Overcoming the drug-interactions barrier.

Under national guidelines, patients with COVID at high risk of serious illness should be prescribed nirmatrelvir (Paxlovid) by GPs, with the less effective molnupiravir (Lagevrio) a second-line option.

Right now, the opposite is occurring probably because GPs are inundated or overworked, says infectious diseases physician Dr Alex Padiglione.

“My understanding is that about 80% of the scripts currently being written by GPs are for Lagevrio, and only 20% are prescribing Paxlovid, and it really should be the other way around. Paxlovid is a significantly more effective drug,” he says.

“It’s because there are a long list of drugs where Paxlovid is contraindicated or you need to adjust a dose or withhold a drug. There are also contraindications for people with liver or kidney problems.

“If you’re running a busy practice and you’ve got someone on the end of the phone, it’s easier to give a script of Lagevrio, even if it is slightly less effective, rather than look up drug interactions.”

Dr Alex Padiglione will deliver a COVID Update at Healthed’s upcoming webcast on 27 September. You can register for free here.