Safety considerations for nirmatrelvir/ritonavir (Paxlovid¨) use in persons living with HIV whether or not on antiretroviral treatment, or persons at risk of HIV while on PrEP who are diagnosed with COVID-19 infection

The COVID-19 therapy Paxlovid¨ consists of the antiviral medication nirmatrelvir co-packaged with the pharmacokinetic enhancer (“booster”) ritonavir, taken as a twice daily, oral, five-day treatment course, with dosage adjustment required for renal impairment (see prescribing information).

Nirmatrelvir/ritonavir treatment is initiated as soon as possible following a positive SARS-CoV-2 test result. Eligibility criteria for nirmatrelvir/ritonavir vary between Canadian provinces and will likely evolve over time. Also, eligibility in British Columbia may be expanded as drug supply increases. Therefore, prescribers are strongly encouraged to refer to current nirmatrelvir/ritonavir prescribing information and local guidelines for treatment eligibility and general contraindications/precautions. In British Columbia, see the BC Centre for Disease Control website: http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/clinical-care/treatments