GlobalRPh Renal Dosing Masterv6.6
Evidence addition

Nirmatrelvir/ritonavir (Paxlovid, adults)

Local official-label summaryBase record retrieved 2026-09-05See the evidence for this drug4 sources available - open source summaries, references and comparisons

Paxlovid

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Renal guidance at a glance

Cautions / source differences (1)

Confirm the product, indication and renal measure. The selected summary is not a complete prescribing monograph.

Choose a source to read (4)

Display order is not a clinical ranking. Date of retrieval is not the label revision date. Sources are never merged into one regimen. Other sources and conflicts remain below.

1 additional source qualifications - review before use
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.

Before applying: Check the treatment day, component doses, renal units and all interactions; a matching mirror is not independent corroboration.

Also check: PAXLOVID: day 1 differs from days 2-5 in severe impairment

Official source

Nirmatrelvir / ritonavir - PAXLOVID official renal regimen

Product / population
Nirmatrelvir / ritonavir - PAXLOVID official renal regimen; selected source sections, not a full prescribing monograph.
Renal measure
Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.

Renal dosing, restrictions and evidence limits

For moderate impairment, printed eGFR >=30 to <60 mL/min, give nirmatrelvir 150 mg with ritonavir 100 mg twice daily for five days. For eGFR <30, including hemodialysis, give 300 mg/100 mg once on day 1, then 150 mg/100 mg once daily on days 2-5. Give after hemodialysis on dialysis days. Mild impairment needs no adjustment. Specify both ingredients and the matching dose pack. The interaction review remains essential; renal reduction does not neutralize ritonavir interactions. The source omits a BSA denominator, so indexing is not silently assigned.

Source revision: Prescribing information revised 02/2026. | Retrieved: 2026-09-08. Retrieval date is not the revision date.

Source: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a99d6d6-fd9e-45bb-b1bf-48c7f761232a

Scope: Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph. GlobalRPh v6.6.

Full source card / provenance

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Source-first renal review

Evidence sources and renal implications

Choose a source to jump directly to its locally stored result. Qualitative precautions and evidence gaps remain visible even when no numerical clearance schedule is supplied.

Read 1 source difference / applicability notes

Official product label

Nirmatrelvir/ritonavir (Paxlovid, adults) - selected U.S. labeling

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.
Retrieved: 2026-09-05

Read local renal resultOpen original reference
Official product label

Nirmatrelvir / ritonavir - PAXLOVID official renal regimen

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Nirmatrelvir / ritonavir - PAXLOVID official renal regimen; selected source sections, not a full prescribing monograph.

Renal method: Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.
Retrieved: 2026-09-08

Read local renal resultOpen original reference
GlobalRPh RX List

GlobalRPh RX List - PAXLOVID

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Nirmatrelvir / ritonavir - PAXLOVID adult renal regimen; selected source sections, not a full prescribing monograph.

Renal method: Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.
Retrieved: 2026-09-08

Read local renal resultOpen original reference
Professional guidance

IDSA COVID-19 guideline - nirmatrelvir/ritonavir

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, units printed as mL/min
Retrieved: 2026-09-05

Read local renal resultOpen original reference

Source presence is not independent validation. A label mirror is not a second independent source; review the original reference and exact formulation.

Product / population check

Confirm the exact formulation before using a renal source

These links compare product identities, not interchangeable doses. A selected summary is not a complete prescribing monograph.

Source-specific review points

PAXLOVID: day 1 differs from days 2-5 in severe impairment

Read the attributed comparison notes and source cards below. No conflict has been silently adjudicated.

Source-quality holds
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Search the stored clinical text

Locate a word or phrase within this drug's source summaries. Choose all sources or one source to focus the search. The selection never hides warnings or source text, changes a dose, or proves that a renal finding is absent.

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All source summaries, original wording and provenance
Before applying a renal protocol

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No patient-specific dose is calculated. Context choices only display reminders; they do not validate, hide or change any regimen.

Share a reproducible source review

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Jump to renal guidanceRead 1 difference / caution notesClinician guide

Select two distinct source versions. The complete stored summaries will appear below.

Build a source-review outline for documentation

This creates a blank decision outline with the source identities you select, not a dose recommendation or completed clinical assessment. No patient fields are collected, saved or sent. Complete the clinical decisions in your approved documentation system.

Choose one or two sources above or use the source checkboxes below.

Renal-context checklist: population, kidney trend and dialysis

These prompts are a reading aid, not a prescription checklist or proof that all requirements have been met. No selections are stored or sent to a server.

Read the exact source scope, renal metric and date before selecting a row. No applicability assessment has been performed.

See source-specific renal methods and the clinical interpretation guide for the supporting context.

Read before choosing a regimen

Source differences and product cautions

Search differences across all drugs

These are specific issues found during source review, not an automated judgment that one source is universally correct. A label mirror and its original label are not independent evidence.

dialysis scope

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.

How to use this: Check the treatment day, component doses, renal units and all interactions; a matching mirror is not independent corroboration.

GlobalRPh RX List - PAXLOVIDNirmatrelvir / ritonavir - PAXLOVID official renal regimen

Source-specific interpretation; independent clinician adjudication pending.

Go directly to the relevant source section

Renal dosing and precautions

Choose a source, then jump to its renal or dialysis section. These links locate stored text; they do not merge regimens or certify that sources agree.

New source summary - independent clinical review pending. Summaries of the identified label sections are included locally. Source import and numeric transcription checks are not independent two-reference validation. Do not treat this card as an approved institutional dosing protocol.
Official source

Nirmatrelvir/ritonavir (Paxlovid, adults) - selected U.S. labeling

Adult mild-to-moderate COVID-19 with high progression risk; oral co-packaged nirmatrelvir AND ritonavir. This is not prophylaxis or pediatric EUA guidance.

Method: eGFR, with units mL/min as printed in the selected label; do not equate with a CrCl estimate.

Renal information and dialysisRead this complete source summary
Official source

Nirmatrelvir / ritonavir - PAXLOVID official renal regimen

Nirmatrelvir / ritonavir - PAXLOVID official renal regimen; selected source sections, not a full prescribing monograph.

Method: Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.

Renal dosing, restrictions and evidence limitsRead this complete source summary
Professional source

IDSA COVID-19 guideline - nirmatrelvir/ritonavir

Adult mild-to-moderate COVID-19 with high progression risk; oral co-packaged nirmatrelvir AND ritonavir. This is not prophylaxis or pediatric EUA guidance.

Method: eGFR, units printed as mL/min

Source-specific renal protocolRead this complete source summary

No dialysis or renal heading shown? Read the complete source summary. Absence of a heading is not evidence that dose adjustment is unnecessary.

Compare or copy source versions

All content below is stored locally. Read a whole source version; do not combine its dose with another source's interval, renal metric or dialysis assumptions.

Original content / product scopeNirmatrelvir/ritonavir (Paxlovid, adults) - selected U.S. labelingNirmatrelvir / ritonavir - PAXLOVID official renal regimenGlobalRPh RX List - PAXLOVIDIDSA COVID-19 guideline - nirmatrelvir/ritonavir
Choose two source checkboxes below.
Exact product and population matter. This added page contains locally stored, source-specific clinical summaries. Historical handbook information, when present, is identified separately and may conflict with U.S. labeling. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.
Locally stored source content

Exact product and population

Product identity selected for the separately displayed source protocols below. Reference: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a99d6d6-fd9e-45bb-b1bf-48c7f761232a

Product and population scope

Adult mild-to-moderate COVID-19 with high progression risk; oral co-packaged nirmatrelvir AND ritonavir. This is not prophylaxis or pediatric EUA guidance.

RDM31-nirmatrelvir-ritonavir-scope · Source section: Editorial scope tied to selected U.S. labelRenal section finder
Separate U.S. product-label layer

FDA / DailyMed dosing and renal information

Official

Nirmatrelvir/ritonavir (Paxlovid, adults) - selected U.S. labeling

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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 higher300 mg + 100 mg every 12 hours for 5 days
30 to less than 60150 mg + 100 mg every 12 hours for 5 days
Below 30, including hemodialysisDay 1: 300 mg + 100 mg once; days 2-5: 150 mg + 100 mg once daily

RDM31-nirmatrelvir-ritonavir-label-dose · Source locator: 2.1-2.3

Renal information and dialysis

On hemodialysis days, administer the dose after dialysis. Prescribe the amount of EACH ingredient and choose the corresponding renal dose pack.

RDM31-nirmatrelvir-ritonavir-label-renal · Source locator: 2.3 Table 1

Selected warnings and limits

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.

RDM31-nirmatrelvir-ritonavir-label-limits · Source locator: Boxed warning; 2.4; 4; 5.1; 7

Source identity and provenance
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a99d6d6-fd9e-45bb-b1bf-48c7f761232a
Retrieved
2026-09-05
DailyMed Set ID
8a99d6d6-fd9e-45bb-b1bf-48c7f761232a
Labeler
Pfizer Laboratories Div Pfizer Inc
DailyMed page updated
2026-02-19
Label revision
02/2026
Renal-function method
eGFR, with units mL/min as printed in the selected label; do not equate with a CrCl estimate.
Source date/version
U.S. prescribing information revised 02/2026; DailyMed page updated 2026-02-19.
Hash meaning
SHA-256 identifies this local summary, not original SPL XML or label PDF.
Local summary SHA-256
c7a89411cec2298e125166c7c684c3619e4b4701cfce0d75f6ca57b5fa2f373a
Official

Nirmatrelvir / ritonavir - PAXLOVID official renal regimen

Open original reference

Open / share this exact local source

DailyMed / Pfizer Laboratories Div Pfizer Inc · Nirmatrelvir / ritonavir - PAXLOVID official renal regimen; selected source sections, not a full prescribing monograph.

Renal method: Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.
Source date: Prescribing information revised 02/2026.
Retrieved: 2026-09-08

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

For moderate impairment, printed eGFR >=30 to <60 mL/min, give nirmatrelvir 150 mg with ritonavir 100 mg twice daily for five days. For eGFR <30, including hemodialysis, give 300 mg/100 mg once on day 1, then 150 mg/100 mg once daily on days 2-5. Give after hemodialysis on dialysis days. Mild impairment needs no adjustment. Specify both ingredients and the matching dose pack. The interaction review remains essential; renal reduction does not neutralize ritonavir interactions. The source omits a BSA denominator, so indexing is not silently assigned.

RDM48-official-nirmatrelvir-ritonavir-d037735996-C1 · Source locator: Prescribing information 2.3 Table 1; boxed interaction warning; 8.6.

Source identity and provenance
Source family
product_label
Source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a99d6d6-fd9e-45bb-b1bf-48c7f761232a
Retrieved
2026-09-08
Exact label title
Nirmatrelvir / ritonavir - PAXLOVID official renal regimen
DailyMed Set ID
8a99d6d6-fd9e-45bb-b1bf-48c7f761232a
Labeler
Pfizer Laboratories Div Pfizer Inc
Label revision
Prescribing information revised 02/2026.
Archive publication date
2026-02-23
SPL version
12
Renal-function method
Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.
Source date/version
Prescribing information revised 02/2026.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
87e13c350e0f29ba3ea1a1a1c4478542e5bd48c0567e26d2968d2e9507000d68
Locally imported selected renal sections

GlobalRPh RX List renal information

Rxlist

GlobalRPh RX List - PAXLOVID

Open original reference

Open / share this exact local source

GlobalRPh-hosted RX List · Nirmatrelvir / ritonavir - PAXLOVID adult renal regimen; selected source sections, not a full prescribing monograph.

Renal method: Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.
Source date: Source revision date not established in selected retrieval.
Retrieved: 2026-09-08

Label mirror, not independent corroboration. This is selected locally stored RX List content. Full monograph import and current official-label review are not implied.
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.

Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.

Renal dosing, restrictions and evidence limits

For moderate impairment, printed eGFR >=30 to <60 mL/min, give nirmatrelvir 150 mg with ritonavir 100 mg twice daily for five days. For eGFR <30, including hemodialysis, give 300 mg/100 mg once on day 1, then 150 mg/100 mg once daily on days 2-5. Give after hemodialysis on dialysis days. Mild impairment needs no adjustment. Specify both ingredients and the matching dose pack. The interaction review remains essential; renal reduction does not neutralize ritonavir interactions. The source omits a BSA denominator, so indexing is not silently assigned.

RDM48-rxlist-nirmatrelvir-ritonavir-5a13ed5337-C1 · Source locator: Dosage: renal impairment Table 1; Use in Specific Populations: renal impairment.

Source identity and provenance
Source family
product_label_mirror
Source
https://globalrph.com/rx-list/paxlovid-drug/
Retrieved
2026-09-08
Renal-function method
Source prints eGFR in mL/min without a body-surface-area denominator. Indexing is not established; no conversion or relabeling.
Source date/version
Source revision date not established in selected retrieval.
Hash meaning
SHA-256 of local authored summary only; not original HTML, PDF or SPL bytes.
Local summary SHA-256
87e13c350e0f29ba3ea1a1a1c4478542e5bd48c0567e26d2968d2e9507000d68
Separate professional-source layer

University and professional protocols

Professional

IDSA COVID-19 guideline - nirmatrelvir/ritonavir

Open original reference

Open / share this exact local source

Infectious Diseases Society of America (IDSA) · 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, units printed as mL/min
Source date: Nirmatrelvir/ritonavir section updated October 14, 2025
Retrieved: 2026-09-05

Separate professional-source protocol; not automatically equivalent to product labeling.

Source-specific renal protocol

For high-risk adults, IDSA lists 300/100 mg every 12 hours for 5 days above eGFR 60; 150/100 mg every 12 hours for 5 days at 30 to below 60; and, below 30 including HD, 300/100 mg once on day 1 followed by 150/100 mg daily on days 2-5. Ingredient order is nirmatrelvir/ritonavir. Medication-interaction screening is required.

RDM31-nirmatrelvir-ritonavir-prof-1 · Source locator: Recommendation: Nirmatrelvir/Ritonavir; Remarks: renal dosing

Source-specific limits

The page prints >60 rather than >=60 for its upper band. The selected U.S. label supplies the exact-60 boundary. Do not use older severe-renal exclusion statements as the current selected label regimen.

Source identity and provenance
Source
https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/
Retrieved
2026-09-05
Renal-function method
eGFR, units printed as mL/min
Source date/version
Nirmatrelvir/ritonavir section updated October 14, 2025
Hash meaning
SHA-256 identifies the local paraphrase, not original source bytes.
Local summary SHA-256
a4402c32cf2ddf692ed59e1c4c820d585a276d799d7435401384a2f9dab49ce5

Provenance and preservation

Additional summaries stored on this page: 2 official-label, 1 RX List, 1 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a99d6d6-fd9e-45bb-b1bf-48c7f761232a
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
multisource addition
Local text SHA-256
2f82ccaeeb95145629334f931cf550ebddc3fcdb05bb1e43017acf2a0be15189
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

This page is an additional exact-product entry, not a recovered GlobalRPh monograph. Its primary scope text and separately attributed clinical summaries are locally included.

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