 12
hours prior to initiation
of PAXLOVID, during
the 5 days of
PAXLOVID treatment,
and for 5 days after
completing PAXLOVID.
HMG-CoA
reductase
inhibitors		 atorvastatin,
rosuvastatin		 ↑ atorvastatin
↑ rosuvastatin		 Consider temporary
discontinuation of
atorvastatin and
rosuvastatin during
treatment with
PAXLOVID. Atorvastatin and
rosuvastatin do not
need to be withheld
prior to or after
completing PAXLOVID.
Hormonal
contraceptive		 ethinyl estradiol ↓ ethinyl estradiol An additional,
nonhormonal method
of contraception
should be considered
during the 5 days of
PAXLOVID treatment
and until one
menstrual cycle after
stopping PAXLOVID.
Immunosuppressants voclosporin ↑ voclosporin Coadministration
contraindicated due to
potential for acute
and/or chronic
nephrotoxicity [see
Contraindications (4)].
Immunosuppressants calcineurin inhibitors:
cyclosporine,
tacrolimus
























mTOR inhibitors:
everolimus,
sirolimus		 ↑ cyclosporine
↑ tacrolimus

























↑ everolimus
↑ sirolimus		 Avoid concomitant
use of calcineurin
inhibitors with
PAXLOVID when close
monitoring of
immunosuppressant
concentrations is not
feasible. If
coadministered, dose
adjustment of the
immunosuppressant
and close and regular
monitoring for
immunosuppressant
concentrations and
adverse reactions are
recommended during
and after treatment
with PAXLOVID.
Obtain expert
consultation to
appropriately manage
the complexity of this
coadministration [see
Warnings and
Precautions (5.1)].

Avoid concomitant
use of everolimus and
sirolimus and
PAXLOVID.

Refer to the individual
immunosuppressant
product label and
latest guidelines for
further information.
Janus kinase (JAK)
inhibitors		 tofacitinib






upadacitinib		 ↑ tofacitinib






↑ upadacitinib		 Dosage adjustment of
tofacitinib is
recommended. Refer
to the tofacitinib
product label for
more information.

Dosing
recommendations for
coadministration of
upadacitinib with
PAXLOVID depends
on the upadacitinib
indication. Refer to
the upadacitinib
product label for
more information.
Long-acting
beta-adrenoceptor
agonist		 salmeterol ↑ salmeterol Avoid concomitant
use with PAXLOVID.
The combination may
result in increased
risk of cardiovascular
adverse events
associated with
salmeterol, including
QT prolongation,
palpitations, and
sinus tachycardia.
Microsomal
triglyceride transfer
protein (MTTP)
inhibitor		 lomitapide ↑ lomitapide Coadministration
contraindicated due to
potential for
hepatotoxicity and
gastrointestinal
adverse reactions [see
Contraindications (4)].
Migraine medications eletriptan












ubrogepant		 ↑ eletriptan












↑ ubrogepant		 Coadministration of
eletriptan within at
least 72 hours of
PAXLOVID is
contraindicated due to
potential for serious
adverse reactions
including
cardiovascular and
cerebrovascular events
[see Contraindications
(4)].

Coadministration of
ubrogepant with
PAXLOVID is
contraindicated due to
potential for serious
adverse reactions [see
Contraindications (4)].
Migraine medications rimegepant rimegepant Avoid concomitant
use with PAXLOVID.
Mineralocorticoid
receptor antagonists		 finerenone ↑ finerenone Coadministration
contraindicated due
to potential for
serious adverse
reactions including
hyperkalemia,
hypotension, and
hyponatremia [see
Contraindications (4)].
Muscarinic receptor
antagonists		 darifenacin ↑ darifenacin The darifenacin daily
dose should not
exceed 7.5 mg when
coadministered with
PAXLOVID. Refer to
the darifenacin
product label for
more information.
Narcotic analgesics fentanyl,
hydrocodone,
oxycodone,
meperidine






















methadone		 ↑ fentanyl
↑ hydrocodone
↑ oxycodone
↑ meperidine






















↓ methadone		 Careful monitoring of
therapeutic and
adverse effects
(including potentially
fatal respiratory
depression) is
recommended when
fentanyl,
hydrocodone,
oxycodone, or
meperidine is
concomitantly
administered with
PAXLOVID. If
concomitant use with
PAXLOVID is
necessary, consider a
dosage reduction of
the narcotic analgesic
and monitor patients
closely at frequent
intervals. Refer to the
individual product
label for more
information.

Monitor methadone-
maintained patients
closely for evidence
of withdrawal effects
and adjust the
methadone dose
accordingly.
Neuropsychiatric
agents		 suvorexant



aripiprazole,
brexpiprazole,
cariprazine,
iloperidone,
lumateperone,
pimavanserin		 ↑ suvorexant



↑ aripiprazole
↑ brexpiprazole
↑ cariprazine
↑ iloperidone
↑ lumateperone
↑ pimavanserin		 Avoid concomitant
use of suvorexant
with PAXLOVID.

Dosage adjustment of
aripiprazole,
brexpiprazole,
cariprazine,
iloperidone,
lumateperone, and
pimavanserin is
recommended. Refer
to individual product
label for more
information.
Opioid antagonists naloxegol ↑ naloxegol Coadministration
contraindicated due
to the potential for
opioid withdrawal
symptoms [see
Contraindications (4)].
Pulmonary
hypertension agents
(PDE5 inhibitors)		 sildenafil (Revatio®) ↑ sildenafil Coadministration of
sildenafil with
PAXLOVID is
contraindicated for
use in pulmonary
hypertension due to
the potential for
sildenafil associated
adverse events,
including visual
abnormalities,
hypotension,
prolonged erection,
and syncope [see
Contraindications (4)].
Pulmonary
hypertension agents
(PDE5 inhibitors)


 tadalafil (Adcirca®)




 ↑ tadalafil




 Avoid concomitant
use of tadalafil with
PAXLOVID for
pulmonary
hypertension.
Pulmonary
hypertension agents
(sGC stimulators)		 riociguat ↑ riociguat Dosage adjustment is
recommended for
riociguat when used
for pulmonary
hypertension. Refer
to the riociguat
product label for
more information.
Erectile dysfunction
agents (PDE5
inhibitors)		 avanafil






sildenafil, tadalafil,
vardenafil		 ↑ avanafil






↑ sildenafil
↑ tadalafil
↑ vardenafil		 Do not use PAXLOVID
with avanafil because
a safe and effective
avanafil dosage
regimen has not been
established.

Dosage adjustment is
recommended for use
of sildenafil, tadalafil,
or vardenafil with
PAXLOVID when used
for erectile
dysfunction. Refer to
individual product
label for more
information.
Sedative/hypnotics triazolam,
oral midazolama 		↑ triazolam
↑ midazolam		 Coadministration
contraindicated due
to potential for
extreme sedation and
respiratory depression [see
Contraindications (4)].
Sedative/hypnotics buspirone,
clorazepate,
diazepam,
estazolam,
flurazepam,
zolpidem


midazolam
(administered
parenterally)		 ↑ sedative/hypnotic






↑ midazolam		 A dose decrease may
be needed for these
drugs when
coadministered with
PAXLOVID and
monitoring for
adverse events.

Coadministration of
midazolam
(parenteral) should
be done in a setting
which ensures close
clinical monitoring
and appropriate
medical management
in case of respiratory
depression and/or
prolonged sedation.
Dosage reduction for
midazolam should be
considered,
especially if more
than a single dose of
midazolam is
administered.

Refer to the
midazolam product
label for further
information.
Serotonin receptor 1A
agonist/serotonin
receptor 2A
antagonist		 flibanserin ↑ flibanserin Coadministration
contraindicated due
to potential for
hypotension,
syncope, and CNS
depression [see
Contraindications (4)].
Vasopressin receptor
antagonists		 tolvaptan ↑ tolvaptan Coadministration
contraindicated due
to potential for
dehydration,
hypovolemia, and
hyperkalemia [see
Contraindications (4)].
aSee Pharmacokinetics, Drug Interaction Studies Conducted with Nirmatrelvir and Ritonavir (see PAXLOVID Prescribing Information section 12.3).
EXPLORE MORE Safety

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 Safety Loading References:1.  PAXLOVID Prescribing Information. Pfizer Inc.; 2023. 2. Talha B, Dhamoon AS. Ritonavir. StatPearls Publishing LLC. Accessed February 12, 2024. https://www.ncbi.nlm.nih.gov/books/NBK544312/?report=printable DDI Pocket Resource

Learn more about drug interactions with PAXLOVID and quickly reference a color-coded chart in addition to consulting the drug interactions table.

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 Safety Loading References:1.  PAXLOVID Prescribing Information. Pfizer Inc.; 2023. 2. Talha B, Dhamoon AS. Ritonavir. StatPearls Publishing LLC. Accessed February 12, 2024. https://www.ncbi.nlm.nih.gov/books/NBK544312/?report=printable

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PP-C1D-USA-1036
INDICATION PAXLOVID is indicated for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.

Limitations of Use

PAXLOVID is not approved for use as pre-exposure or post-exposure prophylaxis for prevention of COVID-19.

Please see Full Prescribing Information, including BOXED WARNING and Patient Information