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適用於發病5天內、具有重症風險因子*之成人與兒童病人(12 歲以上且體重至少 40 公斤)的輕度至中度COVID-19確診者
COVID-19, mild to moderate [FDA emergency use authorization (EUA)]

*重症風險因子：60歲以上、BMI>25、糖尿病、慢性肺部疾病(含氣喘)、吸菸、慢性腎病、高血壓、心血管疾病、免疫不全疾病或免疫抑制劑治療、鐮刀球血症、神經發展疾患、癌症、因醫療需求致機器依賴者。

Nirmatrelvir: peptidomimetic inhibitor of the SARS-CoV-2 main protease (Mpro; also known as 3C-like protease or nsp5 protease); inhibition of Mpro prevents processing of polyprotein precursors, resulting in inhibition of viral replication.
Ritonavir: pharmacokinetic enhancer with no activity against SARS-CoV-2 Mpro; Ritonavir inhibits CYP3A-mediated metabolism of nirmatrelvir, resulting in increased nirmatrelvir plasma concentrations

Distribution:
1.Vz/F: (Nirmatrelvir, when given with ritonavir) 104.7 L; (Ritonavir) 112.4 L
2. Protein binding: (Nirmatrelvir, when given with ritonavir): 69%; (Ritonavir) 98-99%
Metabolism:
1. Nirmatrelvir, when given with ritonavir: Minimal
2. Ritonavir: Hepatic via CYP3A4 (major) and CYP2D6 (minor)
Excretion:
1. Nirmatrelvir, when given with ritonavir: Urine (35.3%); feces (49.6%)
2. Ritonavir: Urine (11.3%); feces (86.4%)
Half-life elimination:
1. Nirmatrelvir, when given with ritonavir: 6.05 ± 1.79 hours
2. Ritonavir: 6.15 hours
Time to peak:
1. Nirmatrelvir, when given with ritonavir: 3 hours (range: 1.02 to 6 hours)
2. Ritonavir: 3.98 hours

1. Not authorized for initiation of treatment in patients requiring hospitalization due to severe or critical COVID-19
2. Not authorized for pre-exposure or post-exposure prophylaxis for prevention of COVID-19
3. Not authorized for use longer than 5 consecutive days

There are no available human data on the use of nirmatrelvir during pregnancy

There are no available data on the presence of nirmatrelvir in human or animal milk, the effects onthe breastfed infant, or the effects on milk production.

Dysgeusia, diarrhea, hypertension, myalgia

1. Dosage: 300 mg nirmatrelvir (two 150 mg tablets) with 100 mg ritonavir (one 100 mg tablet), all three tablets taken together twice daily for 5 days, with or without food
2. Administration: Initiate PAXLOVID treatment as soon as possible after diagnosis of COVID-19 and within 5 days of symptom onset

Use in children ≥12 years of age and weighing at least 40 kg

1. Moderate renal impairment (eGFR 30-60 mL/min): 150 mg nirmatrelvir (one 150 mg tablet) with 100 mg ritonavir (one 100 mg tablet), with both tablets taken together twice daily for 5 days
2. Severe renal impairment (eGFR <30 mL/min): Use is not recommended

1. Mild or moderate impairment (Child-Pugh class A or B): No dosage adjustment necessary
2. Severe impairment (Child-Pugh class C): Use is not recommended (has not been studied)