Liverpool COVID-19 Interactions

Do Not Coadminister

Nirmatrelvir/ritonavir (5 days)

Daridorexant

Quality of Evidence: Very Low

Summary:

Coadministration has not been studied but is contraindicated. Daridorexant is mainly metabolised by CYP3A4. Nirmatrelvir/ritonavir is metabolized by CYP3A. Daridorexant is a weak inhibitor of CYP3A4 but is unlikely to have a clinically significant effect on nirmatrelvir/ritonavir. However, nirmatrelvir/ritonavir is a strong CYP3A4 inhibitor and is expected to significantly increase daridorexant concentrations. Coadministration of daridorexant (25 mg) and the moderate CYP3A4 inhibitor diltiazem (240 mg once daily) increased daridorexant AUC and Cmax by 2.4- and 1.4-fold, respectively. No clinical study was conducted with a strong CYP3A4 inhibitor. Coadministration with strong CYP3A4 inhibitors is contraindicated in the European product label for daridorexant, whereas the American product label recommends to avoid coadministration.

Description:

(See Summary)