A descriptive analysis of drug related problems identified when prescribing the COVID-19 antiviral drug Paxlovid®
Alina Stoiber, Gwen Gray, Gudrun Sailer, Wolfgang Huf, Antonella Tonna
doi:10.21203/rs.3.rs-4973191/v1
Background Paxlovid® is the only licensed oral COVID - 19 antiviral containing nirmatrelvir and ritonavir. Ritonavir is a potent inhibitor of cytochrome P450 enzymes resulting in clinically signi cant drug-drug interactions (DDIs).
Aim To describe the frequency, type, and severity of detected drug related problems (DRPs) with Paxlovid®
Method This study involved a retrospective, quantitative data analysis. All patients prescribed Paxlovid® in a public hospital in Vienna, were included. Data was collected from the patients' records and recorded on a customised and piloted data collection form. Any DRPs were also noted. The severity of DDIs was classi ed using an established checker tool.
Results 122 of 140 (87.1%) patients required interventions to prevent DRPs; 63.6% of cases required intervention by the pharmacist at dispensing. The most common DRPs were DDIs (57.1%). In 24.3% of cases both renal impairment and DDIs were noted. 313 DDIs were recorded in 114 patients; in 24 patients, the interactions recorded were severe. In 3 patients (2.1%), Paxlovid® was prescribed despite being contraindicated due to severe renal impairment requiring pharmacist intervention.
Conclusion This study demonstrated that numerous DRPs involving Paxlovid® were identi ed by the pharmacist following prescribing. Pharmacists' involvement in prescribing highly interacting drugs such as Paxlovid® is bene cial to enhance patient safety.
Impact on Practice Pharmacist screening for drug related problems at the point of dispensing is likely to increase patient safety and mitigate risk associated with high-risk drugs. The study con rms that a strong focus needs to be placed on reviewing the patients´ renal function and adjusting dosing accordingly both as part of the prescribing and screening processes.
Con ict of Interests The authors declare that they have no con ict of interest.
Characteristics
Supplementary Files This is a list of supplementary les associated with this preprint. Click to download. Appendices.docx
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