Paxlovid Available Strengths
Paxlovid is available in two fixed-dose combinations: the standard dose of nirmatrelvir 300 mg/ritonavir 100 mg (two 150 mg nirmatrelvir tablets plus one 100 mg ritonavir tablet) and a reduced dose of nirmatrelvir 150 mg/ritonavir 100 mg (one 150 mg nirmatrelvir tablet plus one 100 mg ritonavir tablet) for patients with moderate renal impairment. 1
Standard Dosing
The standard dose consists of:
- Nirmatrelvir: Two 150 mg tablets (total 300 mg)
- Ritonavir: One 100 mg tablet
All three tablets are taken together orally twice daily for 5 days 2, 1.
Tablet Characteristics
Nirmatrelvir tablets: Oval, pink, immediate-release, film-coated tablets debossed with "PFE" on one side and "3CL" on the other side. Each tablet contains 150 mg of nirmatrelvir 1
Ritonavir tablets: White or white to off-white film-coated tablets. Each tablet contains 100 mg of ritonavir 1
Renal Dose Adjustment
For patients with moderate renal impairment (eGFR 30-59 mL/min), the dose is reduced to nirmatrelvir 150 mg/ritonavir 100 mg (one 150 mg nirmatrelvir tablet plus one 100 mg ritonavir tablet) taken together twice daily for 5 days. 2, 1
Critical Dosing Considerations:
No dose adjustment needed for mild renal impairment (eGFR ≥60 to <90 mL/min) 1
Not recommended for severe renal impairment (eGFR <30 mL/min) until more data are available, though recent evidence from the EPIC-SRI study suggests that nirmatrelvir/ritonavir 150/100 mg once daily may be safe and effective in this population 3
No dose adjustment needed for mild or moderate hepatic impairment (Child-Pugh Class A or B); not recommended for severe hepatic impairment (Child-Pugh Class C) 1
Important Prescribing Note
Prescriptions should specify the numeric dose of each active ingredient within Paxlovid, and providers must counsel patients about renal dosing instructions to ensure proper administration. 1 This is particularly important because the co-packaged formulation requires clear communication about which tablets to take based on renal function.