Ondansetron in a Paxlovid Intolerant Man

A symptomatic 22-year-old man, unvaccinated and living with high-risk elder parents, was prescribed nirmatrelvir/ritonavir (Paxlovid®) after testing positive for COVID-19. The patient developed persistent moderate to severe nausea the first dose, progressing several vomiting episodes second dose. To avoid discontinuing Paxlovid, a trial ondansetron8 mg PO, initiated, dose given one hour last episode. Due improvement in absence of retching vomiting, treatment continued at 8 twice daily, 1-2 hours before each Paxlovid maintained until completion five-day antiviral treatment. No or reported during ondansetron. In COVID-19 patients intolerant due development use ondansetronmay prevent discontinuation, allow recommended course therapy. Ondansetron is not expected exert drug-interactions nirmatrelvirritonavircombination.