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  • Correspondence on ‘Management of nirmatrelvir/ritonavir and tacrolimus interaction in kidney transplant recipients infected by COVID-19: a three-case series’

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Correspondence on ‘Management of nirmatrelvir/ritonavir and tacrolimus interaction in kidney transplant recipients infected by COVID-19: a three-case series’
  1. Xiaohua Xiao Zhou1,2,
  2. Hong Jian Ji3
  1. 1 Department of Nephrology, Yancheng Third People's Hospital, Yancheng, Jiangsu, China
  2. 2 Department of Nephrology, The Sixth Affiliated Hospital of Nantong University, Yancheng, Jiangsu, China
  3. 3 School of Pharmacy, Jiangsu Vocational College of Medicine, Yancheng, China
  1. Correspondence to Dr Xiaohua Xiao Zhou, Department of Nephrology, Yancheng Third Peoples'Hospital, Yancheng, Jiangsu, People's Republic of China; zhouxiaohua1983{at}126.com

https://doi.org/10.1136/ejhpharm-2023-003701

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    We read with great interest the recent study conducted by Guzmán Cordero and Saez-Torres de Vicente,1 which reported how to manage patients treated with nirmatrelvir/ritonavir (brand name Paxlovid) and tacrolimus. The results hinted that nirmatrelvir/ritonavir combined with tacrolimus interaction could be controlled and achieve a good clinical effect. Based on these findings, we believe these provide valuable reference materials for medical staff, especially nephrologists and clinical pharmacists.

    Following the announcement in December 2022 that the Chinese government was lifting the COVID-19 controls, more and more Chinese people have become infected with COVID-19. Hospitals in China are experiencing enormous pressure due to a very large population and regional differences. Our institution is a general tertiary hospital with 1800 beds; infected people with membranous nephropathy take tacrolimus and are regularly encountered in the department of nephrology. Due to elderly patients with underlying diseases, COVID-19 could put the patient at high risk for progression to severe new coronary pneumonia. Paxlovid, as a mainstream antiviral drug, is recommended by the guidelines.2 However, high protein binding and extensive transhepatic metabolism of Paxlovid may interact with drugs or herbs, causing severe adverse events. …

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    Footnotes

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.