Potential drug interaction after withdrawal of nirmatrelvir-ritonavir in hospitalized patients with COVID-19 infection.

BACKGROUND

Nirmatrelvir-ritonavir is effective in the treatment of SARS-CoV-2 infection. It can cause drug‒drug interactions (DDIs), even several days after withdrawal, due to irreversible inhibition of the cytochrome enzyme.

METHODS

Hospitalized patients diagnosed with COVID-19 infection and treated with nirmatrelvir-ritonavir were retrospectively included according to preset criteria. Personal information, as well as drug use, were obtained from the hospital information system. Potential DDIs were screened and classified according to three databases (FDA fact sheet, University of Liverpool Drug Interactions resources and Lexicomp).

RESULTS

A total of 332 hospitalized patients with COVID-19 infection who received nirmatrelvir-ritonavir treatment were included in this study. The prevalence of potential DDI risk after withdrawal of nirmatrelvir-ritonavir in hospitalized patients was 57.2 %. Most patients resumed potentially interacting medications on the first day of nirmatrelvir-ritonavir withdrawal, and those drugs with DDI risk at the avoidance level mainly included dexamethasone and rivaroxaban, whereas drugs at the caution level mainly included lidocaine.

CONCLUSION

The prevalence of potential DDI risk after withdrawal of nirmatlevir-ritonavir was high and should be given more attention.