Pharmacists help prevent DDIs in patients taking NMV/r for COVID-19

Clinically relevant drug–drug interactions (DDIs) are highly prevalent among oncohematology patients treated with nirmatrelvir/ritonavir (NMV/r) for COVID-19, reveals a study. Pharmacists have played an important role in detecting, categorizing, and mitigating these DDIs. 

“The results underscore the need for comprehensive studies to evaluate the impact of pharmacist-led interventions in optimizing drug therapy and enhancing patient safety in this vulnerable population,” the authors said.  

Forty-two oncohematology patients were included in this prospective, observational study. These patients received NMV/r in a tertiary-level hospital. A certified oncology pharmacist assessed potentially clinically relevant DDIs using three databases and made recommendations to prescribing physicians. 

The authors then examined the association between prescribed drugs and DDIs using linear and logistic regression analyses. 

Clinically relevant DDIs were found in most patients (76.2 percent), with 18.1 percent of medications involved in DDIs. Atorvastatin and imatinib were the most common drugs implicated. 

Micromedex found 63.3 percent of these DDIs as major severity, while Lexicomp and University of Liverpool classifications were not as restrictive. 

Of note, pharmacists succeeded in preventing most DDIs from harming patients through various interventions, which included monitoring (44.2), discontinuation (36.5 percent), and dose reduction (17.3 percent).  

“New drugs developed for SARS-CoV-2 infection, such as NMV/r, represent a potential for oncohematology patients but also pose a challenge in managing the potential clinically relevant pDDIs that may arise,” they noted.