From the Guidelines
No, you should not take Paxlovid (nirmatrelvir/ritonavir) 11 hours after the first dose, as the recommended dosing interval is every 12 hours. Paxlovid should be taken every 12 hours, with each dose consisting of two nirmatrelvir tablets (150 mg each) and one ritonavir tablet (100 mg) taken together. Taking doses too close together can increase the risk of side effects and toxicity. If you've taken your first dose and it hasn't been 12 hours yet, you should wait until the 12-hour mark before taking your next dose. This timing is important because the medication needs to maintain certain blood levels to effectively fight the SARS-CoV-2 virus. The standard treatment course for Paxlovid is five days (10 doses total). Although a living WHO guideline on drugs for COVID-19 suggests not to use nirmatrelvir/ritonavir for patients with non-severe COVID-19 at low risk of hospitalization 1, this does not affect the dosing schedule for those who are prescribed the medication. If you're concerned about your dosing schedule, contact your healthcare provider for personalized advice. They can help you establish a proper dosing schedule that works with your daily routine while ensuring the medication's effectiveness.
Some key points to consider when taking Paxlovid include:
- Taking the medication at the same time every day to maintain consistent blood levels
- Completing the full five-day treatment course, even if symptoms improve before finishing the medication
- Monitoring for potential side effects and reporting them to your healthcare provider
- Following the recommended dosing schedule to minimize the risk of side effects and ensure the medication's effectiveness.
It's essential to prioritize the recommended dosing schedule and consult with your healthcare provider if you have any questions or concerns about taking Paxlovid.
From the FDA Drug Label
If the patient misses a dose of PAXLOVID within 8 hours of the time it is usually taken, the patient should take it as soon as possible and resume the normal dosing schedule. If the patient misses a dose by more than 8 hours, the patient should not take the missed dose and instead take the next dose at the regularly scheduled time.
Since 11 hours is more than 8 hours, you should not take the missed dose. Instead, take the next dose at the regularly scheduled time. Do not double the dose to make up for a missed dose 2.
From the Research
Paxlovid Dosage Interval
- The recommended dosage interval for Paxlovid (nirmatrelvir/ritonavir) is every 12 hours for 5 days 3.
- There is no direct evidence in the provided studies to support taking Paxlovid 11 hours after the first dose.
- However, the studies suggest that Paxlovid is effective in reducing the risk of hospitalization and death in patients with COVID-19 when taken as directed 4, 5, 3.
Medication Adherence
- Medication adherence is crucial for the success of treatment, and non-adherence can be costly for the health service 6.
- Factors such as intentional or non-intentional non-adherence, multimorbidity, and multiple medications can affect an individual's compliance with a medication regimen 6.
- Interaction with a health professional is important for understanding the reason for non-adherence and promoting adherence 6.
Home Antiviral Therapy
- Home antiviral treatment (HAVT) with Paxlovid was approved in December 2021, but utilization during the COVID-19 pandemic was low 7.
- Factors associated with seeking HAVT treatment include loss of taste or smell, male sex, younger age, Black race, Hispanic ethnicity, and medical discrimination 7.
- Barriers to obtaining treatment include feeling uncomfortable obtaining HAVT while sick and lack of transportation 7.