Nirmatrelvir Oral tablet, Ritonavir Oral tablet

NIRMATRELVIR; RITONAVIR (NIR ma TREL vir; ri TOE na veer) treats mild to moderate COVID-19. It may help people who are at high risk of developing severe illness. It works by limiting the spread of the virus in your body.

This product contains 2 different medications that are packaged together. For the standard dose, take 2 pink tablets of nirmatrelvir with 1 white tablet of ritonavir (3 tablets total) by mouth with water twice daily. Talk to your care team if you have kidney disease. You may need a different dose. Swallow the tablets whole. You can take it with or without food. If it upsets your stomach, take it with food. Take all of this medication unless your care team tells you to stop it early. Keep taking it even if you think you are better.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 12 years for selected conditions, precautions do apply.

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Change in taste
• Diarrhea
• General discomfort and fatigue
• Increase in blood pressure
• Muscle pain
• Nausea
• Stomach pain

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

They need to know if you have any of these conditions:

• Any allergies
• Any serious illness
• Kidney disease
• Liver disease
• An unusual or allergic reaction to nirmatrelvir, ritonavir, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

Do not take this medication with any of the following:

• Alfuzosin
• Certain medications for anxiety or sleep, such as midazolam or triazolam
• Certain medications for cancer, such as apalutamide
• Certain medications for cholesterol, such as lovastatin or simvastatin
• Certain medications for irregular heartbeat, such as amiodarone, dronedarone, flecainide, propafenone, quinidine
• Certain medications for mental health conditions, such as lurasidone or pimozide
• Certain medications for seizures, such as carbamazepine, phenobarbital, phenytoin, primidone
• Colchicine
• Eletriptan
• Eplerenone
• Ergot alkaloids, such as dihydroergotamine, ergotamine, methylergonovine
• Finerenone
• Flibanserin
• Ivabradine
• Lomitapide
• Lumacaftor; ivacaftor
• Naloxegol
• Ranolazine
• Red Yeast Rice
• Rifampin
• Rifapentine
• Sildenafil
• Silodosin
• St. John's wort
• Tolvaptan
• Ubrogepant
• Voclosporin

This medication may affect how other medications work, and other medications may affect the way this medication works. Talk with your care team about all of the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended.

If you miss a dose, take it as soon as you can unless it is more than 8 hours late. If it is more than 8 hours late, skip the missed dose. Take the next dose at the normal time. Do not take extra or 2 doses at the same time to make up for the missed dose.

Your condition will be monitored carefully while you are receiving this medication. Visit your care team for regular checkups. Tell your care team if your symptoms do not start to get better or if they get worse.

If you have untreated HIV infection, this medication may lead to some HIV medications not working as well in the future.

Estrogen and progestin hormones may not work as well while you are taking this medication. Your care team can help you find the contraceptive option that works for you.