Frequently asked questions
about ▼ PAXLOVID ®

Regulatory information about Paxlovid

What is Conditional Marketing Authorisation?

A Conditional Marketing Authorisation (CMA) Means that further evidence on this medical product is awaited.

New information on this medicinal product will be reviewed at least every year and the product information will be updated as necessary.

What does the black triangle on ‎▼Paxlovid (nirmatrelvir/ritonavir) mean?

When medicines come onto the market, we may have relatively limited information about their safety from clinical trials. These trials generally involve only relatively small numbers of patients who take the medicine for a relatively short time and will identify only the more common adverse effects of treatment. Only when large numbers of patients have taken a medicine can rare or long latency adverse effects be identified. Therefore, effective surveillance after marketing is essential for the identification of rare adverse effects, and to ensure that appropriate action is taken.

If a medicine is labelled with the black triangle, this means that it is being monitored even more intensively than other medicines to ensure that any new safety hazards are identified promptly.

About Paxlovid

What is Paxlovid?

Paxlovid is a combination of two active substances, nirmatrelvir and ritonavir.

Nirmatrelvir is active against the virus that causes COVID-19 and stops it from multiplying in your body. This keeps virus levels in the body low and helps your immune system to overcome the infection.

Ritonavir prolongs the therapeutic effect of Nirmatrelvir.

Why have I been prescribed this medicine?

You have been prescribed Paxlovid because you have tested positive for COVID-19, the disease caused by the SARS-CoV-2 virus, and you have been assessed as potentially being at high risk of severe symptoms. Paxlovid is used to treat mild-to-moderate COVID-19. COVID-19 is caused by a virus. Paxlovid stops the virus multiplying in cells and this stops the virus multiplying in the body. This can help your body to overcome the virus infection, and may help you get better faster.

This website aims to cover key information you may find useful if you have been prescribed Paxlovid. It is intended to complement but not replace the information provided by your healthcare team. As with any medication you are prescribed, you should also read the Patient Information Leaflet thoroughly for a full overview. You can find this inside your medicine packet or by clicking here.

Make sure you follow the current UK government guidance on self-isolation and testing, since you have tested positive for COVID- 19.

Taking Paxlovid

What do I need to know before taking this medicine?

Do not take Paxlovid if:

• You have any allergies to the active ingredients (nirmatrelvir, ritonavir) or any of the other ingredients of Paxlovid (listed in section 6 of the Patient Information Leaflet)
• You have severe kidney disease or severe liver disease
• You are taking any medicines listed in section 2 of the Patient Information Leaflet as having the potential to cause serious or life-threatening side effects, or to affect how Paxlovid works

Other things to be aware of:

Warnings and precautions

• Allergic reactions Allergic reactions, including severe allergic reactions (known as ‘anaphylaxis’) and serious skin reactions (known as ‘toxic epidermal necrolysis’ and ‘Stevens-Johnson syndrome’), can happen in people taking Paxlovid, even after only 1 dose.

Stop taking Paxlovid and call your doctor right away if you get any of the following symptoms of an allergic reaction:

• Trouble swallowing or breathing
• Swelling of the tongue, mouth, and face
• Throat tightness
• Hoarseness
• Red and painful skin
• Blisters and peeling skin
• Blisters or sores in your mouth or lips

Risk of HIV-1 resistance development - If you have untreated or uncontrolled HIV infection, Paxlovid may lead to some HIV medicines not working as well in the future.

Liver disease - Tell your healthcare provider if you have or have had liver disease; do not take Paxlovid if you have severe liver disease.

Children and adolescents

• Do not give this medicine to children and adolescents under 18 years.

Taking this medicine with other medicines (see the Patient Information Leaflet)

• Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including prescription and over-the-counter medicines, vitamins and herbal supplements.
• Do not start taking a new medicine without telling your doctor; your doctor can tell you if it is appropriate to take Paxlovid with other medicines.
• If you have forgotten to tell your doctor or pharmacist about one or more of the medicines you are taking, or if you have any questions, please contact your GP.

Oral contraceptives

• If you can become pregnant, it is recommended that you refrain from sexual activity or use effective barrier contraception while taking Paxlovid and until after one full menstrual cycle is completed after stopping Paxlovid treatment.
• Please tell your doctor if you are taking oral contraceptive pills as you may need to take extra contraceptive precautions such as using a condom.

Pregnancy and breastfeeding

• This medicine is not recommended during pregnancy unless your clinical condition requires this treatment.
• Breastfeeding is not recommended during treatment and for 48 hours after the last dose of Paxlovid.

Driving and using machines

• Paxlovid has not been specifically tested for its possible effects on the ability to drive a car or operate machines.

Paxlovid contains lactose (a type of sugar)

• If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

Information on sodium content

• This medicine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially ‘sodium-free’.

Make sure you follow the current UK government guidance on self-isolation and testing, since you have tested positive for COVID- 19.

How do I take Paxlovid?

Paxlovid contains two medicines (nirmatrelvir and ritonavir) that are packaged together.

Each Paxlovid dose consists of two tablets of nirmatrelvir (pink tablets) and one tablet of ritonavir (white tablet) that are taken together twice a day, for a total of 5 days. The blister foil for each day of treatment is divided into two different coloured sections – one for the morning (AM) dose and one for the evening (PM) dose.

Patients with moderate kidney disease; Please talk to your healthcare provider for an appropriate lower dose of Paxlovid.

Do not take Paxlovid if you have severe kidney or liver disease.

Taking Paxlovid:

• Swallow the tablets whole, without chewing, breaking or crushing them
• Paxlovid can be taken with or without food
• Do not save pills for later or share with others
• A treatment course lasts for 5 days. Even if you feel better do not stop taking Paxlovid without speaking to your healthcare provider.
• You should dispose of unused tablets as advised by your pharmacist or doctor
• If you forget to take a dose of Paxlovid take it as soon as you remember. If more than 8 hours have passed since your missed dose, then do not take your missed dose and just carry on as before. Do not take a double dose to make up for a forgotten dose.
• If you take too much Paxlovid, call your healthcare provider or go to the nearest hospital emergency room straight away.

For more information please see the 'How to Take' page.

What to do if you are taking other medicines

If you are taking any other medicines, please read the following carefully before taking Paxlovid.

Taking Paxlovid at the same time as some other medicines may:

• Cause serious or life threatening side effects
• Affect how Paxlovid works

Keep a list of your medicines to show your doctor and pharmacist. Do not start taking a new medicine without telling your doctor. Your doctor can tell you if it is appropriate to take Paxlovid with other medicines.

These can include:

• Medicines prescribed by your GP practice or hospital
• Medicines prescribed privately outside of the NHS
• Any medicines bought from a pharmacy, shop or online without a prescription
• Herbal remedies
• Vitamin supplements
• Medicines that come in patches, inhalers, suppositories, pessaries, lozenges, gels, ointments or creams

If you have forgotten to tell your doctor or pharmacist about one or more of the medicines you are taking, or if you have any questions, please contact your healthcare provider.

Read the Paxlovid Patient Information Leaflet carefully for more information about medicines that should not be taken with, or may interact with, Paxlovid.

What if I miss a dose?

If you forget to take a dose, take it as soon as you remember. If more than 8 hours have passed since your missed dose, do not take your missed dose; instead, take the next dose at your regular time. Do not take two doses at the same time. Do not take a double dose to make up for a forgotten dose.

What if I need to stop, start or change medication?

Tell your doctor or pharmacist that you are taking Paxlovid before:

• Starting a new medicine
• Stopping a medicine you are already taking
• Changing the dose of a medicine you are already taking

Alternatively refer to the Patient Information Leaflet.

Pregnancy, breastfeeding, kidney disease, liver disease or HIV

What about pregnancy and breastfeeding?

Paxlovid is not recommended during pregnancy because:

• There is not enough information to be sure it is not harmful for pregnant patients
• It is not known if it will harm your baby while you are pregnant

Ask your doctor for advice, if you are, think you may be, or are planning to get pregnant. If you can become pregnant, it is recommended that you refrain from sexual activity or use effective barrier contraception while taking Paxlovid and until one full menstrual cycle is completed after stopping Paxlovid treatment. Please tell your doctor if you are taking oral contraceptive pills as you may need to take extra contraceptive precautions such as using a condom.

If you find out you are pregnant, or became pregnant while taking Paxlovid, or shortly after, report this by contacting the UK COVID-19 Antivirals in Pregnancy Registry on 0344 892 0909 or by asking your doctor to do this on your behalf.

Breastfeeding

If you are breast-feeding or are planning to breastfeed, tell your doctor before taking this medicine. Paxlovid is excreted in breast milk in small amounts and it is not known if this may effect the baby.

Breast feeding is not recommended during treatment with Paxlovid and for 48 hours after the last Paxlovid dose.

Liver disease or kidney disease

Tell your healthcare provider if you have or have had liver or kidney disease.
Do not take Paxlovid if you have severe liver disease or severe kidney disease.
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including prescription and over-the-counter medicines, vitamins and herbal supplements.
The dosing of Paxlovid differs for patients with moderate kidney disease: Tell your doctor if you have moderate kidney disease because you will need an appropriate lower dose of Paxlovid. You should dispose of the unused tablets as advised by your pharmacist or doctor.

HIV

Paxlovid treatment may result in medicines used to treat HIV becoming less effective.
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including prescription and over-the-counter medicines, vitamins and herbal supplements.

Side effects

What are the possible side effects of taking Paxlovid?

Like all medicines, Paxlovid can cause side effects, although not everybody gets them. Paxlovid is still being studied, so it is possible that all of the risks are not known at this time. If you get any side effects, talk to your doctor or pharmacist.

Common side effects which may affect up to 1 in 10 people are:

• Diarrhoea
• Nausea
• Altered sense of taste (such as metallic, bitter taste)
• Headache

Uncommon side effects which may affect up to 1 in 100 people are:

• Allergic reaction (such as hives, trouble swallowing or breathing, swelling of the mouth, lips, or face, throat tightness, hoarseness or skin rash)
• Vomiting
• Abdominal pain
• High blood pressure

Rare side effects which may affect up to 1 in 1,000 people are:

• Severe allergic reaction known as ‘anaphylaxis’ (such as swelling of tongue, mouth and face, trouble swallowing or breathing, throat tightness, or hoarseness)
• Serious skin reactions known as ‘toxic epidermal necrolysis’ and ‘Stevens-Johnson syndrome’ (such as red and painful skin, blisters and peeling skin, blisters or sores in your mouth or lips)
• Feeling generally unwell

Allergic reactions

Allergic reactions, including severe allergic reactions (known as ‘anaphylaxis’) and serious skin reactions (known as ‘toxic epidermal necrolysis’ and ‘Stevens-Johnson syndrome’), can happen in people taking Paxlovid, even after only 1 dose.

Stop taking Paxlovid and call your doctor right away if you get any of the following symptoms of an allergic reaction:

• Trouble swallowing or breathing
• Swelling of the tongue, mouth, and face
• Throat tightness
• Hoarseness
• Red and painful skin
• Blisters and peeling skin
• Blisters or sores in your mouth or lips

For more information about the possible side effects when taking Paxlovid, read the Patient Information Leaflet.

Any suspected side effects (also called adverse events) should be reported, so use the steps below if you think you are experiencing a side effect:

1. Speak to your doctor, pharmacist or nurse for advice about any side effects not listed in the Patient Information Leaflet or if you are worried about your health.
2. Report side effects on the MHRA Coronavirus Yellow Care reporting site (https://coronavirus-yellowcard.mhra.gov.uk) or search for MHRA Yellow Card in the Google Play or Apple App Store.
3. If you are unsure or in doubt, report it anyway, as only a suspicion of a side effect is needed to report.

Adverse event reporting website