Managing High-Risk Drug Interactions With Nirmatrelvir/Ri...

연구 요약

Managing High-Risk Drug Interactions With Nirmatrelvir/Ritonavir: Experience From a Dedicated Pharmacology Advice Service.

Clinical and translational science 학술지에 발표된 이 연구는 Libiad Y, Franck B, Tron C 외 연구팀이 수행하였습니다.

핵심 내용

Nirmatrelvir boosted with ritonavir is a key antiviral against COVID-19, yet ritonavir's potent CYP3A4 inhibition exposes patients to numerous drug-drug interactions. To make prescribing safer, a national proactive system providing expert pharmacology advice was implemented in France. This retrospective study reports the experience of the pharmacology department at Rennes University Hospital, which provided these expert services from February 2022 to December 2024. We evaluated 455 consecutive patients (median age 75 years, median eight co-medications per patient, 3813 prescription lines). Nirmatrelvir/ritonavir was ultimately contra indicated in 26 patients. Among the 429 eligible patients (3582 prescription lines), 86.7% (372/429) had at least one clinically relevant drug interaction; 60.8% (261/429) had ≥ 2; 30.4% (130/429) had ≥ 3. Among the 831 interacting medication lines, the main drug classes involved: statins (17.7%, 147/831), immunosuppressants (12.0%, 100/831), and direct oral anticoagulants (10.5%, 87/831), with the drug mix evolving over time from transplant-related immunosuppressants in 2022 to statin agents in 2023-2024. Expert review identified options to navigate initial contraindications in 13.5% (58/429) of patients.

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의사/약사의 전문적 판단을 대체하지 않습니다 (PMID: 41772767)