Indications for Paxlovid calculator

Clinical inputs

• Age (years)Accepted range: 0 to 120
• Disease setting
• Days since symptom onsetAccepted range: 0 to 30
• High risk for progression to severe COVID-19
• Clinically significant hypersensitivity to nirmatrelvir, ritonavir, or a component
• Takes a section 4 interacting drug
• Estimated glomerular filtration rate (mL/min)Accepted range: 0 to 200
• Hepatic impairment

Primary source

Pfizer. PAXLOVID (nirmatrelvir tablets; ritonavir tablets) prescribing information, initial U.S. approval 2023, Reference ID 5178484. Section 1: treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. Not approved for pre-exposure or post-exposure prophylaxis. Section 2.1: start as soon as possible after diagnosis and within 5 days of symptom onset. Section 2.2: 300 mg nirmatrelvir with 100 mg ritonavir twice daily for 5 days. Section 2.3: eGFR at least 60 to under 90 mL/min needs no dose change; eGFR at least 30 to under 60 mL/min uses 150 mg nirmatrelvir with 100 mg ritonavir twice daily for 5 days; eGFR under 30 mL/min is not recommended. Section 2.4: Child-Pugh A or B needs no dose change; Child-Pugh C is not recommended. Section 4: contraindicated after a clinically significant hypersensitivity reaction to nirmatrelvir, ritonavir, or a product component, and contraindicated with the listed CYP3A substrates and strong CYP3A inducers. Section 14.1 lists the EPIC-HR risk factors used in the trial: diabetes, BMI over 25, chronic lung disease including asthma, chronic kidney disease, current smoker, immunosuppressive disease or treatment, cardiovascular disease, hypertension, sickle cell disease, neurodevelopmental disorders, active cancer, medically related technological dependence, or age 60 years or older. (2023)