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Classification: A

Drug products: Paxlovid

ATC code: J05

Substances: nirmatrelvir


The pivotal clinical studies show similar efficacy of nirmatrelvir/ritonavir in men and women.

Additional information

Pharmacokinetics and dosing

Influence of patient’s sex on nirmatrelvir pharmacokinetics have not been evaluated [1, 2].


A phase 2/3 trial conducted by the original manufacturer showed that a similar proportion of men and women treated with nirmatrelvir/ritonavir (520 men, 519 women) had COVID-19-related hospitalization or death from any cause at day 28 [2].

Adverse effects

Sex differences in adverse event reports from nirmatrelvir/ritonavir have been analyzed using the FDA Adverse Event Reporting System (FAERS). Of the 11 997 reports, 59.5% of the adverse events were reported in women. The distribution of specific adverse events was similar in men and women [3].

Reproductive health issues

Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan).

Updated: 2023-01-20

Date of litterature search: 2023-01-12


  1. Paxlovid (nirmatrelvir, ritonavir). Pfizer Europe MA EEIG. EMA EPAR Product Information. Updated 03/11/2022.
  2. EMA. Assessment report Paxlovid. EMA [www]. [updated 2021-12-16, cited 2022-04-14]. EMA
  3. Li M, Zhang QS, Liu XL, Wang HL, Liu W. Adverse Events Associated with Nirmatrelvir/Ritonavir: A Pharmacovigilance Analysis Based on FAERS. Pharmaceuticals (Basel). 2022;15(12). PubMed
  4. VAL-databasen. Region Stockholm. 2021 [cited 2023-01-20.] länk

Authors: Linnéa Karlsson Lind

Reviewed by: Diana Rydberg, Carl-Olav Stiller, Pauline Raaschou

Approved by: Karin Schenck-Gustafsson