Covid

[Longlegs33]

I have covid and cll just recently I had double pneumonia and was in hospital in intensive care. I have been given paxlovid and my meds list was on my report from hospital that I am on simvastatin. Do I take the paxlovid or not ?

[GMa27]

Not sure what u are asking. Are u told u can't have Paxlovid while on Simvastatin? Or should you take Paxlovid? I am on simvastatin & have never been told I can't have Paxlovid. I got covid for the first time in June. It was just like a cold so I just took otc meds. When I contacted my doc few days after, she said Paxlovid wasn't necessary. I didn't want it anyway due to rebounding. I hope you feel better!

[AussieNeil Partner Administrator]

Welcome to our community! I hope you'll find plenty in our pinned posts section healthunlocked.com/cllsuppo... to help you live long and well with CLL.

We can't give you medical advice, but we can share our experiences and provide you with references from reliable medical information sites that you can then discuss with your medical team about its relevance to your situation.

With respect to your question, according to the drugs . com interactions checker (consumer) drugs.com/interactions-chec...

4 potential interactions and/or warnings found for the following 2 drugs:

Interactions between your drugs: Major(1), Food (3)

Applies to: simvastatin, Paxlovid (nirmatrelvir / ritonavir)

Using simvastatin together with ritonavir is not recommended. Combining these medications may significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with simvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. etc.

So according to the above, you probably should have been advised to take a reduced dose of simvastatin or preferably another drug with a similar action to simvastatin that doesn't interact with paxlovid. Indeed, the professional section of the interactions checker states;

MANAGEMENT: Concomitant use of lovastatin or simvastatin is considered contraindicated during treatment with ritonavir due to the potential for severe interaction. Red yeast rice, which contains lovastatin, should also be avoided. Fluvastatin and pravastatin are probably safer alternatives, since they are not metabolized by CYP450 3A4. When initiating treatment with nirmatrelvir/ritonavir, the manufacturer recommends discontinuing lovastatin or simvastatin for at least 12 hours prior to treatment. All patients treated with HMG-CoA reductase inhibitors should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

I hope you can get this potentially major drug interaction concern resolved before the weekend to reduce your risk of COVID-19 complications.

Neil

[Sepsur]

The antivirals are most effective if you start to take the course within the first five days off showing first infection. - I can’t tell you anything about other meds.

I also know that if you have spent anytime in ICU you will be far more susceptible to infections and chest issues.

I have no desire to return to ICU

[Pekingese]

Hi I was told not to take it with Plaxoide for 8 days from the hospital.

[Ibru]

I can't give advice, but if it was me I would skip the simvistatin and take the Paxlovid. You are not going to die of high cholesterol if you skip it for a week, but you could die from covid complications.