Howdy - I know I should check with a Dr., and have sent a message to, but I’m curious if anyone on here took Paxlovid while being on low dose Rapamycin? I’m on 5 mg week from Healthspan. I am 99% sure I did not take it on Saturday (my weekly day) so last dose would have been last Saturday (7/27) but I’m freaking out a bit after googling interactions since I took the first dose of Paxlovid right away (today.)
Covid symptoms started Monday, positive test Tuesday. Got Paxlovid today (Wed, 8/7.) Full vaccs and boosters up to last year, have not gotten vaccinated this year. Have had COVID before but not as symptomatic as this time. Also on Wegovy but not sure of that makes difference.
Has anyone taken Paxlovid while on Rapamycin? Is it safe to continue? If I am wrong and did take it on Saturday (4 days ago) should I not take more Paxlovid? Curious for any perspectives since I can’t find much online and am freaking out a little bit.
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Just note that Paxlovid has ritonavir in it, so it’s going to increase the impact of the rapamycin along similar lines to the grapefruit thing.
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BTW welcome to the community!
Why was the Rx for Paxlovid issued? It is a very expensive medication with plenty of side effects. Unless you have multiple multiple comorbidities, in your stated age group … I don’t Rx it, as it has no evidence of benefit currently, and you’ll get side effects.
I don’t even test people unless they meet criteria for evidence based decreased rate of hospitalization or death based upon taking this medication.
So if you have a horrendous amount of co-morbidities … maybe one could justify an Rx … but unless there is more to the story … I’d not bother answering the question of Rapamycin + Paxlovid for you.
I do test and Rx this medication for groups who have reasonable evidence of benefit from treatment (not 30-40 year olds).
Epocrates interaction checker states “contraindicated if starting ritonavir as part of fixed-dose combo for HCV; avoid combo if ritonavir administered with nirmatrelvir (which it would be as Paxlovid has both); otherwise monitor sirolimus levels. The combination may increase sirolimus levels, risk of serious infection, other adverse events.”
I’d point out that if one is 2 days post taking Rapamycin - if on a standard type of dose such as 5-8 mg weekly - this wouldn’t be an issue - their interaction here more relates to ongoing sirolimus daily along with Paxlovid.
Not medical advice for anyone to act on, but just a little information to contemplate. Talk to your prescriber.
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Thank you so much for the replies!
I had some colleagues at work who had success quickly getting over covid with Paxlovid and CVS pharmacy prescribes it directly now and very cheap with insurance - they had me share recent blood work to check alt and creatinine first but otherwise said I qualify. Only comorbidities are overweight (was obese but on Wegovy for about a year with great success) and former smoker. I was hoping it would help me kick Covid quickly since this has been longer and worse than when I had it before.
I most likely took 5 mg rapamycin on 7/27, but there is a very slim possibility I took it 8/3 as well. Given that was 4 days ago, unlikely as it is, would it be safe to continue the Paxlovid?
Although it sounds like maybe regardless Paxlovid isn’t worth taking? I just wanted to get past the covid symptoms ASAP but not at the cost of any potential complications. I don’t want to end up in the hospital for mixing meds when I could have just dealt with the covid symptoms for a few more days lol.
It would be ongoing daily doses that would accumulate with the sirolimus while taking Paxlovid. You aren’t currently doing this.
As an aside, the insurance companies need to be a bit better about only covering Paxlovid when there is an evidence based reason to do so. The cost is $1390 currently for the 5 day course.
Paxlovid will knock down the viremia within 24 hours or so … but pretty likely to have some recurrent symptoms on ceasing.
Those of us on the front line who decide to practice evidence based medicine pretty much treat covid like any cold. It has been over a year since I’ve hospitalized anyone specifically for Covid - and I work at a high volume urban ER. Yes, I’ve admitted old frail individuals who are barely able to function when in their usual state of health, and they get covid and they can’t cope due to feeling weak … I don’t count these as any trivial insult would have done the same.
Covid isn’t a reason for panic like it was with alpha and delta back at the beginning. This is why CDC is no longer really recommending any isolation and their recommendations have people going to work who are clearly contagious with covid.
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