Paxlovid Contraindications

PAXLOVID is contraindicated in patients with a history of clinically significant hypersensitivity to the active substances (nirmatrelvir/ritonavir) or to any of the product excipients.
PAXLOVID is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions (see Interactions). Drugs listed in this section and Interactions are a guide and not considered a comprehensive list of all possible drugs that may be contraindicated with PAXLOVID.
Alpha 1-adrenoreceptor antagonist: alfuzosin.
Antianginal: ranolazine.
Antiarrhythmic: amiodarone, dronedarone, flecainide, propafenone, quinidine.
Anti-gout: colchicine.
Antipsychotics: lurasidone, pimozide.
Benign prostatic hyperplasia agents: silodosin.
Cardiovascular agents: eplerenone, ivabradine.
Ergot derivatives: dihydroergotamine, ergotamine, methylergonovine.
HMG-CoA reductase inhibitors: lovastatin, simvastatin.
Immunosuppressants: voclosporin.
Microsomal triglyceride transfer protein inhibitor: lomitapide.
Migraine medications: eletriptan, ubrogepant.
Mineralocorticoid receptor antagonists: finerenone.
Non-opioid analgesic (selective blocker of Na_v1.8 sodium channels): suzetrigine.
Opioid antagonists: naloxegol.
PDE5 inhibitor: sildenafil when used for pulmonary arterial hypertension (PAH).
Sedative/hypnotics: triazolam, oral midazolam.
Serotonin receptor 1A agonist/serotonin receptor 2A antagonist: flibanserin.
Vasopressin receptor antagonists: tolvaptan.
PAXLOVID is contraindicated with drugs that are potent CYP3A inducers where significantly reduced nirmatrelvir or ritonavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance. PAXLOVID cannot be started immediately after discontinuation of any of the following medications due to the delayed offset of the recently discontinued CYP3A inducer (see Interactions).
Anticancer drugs: apalutamide, enzalutamide.
Anticonvulsant: carbamazepine, phenobarbital, primidone, phenytoin.
Antimycobacterials: rifampin, rifapentine.
Cystic fibrosis transmembrane conductance regulator potentiators: lumacaftor/ivacaftor.
Herbal products: St. John's Wort (Hypericum perforatum).