@Ottawa

Do not use PAXLOVID if:

• You are allergic to nirmatrelvir, ritonavir or to any of the other ingredients in PAXLOVID (see What the medicinal ingredient is or What the non-medicinal ingredients are).
• You are taking any of the following medicines:
  • alfuzosin, used to treat high blood pressure
  • amiodarone, bepridil^*, dronedarone, flecainide, propafenone, quinidine, used to treat irregular heartbeats
  • apalutamide, used for prostate cancer
  • astemizole^* or terfenadine^*, used to relieve allergy symptoms
  • cisapride^*, used to relieve certain stomach problems
  • colchicine, when used in patients with kidney and/or liver problems, used to treat gout
  • ergotamine^*, dihydroergotamine (used to treat headaches), ergonovine, methylergonovine^* (used after labour and delivery)
  • fusidic acid, used as an antibiotic
  • lovastatin, lomitapide or simvastatin, used to lower cholesterol
  • lurasidone, pimozide, used to treat mental health problems
  • neratinib, used to treat breast cancer
  • ranolazine, used to treat chronic angina (chest pain)
  • rifampin and saquinavir, used to treat tuberculosis, should not be used together with ritonavir
  • rivaroxaban, used as an anticoagulant
  • salmeterol, used for asthma and chronic obstructive pulmonary disease
  • St. John’s Wort (Hypericum perforatum), an herbal product used to treat depression
  • triazolam and midazolam^* (oral or injected), used to relieve anxiety and/or trouble sleeping
  • PDE5 inhibitors vardenafil, used to treat erectile dysfunction, or sildenafil, used for the treatment of pulmonary arterial hypertension (PAH)
  • voriconazole, used as an antifungal
  • venetoclax during the dose initiation and during the ramp-up phase, used to treat chronic lymphocytic leukemia
  • carbamazepine, phenobarbital, phenytoin used to treat seizures (epilepsy)

The following may also interact with PAXLOVID:

• medicines used to treat erectile dysfunction, such as tadalafil
• medicines used to treat pulmonary arterial hypertension, such as bosentan or tadalafil
• medicines used to lower blood cholesterol, such as atorvastatin and rosuvastatin
• some medicines affecting the immune system, such as cyclosporin, sirolimus and tacrolimus
• some medicines used to treat seasonal allergies and ear and eye infections, such as budesonide, dexamethasone, fluticasone propionate, prednisone, and triamcinolone
• medicines used to treat AIDS and related infections, such as amprenavir, indinavir^*, nelfinavir, saquinavir, didanosine^*, rifabutin, tipranavir, delavirdine^*, atazanavir, maraviroc, fosamprenavir, raltegravir, tenofovir and darunavir
• medicines used to treat depression, such as trazodone, desipramine and bupropion
• certain heart medicines, such as calcium channel antagonists including diltiazem, nifedipine and verapamil
• medicines used to correct heart rhythm, such as systemic lidocaine and digoxin
• antifungals, such as ketoconazole and itraconazole^*
• morphine-like medicines used to treat severe pain, such as methadone and meperidine
• anticoagulants, such as warfarin
• certain antibiotics, such as rifabutin and clarithromycin
• antibiotics used in the treatment of tuberculosis, such as rifampin
• bronchodilators used to treat asthma, such as theophylline
• medicines used to treat cancer, such as abemaciclib, dasatinib, encorafenib, ibrutinib, nilotinib, vincristine and vinblastine
• medicines used for low blood platelet count, such as fostamatinib
• some heart rhythm drugs, such as mexiletine and disopyramide
• some anticonvulsants, such as clonazepam, divalproex, lamotrigine and ethosuximide
• some narcotic analgesics, such as fentanyl in all forms, tramadol and propoxyphene
• quetiapine used to treat schizophrenia, bipolar disorder and major depressive disorder
• medicines used to treat hepatitis C, such as simeprevir, glecaprevir/pibrentasvir or ombitasvir, paritaprevir and ritonavir with or without dasabuvir^*
• some sedatives or medicines to treat anxiety, such as buspirone, clorazepate, diazepam, flurazepam and zolpidem
• stimulants, such as methamphetamine
• medicines used to treat pain associated with endometriosis, such as elagolix
• medicines used to treat depression, such as amitriptyline, clomipramine, fluoxetine, imipramine, maprotiline^*, nefazodone^*, nortriptyline, paroxetine, sertraline, trimipramine
• medicines used to treat nausea and vomiting, such as dronabinol^*
• medicines used to treat pneumonia, such as atovaquone
• medicines used as a sedative and medicines used to help you sleep (hypnotics), such as estazolam
• medicines used to treat increased pressure in the eye, such as timolol
• medicines used to lower blood pressure, such as metoprolol
• medicines used to treat HIV, such as efavirenz
• medicines used to prevent organ rejection after a transplant, such as everolimus, rapamycin
• medicines used to treat certain mental/mood disorders such as schizophrenia, bipolar disorder, such as perphenazine, risperidone and thioridazine
• medicines used as hormonal contraceptives containing ethinyl estradiol (“the pill”)

^* Product is not or no longer marketed in Canada.

来源：加国无忧编译

加拿大卫生部周一宣布批准了辉瑞公司的抗病毒药Paxlovid后，第一批药物已经运达，加拿大首席卫生官说，那些未接种COVID-19疫苗的人可能会优先使用这款新批准的供不应求的药物。

图源：citynews

据报道，辉瑞公司的抗病毒药Paxlovid批准用于患有轻度或中度COVID-19疾病的成年患者，这些患者患严重疾病需要住院和重症监护的风险较高，该药不能给已经住院的任何人使用，必须是在出现症状后的五天内开处方。

辉瑞公司表示，试验表明，在出现初始症状后不久服用该药可以将成人住院或死亡的几率降低89%。

在被问及疫苗状况是否会影响谁会接受药物治疗的决定时，首席卫生官Dr. Theresa Tam说，那些未接种疫苗的人更有可能需要住院或在重症监护室接受治疗。

图源：推特

她说，这是对一种紧缺药物的科学合理的使用。我们知道，未接种疫苗的人出现严重后果、住院并最终进ICU的风险更高。我认为，作为医疗保健提供者，我们不会对要进入医院并接受治疗的患者挑三拣四，这表明我们正在优先为最需要的人提供治疗。

2021年12月的最新的联邦住院数据显示，12至59岁之间未接种疫苗的人因COVID-19住院的可能性是完全接种疫苗的人的31倍。对于那些60岁及以上的人来说，未接种疫苗的人需要住院治疗的可能性要高出15倍。

Tam说，关于给谁开出有限供应的药物的指导方针是“基于临床风险因素和健康公平考虑”。虽然风险是首要标准，但生活在长期护理院或医疗服务不足的农村或偏远社区的人也被优先考虑，60岁及以上的原住民、因纽特人或梅蒂斯人也会优先考虑。

Tam说，我想提醒一下，包括Paxlovid在内的任何药物都不能替代疫苗接种或公共卫生措施。接种包括加强剂的疫苗是保护自己、家人和社区免受COVID-19严重后果的最佳方式。

相关链接：

https://toronto.citynews.ca/2022/01/18/canada-covid-pills-paxlovid-unvaccinated/