Covid warning as Pfizer pill has risk ‘of serious side effects’ when combined with tablet

Anthony Fauci discusses using Covid antivirals

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The newly approved Covid pill developed by Pfizer Pharmaceuticals has been given the brand name Paxlovid. However, there are concerns that it could cause serious side effects when taken with other drugs such as satins which are used to deal with cholesterol, blood thinners and antidepressants.

According to reports by US-based NBC News, “when Paxlovid is combined with other drugs that are also metabolised by the CYP3A enzyme, the main concern is that ritonavir may increase the co-administered drugs to toxic levels”.

Paxlovid was approved on 22 December to treat severe to moderate Covid in people over the age of 12.

It can be purchased with a prescription and patients must take it within five days of the onset of their symptoms.

Paxlovid is based on a combination of two separate pills.

One is the antiviral nirmatrelvir and the other is a ritonavir pill that has long been used as a stimulant in HIV treatment.

Ritonavir suppresses a liver enzyme called CYP3A, which metabolises many drugs, including nirmatrelvir.

When Paxlovid is used on a Covid patient, ritonavir helps slow down the breakdown of the active antiviral drug in the body.

It also helps it remain at a therapeutic level for longer, so the patient feels the effect of the drug and avoids serious illness. 

Drugs that could cause a risk are those that are widely used by those with a higher risk of severe Covid.

These include anticoagulants, anti-epileptic drugs, arrhythmia drugs, drugs for high blood pressure and cholesterol, as well as drugs used to treat depression and anxiety.

Medicine used for HIV (AIDS), cancer and erectile dysfunction could also potentially cause side effects.

In section 7 of the Paxlovid label, the US Food and Drug Administration (FDA) gives a detailed list of drugs that could negatively interact with ritonavir and should be avoided during treatment for Covid. 


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However, experts say that the treatment is a ‘breakthrough’ and that drug-drug interactions are ‘manageable’.

They also argue that Paxlovid is only authorised for a maximum of five days and that patients should inform their doctor about other medications they are taking.

Additional reporting by Maria Ortega.

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