InfoCons Consumer Protection informs you – Paxlovid – Package Leaflet

Before anything else

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet . See section 4 .

ℹ️ 1. What Paxlovid is and what it is used for

Paxlovid contains two active substances nirmatrelvir and ritonavir in two different tablets . Paxlovid is an antiviral medicine used for treating adults and children and adolescents 6 years to less than 18 years of age weighing at least 20 kg with COVID -19 who do not require supplemental oxygen and who are at increased risk for progressing to severe disease .

COVID -19 is caused by a virus called a coronavirus. This medicine stops the virus multiplying in cells and this stops the virus multiplying in the body. This can help your body to overcome the virus infection, and may prevent you from developing severe illness .

You must talk to a doctor if you do not feel better or if you feel worse after 5 days.

⚠️ 2. What you need to know before you take Paxlovid

Do not take Paxlovid

• if you are allergic to nirmatrelvir , ritonavir or any of the other ingredients of this medicine (listed in section 6).
• if you are taking any of the following medicines. Taking Paxlovid with these medicines may cause serious or life -threatening side effects or affect how Paxlovid works:
• Alfuzosin (used to treat symptoms of an enlarged prostate )
• Ranolazine (used to treat chronic chest pain [angina])
• Dronedarone, propafenone , quinidine (used to treat heart conditions and correct irregular heartbeats)
• Rifampicin , rifapentine (used to treat bacterial infections)
• Apalutamide, enzalutamide, neratinib, venetoclax (used to treat cancer)
• Carbamazepine, phenobarbital, phenytoin , primidone (used to prevent and control seizures ) 50 – Colchicine (used to treat gout)
• Terfenadine (used to treat allergies)
• Cariprazine and l urasidone (used to treat schizophrenia )
• Pimozide, quetiapine (used to treat schizophrenia, bipolar disorder, severe depression and abnormal thoughts or feelings)
• Silodosin (used to treat enlarged prostate gland)
• Eplerenone and ivabradine (used to treat heart and/or blood vessel problems)
• Dihydroergotamine and ergotamine (used to treat migraine headaches)
• Ergonovine and methylergonovine (used to stop excessive bleeding that may occur following childbirth or an abortion )
• Cisapride (used to relieve certain stomach problems)
• St. John’s wort (Hypericum perforatum ) (a herbal remedy used for depression and anxiety)
• Voclosporin (used to treat immune disorders)
• Lovastatin, simvastatin , lomitapide (used to lower blood cholesterol)
• Eletriptan (used to treat migraine headaches)
• Lumacaftor/ivacaftor (used for cystic fibrosis)
• Finerenone (used to treat chronic kidney disease associated with Type 2 diabetes)
• Naloxegol (used to treat opioid -induced constipation)
• Avanafil, vardenafil (used to treat erectile dysfunction [also known as impotence])
• Sildenafil , tadalafil ( used to treat erectile dysfunction [also known as impotence] or pulmonary arterial hypertension [high blood pressure in the pulmonary artery ])
• Clorazepate, diazepam, estazolam, flurazepam, triazolam, midazolam taken orally (used to relieve anxiety and/or trouble sleeping)
• Tolvaptan used to treat hyponatremia (low sodium levels in the blood)

Warnings and precautions

Allergic reactions Allergic reactions, including severe allergic reactions (known as ‘anaphylaxis’) and serious skin reactions (known as ‘toxic epidermal necrolysis’ and ‘Stevens -Johnson syndrome’) , can happen in people taking this medicine , even after only 1 dose. Stop taking this medicine and call your doctor right away if you get any of the following symptoms of an allergic reaction:

• trouble swallowing or breathing
• swelling of the tongue, mouth, and face
• throat tightness
• hoarseness
• itching
• skin rash
• red and painful skin
• blisters and peeling skin
• blisters or sores in your mouth or lips Liver disease Tell your doctor if you have or have had a liver disease. Liver enzyme abnormalities, hepatitis and jaundice have occurred in patients receiving ritonavir.

Kidney disease Tell your doctor if you have or have had a kidney disease.

High blood pressure Tell your doctor if you have high blood pressure. Your doctor may need to check your blood pressure before taking this medicine and while you are taking this medicine. There have been reports of high blood pressure in people taking this medicine , particularly in older individuals.

51 Risk of HIV -1 resistance development If you have untreated or uncontrolled HIV infection, P axlovid may lead to some HIV medicines not working as well in the future.

Children and adolescents

Do not give this medicine to children under 6 years or children and adolescents 6 years to less than 18 years of age weighing less than 20 kg because this medicine has not been studied in this group .

Other medicines and Paxlovid

There are other medicines that may not be taken together with Paxlovid . Tell your doctor (s) or pharmacist if you are taking, have recently taken or might take any other medicines :

• medicines used to treat cancer, such as afatinib, abemaciclib, ceritinib, dasatinib, encorafenib, fostamatinib, ibrutinib, ivosidenib, nilotinib , vinblastine and vincristine
• medicines used to thin the blood (anticoagulants), such as warfarin, rivaroxaban , dabigatran and apixaban
• medicines used to treat convulsions, such as divalproex, lamotrigine and clonazepam
• medicines used for smoking cessation, such as bupropion
• medicines used to treat allergies, such as fexofenadine and loratadine
• medicines used to treat fungal infections (antifungals), such as itraconazole and voriconazole
• medicines used to treat parasitic infections, such as albendazole
• medicines used to treat Cushing’s syndrome —when the body produces an excess of cortisol — such as ketoconazole tablets
• medicines used to treat HIV infection, such as efavirenz, maraviroc, raltegravir , zidovudine and bictegravir/emtricitabine/tenofovir
• medicines used to treat infections (e.g., antibiotics and antimycobacterials), such as atovaquone, clarithromycin, erythromycin, fusidic acid (taken orally or administered by IV route ), bedaquiline, rifabutin, delamanid and sulfamethoxazole/trimethoprim
• medicines used to treat schizophrenia and abnormal thoughts or feelings , such as clozapine
• medicines used to treat mental or mood disorders, such as haloperidol, risperidone and thioridazine
• medicines used to treat high blood pressure in the blood vessels that supply the lungs, such as bosentan and riociguat
• medicines used to treat high blood pressure (hypertension), such as amlodipine, diltiazem , felodipine, lercanidipine , nicardipine, nifedipine and verapamil
• medicines used to treat heart and/or blood vessel problems, such as alisk iren, ticagrelor, cilostazol and clopidogrel
• medicines used to treat heart conditions and correct irregular heartbeats, such as digoxin , amiodarone, flecainide and disopyramide
• medicines to treat cystic fibrosis, such as ivacaftor, elexacaftor/tezacaftor/ivacaftor and tezacaftor/ivacaftor
• medicines used to treat diabetes such as saxagliptin
• medicines used to treat hepatitis C virus infection, such as glecaprevir /pibrentasvir and sofosbuvir/velpatasvir/voxilaprevir
• medicines used to lower blood cholesterol, such as atorvastatin, fluvastatin, pravastatin and rosuvastatin
• medicines used to treat migraine headaches, such as rimegepant
• medicines used to treat urinary incontinence, such as darifenacin and solifenacine
• medicines used to treat mental health problems, such as aripiprazole and brexpiprazole
• medicines used to suppress your immune system, such as cyclosporine, everolimus, sir olimus and tacrolimus
• medicines used to treat autoimmune disorders including rheumatoid arthritis, psoriatic arthritis or ulcerative colitis, such as tofacitinib and upadacitinib
• medicines used to treat severe pain, such as morphine, fentanyl, oxycodone , methadone, buprenorphine, other morphine -like medicines , pethidine and piroxicam
• medicines used as sedatives, hypnotics, and sleeping agent, such as alprazolam, buspirone and zolpidem 52 – medicines used to treat attention deficit disorder or a sleep disorder called narcolepsy, such as amphetamines
• steroids including corticosteroids used to treat inflammation, such as budesonide, dexamethasone, fluticasone, prednisolone and triamcinolone
• medicines used to treat asthma and other lung -related problems such as chronic obstructive pulmonary disease [COPD], such as salmeterol and theophylline
• medicines used to treat depression, such as amitriptyline, fluoxetine, imipramine, nortriptyline, paroxetine and sertraline
• medicines used as thyroid replacement therapy, such as levothyroxine
• medicine used to treat enlarged prostate, such as tamsulosin
• any of the following other specific medicines:
• oral or patch contraceptive containing ethinyl estradiol used to prevent pregnancy
• midazolam administered by injection (used for sedation [an awake but very relaxed state of calm or drowsiness during a medical test or procedure] or anaesthesia) Many medicines interact with Paxlovid . Keep a list of your medicines to show your doctor (s) and pharmacist. Do not start taking a new medicine without telling your doctor (s). Your doctor (s) can tell you if it is safe to take Paxlovid with other medicines .

Pregnancy and breast -feeding If you are pregnant, think you may be pregnant or are planning to have a baby , ask your doctor for advice before taking this medicine .

There is not enough information to be sure that Paxlovid is safe for use in pregnancy. If you are pregnant, it is not recommended to use this medicine unless your clinical condition requires this treatment . It is recommended that you refrain from sexual activity or use contraception while taking this medicine and for 7 days after completing the treatment as a precaution . If you are taking hormonal contraception, as this medicine may reduce the effectiveness of this medicine, it is recommended that a condom or other non hormonal method of contraception is used. Your doctor will advise you on the duration of this required adjustment of your contraceptive measures.

A small amount of Paxlovid passes into breast milk. You should not breast -feed your baby while taking this medicine and for 48 hours after completing the treatment as a precaution .

Driving and using machines

Paxlovid is expected to have no influence on the ability to drive and use machines.

Paxlovid contains lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medici ne.

Paxlovid contains sodium

Nirmatrelvir and ritonavir tablets each contain less than 1 mmol sodium (23 mg) per dose, that is to say essentially ‘sodium -free’.

💊 3. How to take Paxlovid

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure .

Paxlovid consists of 2 medicines: nirmatrelvir and ritonavir.

A course of treatment lasts 5 days.

Swallow the tablets whole. Do not chew, break or crush the tablets. This medicine can be taken with or without meals.

Recommended dose Adults The recommended dose is 2 pink nirmatrelvir tablets with 1 white ritonavir tablet by mouth every 12 hours (in the morning and in the evening ).

Children and adolescents 6 years to less than 18 years of age

• Weight at least 20 kg to less than 40 kg:

The recommended dose is 1 pink nirmatrelvir tablet with 1 white ritonavir tablet by mouth every 12 hours (in the morning and in the evening) .

• Weight at least 40 kg:

The recommended dose is 2 pink nirmatrelvir tablets with 1 white ritonavir tablet by mouth every 12 hours (in the morning and in the evening).

If you or your child have /has a kidney disease, the dose of Paxlovid should be reduced. Please talk to your healthcare provider for an appropriate dose of PAXLOVID .

Severe kidney disease If you have SEVERE kidney disease, the recommended dose is 2 pink nirmatrelvir tablets with 1 white ritonavir tablet by mouth once on Day 1, and then 1 pink nirmatrelvir tablet with 1 white ritonavir tablet once daily on Days 2 to 5 .

If you take more Paxlovid than you should

If you take too much of this medicine , call your healthcare provider or go to the nearest hospital emergency room right away .

If you forget to take Paxlovid

If you miss a dose of this medicine within 8 hours of the time it is usually taken, take it as soon as you remember. If you miss a dose by more than 8 hours, skip the missed dose and take the next dose at your regular time. Do not take 2 doses at the same time.

Do not take a double dose to make up for a forgotten dose .

If you stop taking Paxlovid

Even if you feel better, do not stop taking this medicine without talking to your doctor.

If you have any further questions on the use of this medicine , ask your doctor or pharmacist .

❗ 4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Common: may affect up to 1 in 10 people

• Diarr hoea
• Vomiting
• Nausea
• Altered sense of taste (such as metallic, bitter taste)
• Headache 54 Uncommon: may affect up to 1 in 100 people
• Allergic reactions
• High blood pressure
• Abdominal pain
• Muscle pain
• Skin rash (also reported as part of allergic reaction)

Rare: may affect up to 1 in 1000 people

• Severe allergic reaction known as ‘anaphylaxis’ (such as swelling of tongue, mouth and face, trouble swallowing or breathing, throat tightness, or hoarseness)
• Serious skin reactions known as ‘t oxic epidermal necrolysis’ and ‘Stevens -Johnson syndrome’ (such as red and painful skin, blisters and peeling skin, blisters or sores in your mouth or lips)
• Malaise
• Itching (also reported as part of allergic reaction)

Reporting of side effects

If you get any side effects , talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V . By reporting side effects you can help provide more information on the safety of this medicine.

🌡️ 5. How to store Paxlovid

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton or the blister after ‘EXP’.

The expiry date refers to the last day of that month.

This medicine does not require any special storage conditions.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

📦 6. Contents of the pack and other information

What Paxlovid contains

• The active substance s in this medicine are nirmatrelvir and ritonavir .
• Each pink film-coated nirmatrelvir tablet contains 150 mg of nirmatrelvir .
• Each white film-coated ritonavir tablet contains 100 mg of ritonavir.
• The other ingredients in the nirmatrelvir tablet are microcrystalline cellulose, lactose

monohydrate (see section 2, ‘ Paxlovid contains lactose’) , croscarmellose sodium, colloidal silicon dioxide and sodium stearyl fumarate (see section 2, ‘ Paxlovid contains sodium ’). The film-coating contains hydrox ypropyl methylcellulose , titanium dioxide, macrogol/ polyethylene glycol and iron oxide red .

• The other ingredients in the ritonavir tablet are copovidone, sorbitan laurate, colloidal anhydrous silica, calcium hydrogen phosphate, sodium stearyl fum arate. The film-coating contains hypromellose, titanium dioxide, macrogol /polyethylene glycol , hydroxypropyl cellulose, talc, colloidal anhydrous silica and polysorbate 80.

What Paxlovid looks like and contents of the pack

Nirmatrelvir 150 mg film -coated tablets are pink, oval -shaped and debossed with ‘PFE’ on one side and ‘3CL’ on the other side.

55 Ritonavir 100 mg film -coated tablets are white to off white, capsule -shaped, and debossed with ‘H’ on one side and ‘R9’ on the other side.

Paxlovid film-coated tablets are available in 5 daily -dose blister cards with a total of 30 tablets or 20 tablets packaged in a carton .

In the 30 -tablet pack, each daily blister card contains 4 nirmatrelvir tablets (150 mg each) and 2 ritonavir tablets (100 mg each) and indicates which tablets need to be taken in the morning and evening (sun and moon symbols) .

In the 20 -tablet pack, e ach daily blister card contains 2 nirmatrelvir tablets (150 mg each) and 2 ritonavir tablets (100 mg each) and indicates which tablets need to be taken in the morning and evening (sun and moon symbols) .

Paxlovid film -coated tablets are also available in a 5-day blister card with a total of 11 tablets packaged in a carton. The 5-day blister card contains 6 nirmatrelvir tablets (150 mg each) and 5 ritonavir tablets (100 mg each) and indicates which tablets need to be taken once daily for 5 days.

Not all pack sizes may be marketed.

Marketing Authorisation Holder

Pfizer Europe MA EEIG Boulevard de la Plaine 17 1050 Bru ssels Belgium

Manufacturer

Pfizer Manufacturing Deutschland GmbH Mooswaldallee 1 79108 Freiburg Im Breisgau Germany Pfizer Italia S.r.L .

Localita Marino del Tronto 63100 Ascoli , Piceno Italy Pfizer Ireland Pharmaceuticals Unlimited Company Little Connell Newbridge County Kildare Ireland For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

België/Belgique/Belgien Luxembourg/Luxemburg Pfizer NV/SA Tél/Tel: +32 (0)2 554 62 11 Latvija Pfizer Luxembourg SARL filiāle Latvijā Tel: + 371 670 35 775 56 България Пфайзер Люксембург САРЛ, Клон България Teл.: +359 2 970 4333 Lietuva Pfizer Luxembourg SARL filialas Lietuvoje Tel: +370 5 251 4000 Česká republika Pfizer, spol. s r.o.

Tel: +420 283 004 111 Magyarország Pfizer Kft .

Tel.: + 36 1 488 37 00 Danmark Pfizer ApS Tlf.: +45 44 20 11 00 Malta Vivian Corporation Ltd.

Tel: +356 21344610 Deutschland PFIZER PHARMA GmbH Tel: +49 (0)30 550055 -51000 Nederland Pfizer bv Tel: +31 (0)800 63 34 636 Eesti Pfizer Luxembourg SARL Eesti filiaal Tel: +372 666 7500 Norge Pfizer AS Tlf: +47 67 52 61 00 Ελλάδα Pfizer Ελλάς A.E.

Τηλ: +30 210 6785800 Österreich Pfizer Corporation Austria Ges.m.b.H .

Tel: +43 (0)1 521 15 -0 España Pfizer, S.L.

Tel: +34 91 490 99 00 Polska Pfizer Polska Sp. z o.o.

Tel.: +48 22 335 61 00 France Pfizer Tél: +33 (0)1 58 07 34 40 Portugal Laboratórios Pfizer, Lda.

Tel: +351 21 423 5500 Hrvatska Pfizer Croatia d.o.o.

Tel: +385 1 3908 777 România Pfizer Romania S.R.L Tel: +40 (0) 21 207 28 00 Ireland Pfizer Healthcare Ireland Unlimited Company Tel: 1800 633 363 (toll free) +44 (0)1304 616161 Slovenija Pfizer Luxembourg SARL Pfizer, podružnica za svetovanje s področja farmacevtske dejavnosti, Ljubljana Tel: +386 (0)1 52 11 400 Ísland Icepharma hf .

Sími: +354 540 8000 Slovenská republika Pfizer Luxembourg SARL, organizačná zložka Tel: + 421 2 3355 5500 Italia Pfizer S.r.l.

Tel: +39 06 33 18 21 Suomi/Finland Pfizer Oy Puh/Tel: +358 (0)9 430 040 Κύπρος Pfizer Ελλάς Α.Ε. (Cyprus Branch) Tηλ: +357 22817690 Sverige Pfizer AB Tel: +46 (0)8 550 520 00 57 This leaflet was last revised i n Scan the code with a mobile device to get the package leaflet in different languages.

URL : www.covid19oralrx.com /en Other sources of information Detailed information on this medicine is available on the European Medicines Agency web site: https://www.ema.europa.eu .

This leaflet is available in all EU /EEA languages on the European Medicines Agency website.

ANNEX I V CONCLUSIONS ON THE REQUEST FOR ONE -YEAR MARKETING PROTECTION PRESENTED BY THE EUROPEAN MEDICINES AGENCY 59 Conclusions presented by the European Medicines Agency on:

• one-year marketing protection The CHMP reviewed the data submitted by the marketing authorisation holder, taking into account the provisions of Article 14(11) of Regulation (EC) No 726/2004, and considers that the new therapeutic indication brings significant clinical benefit in compar ison with existing therapies as further explained in the European Public Assessment Report.

📄 Package Leaflet – official source

This article reproduces the information in the official package leaflet, as authorised in the European Union. You can consult the original document here: Product information Paxlovid (PDF, ec.europa.eu).

You can check this medicine at any time in the Union Register of medicinal products (EU number EU/1/22/1625).

⚠️ Important: This article is for information purposes only and does not replace medical advice or the package leaflet inside the medicine box. Read the leaflet carefully before use. For any questions about your treatment, talk to your doctor or pharmacist. If you experience side effects, tell your doctor or pharmacist and report them through your national reporting system.