ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2022
Early clinical experience with nirmatrelvir/ritonavir for the treatment of COVID-19 in solid organ transplant recipients.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed, 88 citations in OpenAlex.
- Implementation of an Online Drug-Drug Interaction Screener for the STRIVE Ensitrelvir Trial for COVID-19.Open forum infectious diseases · 2025Trial
- IPNA clinical practice recommendations on care of pediatric patients with pre-existing kidney disease during seasonal outbreak of COVID-19.Pediatric nephrology (Berlin, Germany) · 2025Review
- Paxlovid (Nirmatrelvir/Ritonavir)-Induced Tacrolimus Toxicity in Organ Transplant Recipients - A Review on Drug Interactions Involving CYP3A Enzymes.Current drug safety · 2025Review
- Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China: a multicentre, retrospective cohort study.Annals of medicine · 2024Article
- The effectiveness of nirmatrelvir/ritonavir regimen in hospitalized renal transplant patients with prolonged COVID-19 infection: a multicenter clinical experience.Renal failure · 2024Article
- COVID-19 pneumonia in lung transplant recipients: understanding risk factors and treatment outcomes in Japan.Clinical and experimental medicine · 2024Article
- Management of nirmatrelvir/ritonavir and tacrolimus interaction in kidney transplant recipients infected by COVID-19: a three-case series.European journal of hospital pharmacy : science and practice · 2024Article
- Case report and literature review: management of Paxlovid (nirmatrelvir/ritonavir)-induced acute tacrolimus toxicity in a patient with systemic lupus erythematosus.Frontiers in pharmacology · 2024Article
- Pharmacokinetic Interactions of Paxlovid Involving CYP3A Enzymes and P-gp Transporter: An Overview of Clinical Data.Current drug metabolism · 2024Review
- Adaptative Strategy of Immunosuppressive Drugs Dosage Adjustments When Combined With Nirmatrelvir/Ritonavir in Solid Organ Transplant Recipients With COVID-19.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Prevention and treatment strategies for kidney transplant recipients in the context of long-term existence of COVID-19.Frontiers in medicine · 2024Review
- Viral rebound and safety of nirmatrelvir/ritonavir for lung-transplant recipients infected with SARS-CoV-2.Biosafety and health · 2023Article
- Article
- Tacrolimus toxicity due to enzyme inhibition from ritonavir.The American journal of emergency medicine · 2023Article
- Outcome of lung transplant recipients infected with SARS-CoV-2/Omicron/B.1.1.529: a Nationwide German study.Infection · 2023Article
- Antiviral Treatment of Coronavirus Disease-2019 Pneumonia.Clinics in chest medicine · 2023Review
- The COVID-19 Pandemic and Adult Cardiac Transplantation: Impact, Interventions, and Implications.The Canadian journal of cardiology · 2023Review
- Paxlovid (Nirmatrelvir/Ritonavir): A new approach to Covid-19 therapy?Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2023Review
- Case Report: tacrolimus toxicity in the setting of concurrent Paxlovid use in a heart-transplant recipient.European heart journal. Case reports · 2023Article
- Prevalence of potential drug-drug interactions with ritonavir-containing COVID-19 therapy.Journal of managed care & specialty pharmacy · 2023Observational
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nirmatrelvir/ritonavir (NR) use has not yet been described in solid organ transplant recipients (SOTRs) with mild COVID-19. The objective was to evaluate outcomes among SOTR and describe the drug-drug interaction of NR. This is an IRB-approved, retrospective study of all adult SOTR on a calcineurin inhibitor (CNI) or mammalian target of rapamycin inhibitor who were prescribed NR between December 28, 2021 and January 6, 2022. A total of 25 adult SOTR were included (n = 21 tacrolimus, n = 4 cyclosporine, n = 3 everolimus, n = 1 sirolimus). All patients were instructed to follow the following standardized protocol during treatment with 5 days of NR: hold tacrolimus or mTOR inhibitor or reduce cyclosporine dose to 20% of baseline daily dose. Four patients (16%) were hospitalized by day 30; one for infectious diarrhea and three for symptoms related to COVID-19. No patients died within 30 days of receipt of NR. Median tacrolimus level pre- and post-NR were 7.4 ng/ml (IQR, 6.6-8.6) and 5.2 (IQR, 3.6-8.7), respectively. Four patients experienced a supratherapeutic tacrolimus concentration after restarting tacrolimus post-NR. Our results show the clinically significant interaction between NR and immunosuppressive agents can be reasonably managed with a standardized dosing protocol. Prescribers should carefully re-introduce CNI after the NR course is complete.
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