Statement about Paxlovid for people with HIV on antiretroviral therapy

Paxlovid is approved under Emergency Use Authorization to treat COVID-19 in persons at high risk for serious outcomes. It is a two-drug regimen of the protease inhibitors nirmatrelivir and ritonavir and is given twice daily for five days, beginning as soon as possible after diagnosis of COVID-19. As we know from decades of use in HIV treatment, ritonavir has many drug interactions that should be carefully considered before starting Paxlovid. A statement from the HIV Medicine Association of the Infectious Diseases Society of America recommends that people with HIV can take Paxlovid even if they are on a regimen containing ritonavir or cobicistat, but monitor for side effects. This is reiterated in the EUA package insert for Paxlovid. However, Paxlovid may interfere with other drugs you are taking, which would require holding other drugs temporarily or changing their dosage or, possibly, not taking Paxlovid. If you are going to take Paxlovid for COVID-19, be sure to tell your care provider about all the medicines you take, including those that are over the counter. 

Statement from HIVMA and IDSA 

Statement from the COVID19 Treatment Guidelines

FDA Emergency Use Authorization Fact Sheet about Paxlovid