Potential Drug-Drug Interactions With Nirmatrelvir/Ritonavir Among Long-Term Care Facility Residents.

Cohort studyJournal of the American Medical Directors Association· Jul 2026

Potential Drug-Drug Interactions With Nirmatrelvir/Ritonavir Among Long-Term Care Facility Residents.

Marzan A Khan, Lori A Daiello, Sarah D Berry … Andrew R Zullo

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GeriatricsCohort studyClinical practiceQ1IF 2.9

86% of long-term care residents taking Paxlovid had a potential drug interaction.

Potential Drug-Drug Interactions With Nirmatrelvir/Ritonavir Among Long-Term Care Facility Residents.

Marzan A Khan … Andrew R Zullo

Journal of the American Medical Directors Association · Jul 2026 · Q1 in General Medicine

Purpose

The objective of this study was to quantify the prevalence and duration of potential drug-drug interactions among US long-term care facility residents administered nirmatrelvir/ritonavir.

Methods

We conducted a cohort study of long-term care facility residents using electronic medication administration record data from the Long-Term Care Data Cooperative linked to Medicare claims (January 2022-January 2025).

n = 48,260 LTCF residents

Results

most residents on Paxlovid had a potential interaction with another drug

28.1%

Atorvastatin

21.6%

Amlodipine

15.9%

Apixaban

More results

Among 48,260 long-term care facility residents treated with nirmatrelvir/ritonavir, the mean age was 78.8 years (SD, 10.9), 58% were female, and 76% were non-Hispanic White.

More results

The most common potentially interacting medications were atorvastatin (28.1%; 95% confidence limits [CLs], 27.7-28.50), amlodipine (21.6%; 95% CLs, 21.2-21.9), and apixaban (15.9%; 95% CLs, 15.6-16.3).

Median days of overlapping exposure ranged from 5 to 6 days.

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Conclusion · 1 of 2

Potential drug-drug interactions with nirmatrelvir/ritonavir were common among long-term care facility residents, though contraindicated ones were uncommon.

Conclusion · 2 of 2

These findings underscore the need for ongoing medication reviews and clinician and pharmacist oversight to ensure safe antiviral use in LTCFs.

Potential Drug-Drug Interactions With Nirmatrelvir/Ritonavir Among Long-Term Care Facility Residents.

Potential Drug-Drug Interactions With Nirmatrelvir/Ritonavir Among Long-Term Care Facility Residents.

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