Liverpool COVID-19 Interactions

Do Not Coadminister

Nirmatrelvir/ritonavir (5 days)

Mitotane

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but should be avoided. Mitotane is primarily metabolized in adrenal cells and is an inducer of CYP3A4. Mitotane may cause large decreases in nirmatrelvir/ritonavir concentrations which may in turn significantly decrease the nirmatrelvir/ritonavir therapeutic effect. Due to the persisting inducing effect upon discontinuation of a strong inducer, consider an alternative COVID-19 treatment. In addition, nirmatrelvir/ritonavir should not be used 3-6 months after the last dose of mitotane given the very long elimination half-life (18-159 days) of mitotane.

Description:

(See Summary)