Standard Dosing for Paxlovid in COVID-19 Treatment
Adults with COVID-19 take Paxlovid as nirmatrelvir 150 mg (two 75 mg tablets) plus ritonavir 100 mg (one 100 mg tablet), all orally twice daily for 5 days. Start treatment within 5 days of symptom onset.[1][2]
Dosing Adjustments for Kidney Impairment
For mild to moderate kidney issues (eGFR 30 to <60 mL/min), reduce nirmatrelvir to 150 mg (two 75 mg tablets) once daily with ritonavir 100 mg (one 100 mg tablet) once daily for 5 days. Do not use in severe impairment (eGFR <30 mL/min) or end-stage renal disease.[1][2]
Weight-Based Dosing in Children (≥12 Years, ≥40 kg)
Adolescents weighing 40 kg or more follow adult dosing: nirmatrelvir 150 mg (two 75 mg tablets) twice daily with ritonavir 100 mg once daily for 5 days. Not approved under 40 kg.[1]
When to Take and Missed Doses
Take with or without food, at the same times each day, about 12 hours apart. If a dose is missed by less than 8 hours, take it soon as possible; otherwise, skip and resume the next scheduled dose. Avoid double dosing.[2]
Key Drug Interactions and Contraindications
Ritonavir boosts nirmatrelvir levels but interacts with many drugs like statins, certain heart medications, and CYP3A inhibitors/inducers—check interactions via tools like the Paxlovid interaction checker. Contraindicated with drugs highly dependent on CYP3A or strong CYP3A inducers.[1][2]
Sources:
[1] FDA Paxlovid Prescribing Information
[2] CDC Paxlovid Guidance