METHODS: Six clinical pharmacologists search the scientific literature to provide a first draft of recommendations. Thereafter, twelve other clinical pharmacologists verified the recommendations and proposed modifications. The final draft was then validated by all 18 participants.
RESULTS: Five distinct recommendations were issued: i) contra-indications, ii) \"PAXLOVID™ not recommended with the comedication\", iii) \"PAXLOVID™ possible whether the comedication is discontinued\", iv) \"PAXLOVID™ possible only after an expert advice\" and v) \"PAXLOVID™ possible without modification of the associated treatment\". The final document comprises recommendations for 171 drugs/therapeutic classes aiming to secure prescription. In complex situations, clinicians are advised to contact their pharmacology department to obtain specific recommendations on the management of drug-drug interactions with nirmatrelvir/ritonavir.
CONCLUSIONS: These recommendations intend to be a help for clinicians willing to prescribe nirmatrelvir/ritonavir and to prevent drug-drug interactions leading to adverse drug reactions or loss of efficacy. They constitute a guideline for primary care situations. Of course, some complex situations may require expert advices and here, again, clinical pharmacologists are at the forefront in providing therapeutic advice.
方法:六位临床药理学家搜索科学文献以提供建议初稿。此后,其他12名临床药理学家验证了这些建议并提出了修改建议.最终草案随后由所有18名参与者验证。
结果:发布了五项不同的建议:i)禁忌症,ii)\“PAXLOVID™不推荐与妥协\”,iii)\“PAXLOVID™可能是否停止了奉献\”,iv)\"PAXLOVID™仅在获得专家建议后才能使用\"和v)\"PAXLOVID™在不修改相关治疗的情况下可能使用\"。最终文件包括旨在确保处方的171种药物/治疗类别的建议。在复杂的情况下,我们建议临床医生联系他们的药理学部门,获得关于尼马特雷韦/利托那韦药物相互作用管理的具体建议.
结论:这些建议旨在帮助愿意开尼马特雷韦/利托那韦的临床医生,并防止药物相互作用导致药物不良反应或疗效丧失。它们构成了初级保健情况的指导方针。当然,一些复杂的情况可能需要专家的建议,在这里,再次,临床药理学家在提供治疗建议方面处于最前沿。