Stoiber Alina, Gray Gwen, Sailer Gudrun, Huf Wolfgang, Tonna Antonella
School of Pharmacy, Applied Sciences and Public Health, Robert Gordon University, Garthdee Road, Aberdeen, AB10 7QB, Scotland, UK.
Hospital Pharmacy, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria.
Int J Clin Pharm. 2025 Apr;47(2):471-476. doi: 10.1007/s11096-024-01852-5. Epub 2024 Dec 21.
Paxlovid® (nirmatrelvir and ritonavir) is the only licensed oral antiviral for COVID-19. Ritonavir is a potent inhibitor of cytochrome P450 enzymes causing numerous drug-drug interactions (DDIs).
To describe the frequency, type, and severity of detected drug related problems (DRPs) associated with Paxlovid®.
This study involved a retrospective quantitative analysis including all patients prescribed Paxlovid® at a public hospital in Vienna, Austria. Data were collected from the patients' records by a clinical pharmacist. A customised, piloted data collection form was used. A sample of data was checked for consistency by an independent clinical pharmacist. Any DDI and severity classification was recorded using an established interaction checker tool. Dosage adjustments due to renal impairment were recorded.
One hundred twenty-two of 140 patients (87.1%) required interventions to prevent DRPs. Pharmacists' intervention at dispensing was needed in 63.6% (n = 89) of cases. In 3 (2.1%) patients, Paxlovid® was prescribed despite being contraindicated due to severe renal impairment. The most common were DDIs (n = 80; 57.1%). Renal impairment and DDIs were noted in 24.3% (n = 34) of cases. A total of 313 DDIs were recorded in 114 (81.4%) patients, with severe interactions in 24 (17%) patients.
Pharmacists' involvement in prescribing highly interacting drugs such as Paxlovid® is essential to enhance patient safety.
帕罗韦德（Nirmatrelvir和利托那韦）是唯一获得许可用于治疗新冠病毒肺炎的口服抗病毒药物。利托那韦是一种强效细胞色素P450酶抑制剂，会引发大量药物相互作用（DDIs）。
描述与帕罗韦德相关的已检测到的药物相关问题（DRPs）的频率、类型和严重程度。
本研究涉及一项回顾性定量分析，纳入了奥地利维也纳一家公立医院所有开具帕罗韦德处方的患者。数据由临床药师从患者记录中收集。使用了一份经过试点的定制数据收集表。由一名独立临床药师检查样本数据的一致性。使用既定的相互作用检查工具记录任何药物相互作用和严重程度分类。记录因肾功能损害而进行的剂量调整。
140名患者中有122名（87.1%）需要进行干预以预防药物相关问题。63.（6%）（n = 89）的病例在配药时需要药师干预。3名（2.1%）患者尽管因严重肾功能损害而禁忌，但仍开具了帕罗韦德。最常见的是药物相互作用（n = 80；57.1%）。24.3%（n = 34）的病例中发现肾功能损害和药物相互作用。114名（81.4%）患者共记录到313次药物相互作用，其中24名（17%）患者存在严重相互作用。
药师参与开具如帕罗韦德这类具有高度相互作用的药物的处方对于提高患者安全性至关重要。
