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1 local source card selected. Local card fingerprints checked where supplied. This is not an original-document hash, source-currency guarantee or clinical approval. Record-level cautions below are the current library's cautions, not a frozen prior version.
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Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
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Nirmatrelvir/ritonavir (Paxlovid, adults) - selected U.S. labeling
Product / population
Adult mild-to-moderate COVID-19 with high progression risk; oral co-packaged nirmatrelvir AND ritonavir. This is not prophylaxis or pediatric EUA guidance.
Renal method
eGFR, with units mL/min as printed in the selected label; do not equate with a CrCl estimate.
Source revision
U.S. prescribing information revised 02/2026; DailyMed page updated 2026-02-19.
Retrieved
2026-09-05
Local review status
Selected dosing/renal sections read; concise local summary, not full prescribing information.
Documented differences and cautions on this drug
All record notes are retained here, including notes about sources not selected in this review.
PAXLOVID: day 1 differs from days 2-5 in severe impairment
The rechecked RX and official tables retain a day-specific severe-impairment course, with post-HD timing on dialysis days. The same regimen already existed locally.
What to reconcile: Check the treatment day, component doses, renal units and all interactions; a matching mirror is not independent corroboration.
U.S. product labeling / DailyMed · Adult mild-to-moderate COVID-19 with high progression risk; oral co-packaged nirmatrelvir AND ritonavir. This is not prophylaxis or pediatric EUA guidance.
Renal method: eGFR, with units mL/min as printed in the selected label; do not equate with a CrCl estimate. Source date: U.S. prescribing information revised 02/2026; DailyMed page updated 2026-02-19. Retrieved: 2026-09-05
Selected dosing/renal sections read; concise local summary, not full prescribing information.
Labeled basic dosing
Start within 5 days of symptom onset; treat for 5 days. Give both ingredients together.
eGFR (mL/min as printed in label)
Nirmatrelvir + ritonavir
60 or higher
300 mg + 100 mg every 12 hours for 5 days
30 to less than 60
150 mg + 100 mg every 12 hours for 5 days
Below 30, including hemodialysis
Day 1: 300 mg + 100 mg once; days 2-5: 150 mg + 100 mg once daily
Ritonavir creates serious, potentially fatal drug interactions. Review every medication for contraindication, interruption, dose change or monitoring before prescribing. Severe hepatic impairment is not recommended.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh v6.6 | RDM66-DIRECT-PHP-20260911 | Local library date 2026-09-11. Selected-card identity does not imply clinical verification.