Frequency, type and severity of drug-related problems and pharmacist interventions in Paxlovid prescribing: a descriptive analysis.

Stoiber, Alina; Gray, Gwen; Sailer, Gudrun; Huf, Wolfgang; Tonna, Antonella

Abstract

Paxlovid® (nirmatrelvir and ritonavir) is the only licensed oral antiviral for COVID-19. Ritonavir is a potent inhibitor of cytochrome P450 enzymes causing numerous drug-drug interactions (DDIs). The aim of this study was to describe the frequency, type, and severity of detected drug related problems (DRPs) associated with Paxlovid®. This study involved a retrospective quantitative analysis including all patients prescribed Paxlovid® at a public hospital in Vienna, Austria. Data were collected from the patients' records by a clinical pharmacist. A customised, piloted data collection form was used. A sample of data was checked for consistency by an independent clinical pharmacist. Any DDI and severity classification was recorded using an established interaction checker tool. Dosage adjustments due to renal impairment were recorded. 122 of 140 patients (87.1%) required interventions to prevent DRPs. Pharmacists' intervention at dispensing was needed in 63.6% (n=89) of cases. In 3 (2.1%) patients, Paxlovid® was prescribed despite being contra-indicated due to severe renal impairment. The most common were DDIs (n=80; 57.1%). Renal impairment and DDIs were noted in 24.3% (n=34) of cases. A total of 313 DDIs were recorded in 114 (81.4%) patients, with severe interactions in 24 (17%) patients. The study concluded that pharmacists' involvement in prescribing highly interacting drugs such as Paxlovid® is essential to enhance patient safety.

Citation

STOIBER, A., GRAY, G., SAILER, G., HUF, W. and TONNA, A. [2024]. Frequency, type and severity of drug-related problems and pharmacist interventions in Paxlovid prescribing: a descriptive analysis. International journal of clinical pharmacy [online], Latest Articles. Available from: https://doi.org/10.1007/s11096-024-01852-5

• Journal Article Type: Article
• Acceptance Date: Dec 16, 2024
• Online Publication Date: Dec 21, 2024
• Deposit Date: Dec 19, 2024
• Publicly Available Date: Dec 22, 2025
• Journal: International journal of clinical pharmacy
• Print ISSN: 2210-7703
• Electronic ISSN: 2210-7711
• Publisher: Springer
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s11096-024-01852-5
• Keywords: COVID-19; Antiviral drugs; Paxlovid; Nirmatrelvir; Ritonavir; Cytochrome P450 enzymes; Drug-drug interactions; Pharmacist prescribing
• Public URL: https://rgu-repository.worktribe.com/output/2625357