Do you need to stop taking a Selective Serotonin Reuptake Inhibitor (SSRI) when taking Paxlovid (nirmatrelvir/ritonavir)?

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Last updated: June 26, 2025View editorial policy

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From the Research

You should consult with your healthcare provider before taking Paxlovid if you are on an SSRI, as some adjustments may be needed. Most SSRIs can generally be continued during the 5-day Paxlovid course, but your doctor might recommend temporarily reducing the dose 1. However, certain SSRIs like fluvoxamine and fluoxetine require special consideration due to their longer half-lives and potential for stronger interactions with Paxlovid 2. The concern stems from ritonavir in Paxlovid, which inhibits the CYP3A4 enzyme that metabolizes many medications, potentially increasing SSRI levels in your bloodstream 3. This could lead to serotonin syndrome, a potentially serious condition with symptoms like confusion, rapid heart rate, high blood pressure, dilated pupils, muscle rigidity, and fever 4. Some studies have identified that many antidepressants, including SSRIs, are not expected to have significant drug-drug interactions with Paxlovid 5. Your doctor will weigh the benefits of Paxlovid against these risks, considering factors like your specific SSRI, dosage, COVID-19 severity, and overall health status. It is essential to follow your healthcare provider's guidance to minimize potential interactions and ensure safe treatment outcomes. Key considerations include:

  • Monitoring for signs of serotonin syndrome
  • Adjusting SSRI doses as needed
  • Weighing the benefits and risks of Paxlovid treatment
  • Collaborating with healthcare providers to manage potential interactions 1, 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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