What TA878 covers (high-level)
- TA878 recommends several COVID-19 treatments (including nirmatrelvir + ritonavir) for people at increased risk of progression to severe disease.
- Pathways are time-sensitive and operationalised via national/local eligibility criteria (risk groups list, symptom onset window, contraindications).
Interaction-first safety checklist
- Ritonavir strongly inhibits CYP3A: drug–drug interactions are the main prescribing risk. Check all meds (including OTC/herbal).
- Review renal/hepatic function and follow SmPC/local pathway for contraindications, dose adjustments, and whether temporary withholding of interacting drugs is safe.
- If interactions cannot be safely managed, follow local alternatives pathway.
Counselling and safety-netting
- Explain goal: reduce risk of severe disease in high-risk groups; continue isolation and symptom monitoring.
- Urgent help if breathlessness, chest pain, confusion, severe dehydration, or rapid deterioration.
- Use local/national pathways for current sequencing and eligibility (these can change with policy/variants).
Frequently asked questions
Is Paxlovid for everyone with COVID?
No — it is targeted to higher-risk groups and is subject to time windows, contraindications, and national/local eligibility criteria.
What is the biggest practical risk?
Drug–drug interactions due to ritonavir; interaction checking is essential before prescribing.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.