Correspondence on ‘Management of nirmatrelvir/ritonavir and tacrolimus interaction in kidney transplant recipients infected by COVID-19: a three-case series’
Abstract
We read with great interest the recent study conducted by Guzmán Cordero and SaezTorres de Vicente, which reported how to manage patients treated with nirmatrelvir/ritonavir (brand name Paxlovid) and tacrolimus. The results hinted that nirmatrelvir/ritonavir combined with tacrolimus interaction could be controlled and achieve a good clinical effect. Based on these findings, we believe these provide valuable reference materials for medical staff, especially nephrologists and clinical pharmacists. Following the announcement in December 2022 that the Chinese government was lifting the COVID19 controls, more and more Chinese people have become infected with COVID19. Hospitals in China are experiencing enormous pressure due to a very large population and regional differences. Our institution is a general tertiary hospital with 1800 beds; infected people with membranous nephropathy take tacrolimus and are regularly encountered in the department of nephrology. Due to elderly patients with underlying diseases, COVID19 could put the patient at high risk for progression to severe new coronary pneumonia. Paxlovid, as a mainstream antiviral drug, is recommended by the guidelines. However, high protein binding and extensive transhepatic metabolism of Paxlovid may interact with drugs or herbs, causing severe adverse events. Usually, based on the pharmacokinetic profile of drugs, clinical pharmacists and physicians determine whether drugs can be used in combination. Ritonavir, as a major…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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