FHIR IG analytics| Package | hl7.fhir.uv.epi-apac |
| Resource Type | Bundle |
| Id | Bundle-paxlovid-sgp-pil-epi.json |
| FHIR Version | R5 |
No resources found
No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "paxlovid-sgp-pil-epi",
"identifier": {
"system": "https://www.hsa.gov.sg/epi/document-id",
"value": "PAXH-SIN-0126/PIL/0"
},
"type": "document",
"timestamp": "2026-07-01T11:21:25Z",
"entry": [
{
"fullUrl": "https://www.hsa.gov.sg/epi/Composition/comp-paxlovid-pil",
"resource": {
"resourceType": "Composition",
"id": "comp-paxlovid-pil",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Composition_comp-paxlovid-pil\"> </a>\n <p>Package Leaflet (Patient Information Leaflet) — PAXLOVID\n (nirmatrelvir/ritonavir) film-coated tablets. Singapore (HSA). Document\n PAXH-SIN-0126/PIL/0.</p>\n </div>"
},
"identifier": [
{
"system": "https://www.hsa.gov.sg/epi/document-id",
"value": "PAXH-SIN-0126/PIL/0"
}
],
"status": "final",
"type": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/document-type",
"code": "pil",
"display": "Patient Information Leaflet"
}
]
},
"date": "2026-01-14",
"author": [
{
"reference": "Organization/org-owner",
"display": "Pfizer Inc."
}
],
"title": "PAXLOVID Film-Coated Tablets — Package Leaflet: Information for the Patient",
"language": "en",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid",
"display": "PAXLOVID film-coated tablets"
}
],
"section": [
{
"title": "PAXLOVID Film-Coated Tablets — Package Leaflet: Information for the Patient",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "pil",
"display": "PAXLOVID Film-Coated Tablets — Package Leaflet: Information for the Patient"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>\n <b>Package leaflet: Information for the patient</b>\n </p>\n <p><b>PAXLOVID film-coated tablets</b><br/>nirmatrelvir + ritonavir</p>\n <p>\n <b>Read all of this leaflet carefully before you start taking this\n medicine because it contains important information for you.</b>\n </p>\n <ul>\n <li>Keep this leaflet. You may need to read it again.</li>\n <li>If you have any further questions, ask your doctor or\n pharmacist.</li>\n <li>This medicine has been prescribed for you only. Do not pass it\n on to others. It may harm them, even if their signs of illness\n are the same as yours.</li>\n <li>If you get any side effects, talk to your doctor or pharmacist.\n This includes any possible side effects not listed in this\n leaflet. See section 4.</li>\n </ul>\n <p>\n <b>What is in this leaflet</b>\n </p>\n <ol>\n <li>What PAXLOVID is and what it is used for</li>\n <li>What you need to know before you take PAXLOVID</li>\n <li>How to take PAXLOVID</li>\n <li>Possible side effects</li>\n <li>How to store PAXLOVID</li>\n <li>Contents of the pack and other information</li>\n </ol>\n </div>"
},
"section": [
{
"title": "1. What PAXLOVID is and what it is used for",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "1",
"display": "1. What PAXLOVID is and what it is used for"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>PAXLOVID contains two active substances nirmatrelvir and\n ritonavir in two different tablets. PAXLOVID is an antiviral\n medicine used to treat mild-to-moderate Coronavirus Disease 2019\n (COVID-19) in adults who are at high risk for progression to\n severe COVID-19, including hospitalization or death.</p>\n <p>COVID-19 is caused by a virus called a coronavirus. PAXLOVID\n stops the virus multiplying in cells and this stops the virus\n multiplying in the body. This can help your body to overcome the\n virus infection, and may prevent you from developing severe\n illness.</p>\n <p>You must talk to a doctor if you do not feel better or if you\n feel worse after 5 days.</p>\n </div>"
},
"entry": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
},
{
"reference": "ClinicalUseDefinition/cud-ind-1"
}
]
},
{
"title": "2. What you need to know before you take PAXLOVID",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2",
"display": "2. What you need to know before you take PAXLOVID"
}
]
},
"section": [
{
"title": "2.1. Do not take PAXLOVID",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2.1",
"display": "2.1. Do not take PAXLOVID"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>\n <b>Do not take PAXLOVID</b>\n </p>\n <ul>\n <li>if you are allergic to nirmatrelvir, ritonavir or any of\n the other ingredients in PAXLOVID (listed in section 6).</li>\n <li>if you are taking any of the following medicines. Taking\n PAXLOVID with these medicines may cause serious or\n life-threatening side effects or affect how PAXLOVID\n works:<ul>\n <li>Alfuzosin (used to treat symptoms of an enlarged\n prostate)</li>\n <li>Ranolazine (used to treat chronic chest pain\n [angina])</li>\n <li>Amiodarone, dronedarone, flecainide,\n propafenone, quinidine (used to treat heart conditions\n and correct irregular heartbeats)</li>\n <li>Colchicine (used to treat gout)</li>\n <li>Lurasidone, pimozide (used to treat\n schizophrenia)</li>\n <li>Silodosin (used to treat benign prostatic\n hyperplasia)</li>\n <li>Eplerenone and ivabradine (used to treat heart\n and/or blood vessel problems)</li>\n <li>Dihydroergotamine and ergotamine (used to treat\n migraine headaches)</li>\n <li>Methylergonovine (used to stop excessive\n bleeding that may occur following childbirth or an\n abortion)</li>\n <li>Lovastatin, simvastatin, lomitapide (used to\n lower blood cholesterol)</li>\n <li>Voclosporin (used to treat immune disorders)</li>\n <li>Eletriptan, ubrogepant (used to treat migraine\n headaches)</li>\n <li>Finerenone (used to treat chronic kidney\n disease)</li>\n <li>Suzetrigine (used to treat acute pain)</li>\n <li>Naloxegol (used to treat opioid-induced\n constipation)</li>\n <li>Sildenafil used to treat pulmonary arterial\n hypertension (high blood pressure in the pulmonary\n artery)</li>\n <li>Triazolam, midazolam taken orally (used to\n relieve anxiety and/or trouble sleeping)</li>\n <li>Flibanserin (used to treat hypoactive (low)\n sexual desire disorder (HSDD))</li>\n <li>Tolvaptan used to treat hyponatremia (low sodium\n levels in the blood)</li>\n <li>Apalutamide, enzalutamide (used to treat\n prostate cancer)</li>\n <li>Carbamazepine, phenobarbital, primidone,\n phenytoin (used to prevent and control seizures)</li>\n <li>Rifampin and rifapentine (used to treat\n bacterial infections)</li>\n <li>Lumacaftor/ivacaftor (used to treat cystic\n fibrosis)</li>\n <li>St. John’s wort (Hypericum perforatum) (a herbal\n remedy used for depression and anxiety)</li>\n </ul></li>\n </ul>\n </div>"
},
"entry": [
{
"reference": "ClinicalUseDefinition/cud-contra-hypersensitivity"
},
{
"reference": "ClinicalUseDefinition/cud-contra-hypersensitivity"
},
{
"reference": "ClinicalUseDefinition/cud-contra-01-alfuzosin"
},
{
"reference": "ClinicalUseDefinition/cud-contra-02-ranolazine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-03-amiodarone"
},
{
"reference": "ClinicalUseDefinition/cud-contra-04-dronedarone"
},
{
"reference": "ClinicalUseDefinition/cud-contra-05-flecainide"
},
{
"reference": "ClinicalUseDefinition/cud-contra-06-propafenone"
},
{
"reference": "ClinicalUseDefinition/cud-contra-07-quinidine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-08-colchicine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-09-lurasidone"
},
{
"reference": "ClinicalUseDefinition/cud-contra-10-pimozide"
},
{
"reference": "ClinicalUseDefinition/cud-contra-11-silodosin"
},
{
"reference": "ClinicalUseDefinition/cud-contra-12-eplerenone"
},
{
"reference": "ClinicalUseDefinition/cud-contra-13-ivabradine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-14-dihydroergotamine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-15-ergotamine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-16-methylergonovine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-17-lovastatin"
},
{
"reference": "ClinicalUseDefinition/cud-contra-18-simvastatin"
},
{
"reference": "ClinicalUseDefinition/cud-contra-19-voclosporin"
},
{
"reference": "ClinicalUseDefinition/cud-contra-20-lomitapide"
},
{
"reference": "ClinicalUseDefinition/cud-contra-21-eletriptan"
},
{
"reference": "ClinicalUseDefinition/cud-contra-22-ubrogepant"
},
{
"reference": "ClinicalUseDefinition/cud-contra-23-finerenone"
},
{
"reference": "ClinicalUseDefinition/cud-contra-24-suzetrigine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-25-naloxegol"
},
{
"reference": "ClinicalUseDefinition/cud-contra-26-sildenafil-when-used-for-pulmonary-arterial-hype"
},
{
"reference": "ClinicalUseDefinition/cud-contra-27-triazolam"
},
{
"reference": "ClinicalUseDefinition/cud-contra-28-oral-midazolam"
},
{
"reference": "ClinicalUseDefinition/cud-contra-29-flibanserin"
},
{
"reference": "ClinicalUseDefinition/cud-contra-30-tolvaptan"
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{
"reference": "ClinicalUseDefinition/cud-contra-31-apalutamide"
},
{
"reference": "ClinicalUseDefinition/cud-contra-32-enzalutamide"
},
{
"reference": "ClinicalUseDefinition/cud-contra-33-carbamazepine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-34-phenobarbital"
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{
"reference": "ClinicalUseDefinition/cud-contra-35-primidone"
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{
"reference": "ClinicalUseDefinition/cud-contra-36-phenytoin"
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{
"reference": "ClinicalUseDefinition/cud-contra-37-rifampin"
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{
"reference": "ClinicalUseDefinition/cud-contra-38-rifapentine"
},
{
"reference": "ClinicalUseDefinition/cud-contra-39-lumacaftor-ivacaftor"
},
{
"reference": "ClinicalUseDefinition/cud-contra-40-st-john-s-wort-hypericum-perforatum"
}
]
},
{
"title": "2.2. Warnings and precautions",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2.2",
"display": "2.2. Warnings and precautions"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Allergic reactions</b><br/>Allergic reactions, including\n severe allergic reactions (known as ‘anaphylaxis’), can\n happen in people taking PAXLOVID, even after only 1 dose.\n Stop taking PAXLOVID and call your doctor right away if you\n get any of the following symptoms of an allergic reaction:</p>\n <ul>\n <li>trouble swallowing or breathing</li>\n <li>swelling of the tongue, mouth, and face</li>\n <li>throat tightness</li>\n <li>hoarseness</li>\n <li>itching</li>\n <li>skin rash</li>\n </ul>\n <p><b>Liver disease</b><br/>Tell your healthcare provider right\n away if you have any of these signs and symptoms of liver\n problems: loss of appetite, yellowing of your skin and the\n whites of eyes (jaundice), dark-colored urine, pale colored\n stools and itchy skin, stomach area (abdominal) pain.</p>\n <p><b>Kidney disease</b><br/>Tell your doctor if you have or\n have had a kidney disease.</p>\n <p><b>Risk of HIV-1 resistance development</b><br/>If you have\n untreated or uncontrolled HIV infection, PAXLOVID may lead\n to some HIV medicines not working as well in the future.</p>\n <p><b>Children and adolescents</b><br/>The safety and efficacy\n of PAXLOVID have not been studied in patients younger than\n 18 years of age.</p>\n </div>"
},
"entry": [
{
"reference": "ClinicalUseDefinition/cud-warn-interactions"
},
{
"reference": "ClinicalUseDefinition/cud-warn-hypersensitivity"
},
{
"reference": "ClinicalUseDefinition/cud-warn-hepatotoxicity"
},
{
"reference": "ClinicalUseDefinition/cud-warn-hiv-resistance"
}
]
},
{
"title": "2.3. Other medicines and PAXLOVID",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2.3",
"display": "2.3. Other medicines and PAXLOVID"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>There are other medicines that may not be taken together with\n PAXLOVID. Tell your doctor(s) or pharmacist if you are\n taking, have recently taken or might take any other\n medicines:</p>\n <ul>\n <li>medicines used to treat symptoms of an enlarged\n prostate, such as tamsulosin</li>\n <li>medicines used to treat heart rhythm abnormalities\n (arrhythmia), such as lidocaine (systemic) and\n disopyramide</li>\n <li>medicines used to treat cancer, such as abemaciclib,\n ceritinib, dasatinib, encorafenib, ibrutinib,\n ivosidenib, neratinib, nilotinib, venetoclax,\n vinblastine and vincristine</li>\n <li>medicines used to thin the blood (anticoagulants), such\n as warfarin, rivaroxaban, dabigatran, apixaban and\n vorapaxar</li>\n <li>medicines used to treat convulsions, such as clonazepam</li>\n <li>medicines used to treat depression, such as bupropion\n and trazodone</li>\n <li>medicines used to treat fungal infections (antifungals),\n such as voriconazole, ketoconazole, isavuconazonium\n sulfate and itraconazole</li>\n <li>medicines used to treat HIV infection, such as\n atazanavir, darunavir, tipranavir, efavirenz, maraviroc,\n nevirapine, zidovudine and\n bictegravir/emtricitabine/tenofovir</li>\n <li>medicines used to treat infections (e.g., antibiotics\n and antimycobacterials), such as clarithromycin,\n erythromycin, bedaquiline and rifabutin</li>\n <li>medicines used to treat parasitic infections (e.g.,\n albendazole)</li>\n <li>medicines used to treat schizophrenia, bipolar disorder,\n severe depression and abnormal thoughts or feelings,\n such as quetiapine, clozapine, aripiprazole,\n brexpiprazole, cariprazine, iloperidone, lumateperone\n and pimavanserin</li>\n <li>medicines used to treat high blood pressure\n (hypertension), such as amlodipine, diltiazem,\n felodipine, nicardipine, nifedipine, verapamil and\n aliskiren</li>\n <li>medicines used to treat heart conditions and/or correct\n irregular heartbeats, such as digoxin and mavacamten</li>\n <li>medicines used to prevent blood clots (antiplatelets)\n such as ticagrelor, clopidogrel and cilostazol</li>\n <li>steroids including corticosteroids used to treat\n inflammation, such as betamethasone, budesonide,\n ciclesonide, dexamethasone, fluticasone,\n methylprednisolone, mometasone and triamcinolone</li>\n <li>medicines used to treat cystic fibrosis such as\n ivacaftor, elexacaftor/tezacaftor/ivacaftor and\n tezacaftor/ivacaftor</li>\n <li>medicines used to lower blood sugar, such as saxagliptin</li>\n <li>medicines used to treat high blood pressure in the blood\n vessels that supply the lungs, such as bosentan,\n tadalafil and riociguat</li>\n <li>medicines used to treat hepatitis C virus infection,\n such as elbasvir/grazoprevir, glecaprevir/pibrentasvir,\n ombitasvir/paritaprevir/ritonavir and dasabuvir,\n sofosbuvir/velpatasvir/voxilaprevir</li>\n <li>medicines used to lower blood cholesterol, such as\n atorvastatin and rosuvastatin</li>\n <li>medicines used to suppress your immune system, such as\n cyclosporine, tacrolimus, everolimus and sirolimus</li>\n <li>medicines used to treat autoimmune conditions, such as\n tofacitinib and upadacitinib</li>\n <li>medicines used to treat asthma and other lung-related\n problems such as chronic obstructive pulmonary disease\n [COPD], such as salmeterol</li>\n <li>medicines used to treat migraine headaches such as\n rimegepant</li>\n <li>medicines used to treat overactive bladder such as\n darifenacin</li>\n <li>medicines used to treat severe pain, such as fentanyl,\n hydrocodone, oxycodone, meperidine and methadone</li>\n <li>medicines used to treat erectile dysfunction (also known\n as impotence), such as avanafil, sildenafil, tadalafil\n and vardenafil</li>\n <li>medicines used as sedatives, hypnotics, and sleeping\n agent, such as buspirone, clorazepate, diazepam,\n estazolam, flurazepam, zolpidem and suvorexant</li>\n <li>any of the following other specific medicines:<ul>\n <li>oral or patch contraceptive containing ethinyl\n estradiol used to prevent pregnancy</li>\n <li>midazolam administered by injection (used for\n sedation [an awake but very relaxed state of calm or\n drowsiness during a medical test or procedure] or\n anesthesia)</li>\n </ul></li>\n </ul>\n <p>Many medicines interact with PAXLOVID. <b>Keep a list of your\n medicines to show your doctor(s) and pharmacist.</b> Do not\n start taking a new medicine without telling your doctor(s).\n Your doctor(s) can tell you if it is safe to take PAXLOVID\n with other medicines.</p>\n </div>"
},
"entry": [
{
"reference": "ClinicalUseDefinition/cud-int-01-alfuzosin"
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{
"reference": "ClinicalUseDefinition/cud-int-02-tamsulosin"
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{
"reference": "ClinicalUseDefinition/cud-int-03-ranolazine"
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{
"reference": "ClinicalUseDefinition/cud-int-04-amiodarone-dronedarone-flecainide-propafenone-qu"
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{
"reference": "ClinicalUseDefinition/cud-int-05-lidocaine-systemic-disopyramide"
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{
"reference": "ClinicalUseDefinition/cud-int-06-apalutamide-enzalutamide"
},
{
"reference": "ClinicalUseDefinition/cud-int-07-abemaciclib-ceritinib-dasatinib-encorafenib-ibru"
},
{
"reference": "ClinicalUseDefinition/cud-int-08-warfarin-rivaroxaban-dabigatrana-apixaban"
},
{
"reference": "ClinicalUseDefinition/cud-int-09-carbamazepinea-phenobarbital-phenytoin-primidone"
},
{
"reference": "ClinicalUseDefinition/cud-int-10-clonazepam"
},
{
"reference": "ClinicalUseDefinition/cud-int-11-bupropion-trazodone"
},
{
"reference": "ClinicalUseDefinition/cud-int-12-voriconazole-ketoconazole-isavuconazonium-sulfat"
},
{
"reference": "ClinicalUseDefinition/cud-int-13-colchicine"
},
{
"reference": "ClinicalUseDefinition/cud-int-14-atazanavir-darunavir-tipranavir"
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{
"reference": "ClinicalUseDefinition/cud-int-15-efavirenz-maraviroc-nevirapine-zidovudine-bicteg"
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{
"reference": "ClinicalUseDefinition/cud-int-16-clarithromycin-erythromycin"
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{
"reference": "ClinicalUseDefinition/cud-int-17-rifampin-rifapentine"
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{
"reference": "ClinicalUseDefinition/cud-int-18-bedaquiline-rifabutin"
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{
"reference": "ClinicalUseDefinition/cud-int-19-albendazole"
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{
"reference": "ClinicalUseDefinition/cud-int-20-lurasidone-pimozide"
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{
"reference": "ClinicalUseDefinition/cud-int-21-quetiapine-clozapine"
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{
"reference": "ClinicalUseDefinition/cud-int-22-silodosin"
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{
"reference": "ClinicalUseDefinition/cud-int-23-amlodipine-diltiazem-felodipine-nicardipine-nife"
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{
"reference": "ClinicalUseDefinition/cud-int-24-digoxin"
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{
"reference": "ClinicalUseDefinition/cud-int-25-eplerenone-ivabradine"
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{
"reference": "ClinicalUseDefinition/cud-int-26-aliskiren-ticagrelor-vorapaxar-clopidogrel-cilos"
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{
"reference": "ClinicalUseDefinition/cud-int-27-betamethasone-budesonide-ciclesonide-dexamethaso"
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"reference": "ClinicalUseDefinition/cud-int-28-lumacaftor-ivacaftor"
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{
"reference": "ClinicalUseDefinition/cud-int-29-ivacaftor-elexacaftor-tezacaftor-ivacaftor-tezac"
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{
"reference": "ClinicalUseDefinition/cud-int-30-saxagliptin"
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{
"reference": "ClinicalUseDefinition/cud-int-31-bosentan"
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{
"reference": "ClinicalUseDefinition/cud-int-32-dihydroergotamine-ergotamine-methylergonovine"
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{
"reference": "ClinicalUseDefinition/cud-int-33-elbasvir-grazoprevir-glecaprevir-pibrentasvir-om"
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{
"reference": "ClinicalUseDefinition/cud-int-34-st-john-s-wort-hypericum-perforatum"
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{
"reference": "ClinicalUseDefinition/cud-int-35-lovastatin-simvastatin"
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{
"reference": "ClinicalUseDefinition/cud-int-36-atorvastatin-rosuvastatina"
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{
"reference": "ClinicalUseDefinition/cud-int-37-ethinyl-estradiol"
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{
"reference": "ClinicalUseDefinition/cud-int-38-voclosporin"
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{
"reference": "ClinicalUseDefinition/cud-int-39-calcineurin-inhibitors-cyclosporine-tacrolimus-m"
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{
"reference": "ClinicalUseDefinition/cud-int-40-tofacitinib-upadacitinib"
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{
"reference": "ClinicalUseDefinition/cud-int-41-salmeterol"
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{
"reference": "ClinicalUseDefinition/cud-int-42-lomitapide"
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{
"reference": "ClinicalUseDefinition/cud-int-43-eletriptan-ubrogepant"
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{
"reference": "ClinicalUseDefinition/cud-int-44-rimegepant"
},
{
"reference": "ClinicalUseDefinition/cud-int-45-finerenone"
},
{
"reference": "ClinicalUseDefinition/cud-int-46-darifenacin"
},
{
"reference": "ClinicalUseDefinition/cud-int-47-fentanyl-hydrocodone-oxycodone-meperidine-methad"
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{
"reference": "ClinicalUseDefinition/cud-int-48-suvorexant-aripiprazole-brexpiprazole-cariprazin"
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{
"reference": "ClinicalUseDefinition/cud-int-49-suzetrigine"
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{
"reference": "ClinicalUseDefinition/cud-int-50-sildenafil"
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{
"reference": "ClinicalUseDefinition/cud-int-51-tadalafil-riociguat"
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{
"reference": "ClinicalUseDefinition/cud-int-52-avanafil-sildenafil-tadalafil-vardenafil"
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{
"reference": "ClinicalUseDefinition/cud-int-53-naloxegol"
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{
"reference": "ClinicalUseDefinition/cud-int-54-triazolam-oral-midazolama"
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{
"reference": "ClinicalUseDefinition/cud-int-55-buspirone-clorazepate-diazepam-estazolam-fluraze"
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{
"reference": "ClinicalUseDefinition/cud-int-56-flibanserin"
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{
"reference": "ClinicalUseDefinition/cud-int-57-tolvaptan"
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{
"reference": "ClinicalUseDefinition/cud-int-58-a-see-section-5-2-drug-interaction-studies-condu"
}
]
},
{
"title": "2.4. Pregnancy and breast-feeding",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2.4",
"display": "2.4. Pregnancy and breast-feeding"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>If you are pregnant, think you may be pregnant or are\n planning to have a baby, ask your doctor for advice before\n taking this medicine.</p>\n <p>There is not enough information to be sure that PAXLOVID is\n safe for use in pregnancy. If you are pregnant, you should\n not take PAXLOVID unless your healthcare professional\n advises that you can. It is recommended that you refrain\n from sexual activity or use contraception while taking\n PAXLOVID and for 7 days after completing PAXLOVID as a\n precaution. If you are taking hormonal contraception, as\n PAXLOVID may reduce the effectiveness of this medicine, it\n is recommended that a condom or other non-hormonal method of\n contraception is used. Your doctor will advise you on the\n duration of this required adjustment of your contraceptive\n measures.</p>\n <p>A small amount of PAXLOVID passes into breast milk. You\n should not breast-feed your baby while taking PAXLOVID and\n for 48 hours after completing PAXLOVID as a precaution.</p>\n </div>"
}
},
{
"title": "2.5. Driving and using machines",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2.5",
"display": "2.5. Driving and using machines"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>PAXLOVID has not been specifically tested for its possible\n effects on the ability to drive and use machines.</p>\n </div>"
}
},
{
"title": "2.6. PAXLOVID contains lactose",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "2.6",
"display": "2.6. PAXLOVID contains lactose"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>If you have been told by your doctor that you have an\n intolerance to some sugars, contact your doctor before\n taking this medicine.</p>\n </div>"
}
}
]
},
{
"title": "3. How to take PAXLOVID",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "3",
"display": "3. How to take PAXLOVID"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Always take this medicine exactly as your doctor or pharmacist\n has told you. Check with your doctor or pharmacist if you are\n not sure.</p>\n <p>PAXLOVID consists of 2 medicines: nirmatrelvir and ritonavir. A\n course of treatment lasts 5 days.</p>\n <p>Swallow the tablets whole. Do not chew, break or crush the\n tablets. PAXLOVID can be taken with or without meals.</p>\n <p>\n <b>Recommended dose</b>\n </p>\n <p><b>No kidney disease or mild kidney disease</b><br/>If you have\n NO kidney disease or MILD kidney disease, the recommended dose\n is 2 pink nirmatrelvir tablets with 1 white ritonavir tablet by\n mouth twice daily (in the morning and in the evening) for 5\n days.</p>\n <p><b>Moderate kidney disease</b><br/>If you have MODERATE kidney\n disease, the recommended dose is 1 pink nirmatrelvir tablet with\n 1 white ritonavir tablet by mouth twice daily (in the morning\n and in the evening) for 5 days.<br/><i>Note: The pack you\n receive may contain more nirmatrelvir and ritonavir tablets than\n you need.</i></p>\n <p><b>Severe kidney disease</b><br/>If you have SEVERE kidney\n disease, the recommended dose is 2 pink nirmatrelvir tablets\n with 1 white ritonavir tablet by mouth once on Day 1, and then 1\n pink nirmatrelvir tablet with 1 white ritonavir tablet once\n daily on Days 2 to 5.<br/><i>Note: The pack you receive may\n contain more nirmatrelvir and ritonavir tablets than you need.</i></p>\n <p><b>If you take more PAXLOVID than you should</b><br/>If you take\n too much PAXLOVID, call your healthcare provider or go to the\n nearest hospital emergency room right away.</p>\n <p><b>If you forget to take PAXLOVID</b><br/>If you miss a dose of\n PAXLOVID within 8 hours of the time it is usually taken, take it\n as soon as you remember. If you miss a dose by more than 8\n hours, skip the missed dose and take the next dose at your\n regular time. Do not take 2 doses of PAXLOVID at the same time.\n Do not take a double dose to make up for a forgotten dose.</p>\n <p><b>If you stop taking PAXLOVID</b><br/>Even if you feel better,\n do not stop taking PAXLOVID without talking to your doctor.</p>\n <p>If you have any further questions on the use of this medicine,\n ask your doctor or pharmacist.</p>\n </div>"
},
"entry": [
{
"reference": "MedicationKnowledge/mk-paxlovid"
}
]
},
{
"title": "4. Possible side effects",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "4",
"display": "4. Possible side effects"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Like all medicines, this medicine can cause side effects,\n although not everybody gets them.</p>\n <p><b>Common:</b> may affect up to 1 in 10 people</p>\n <ul>\n <li>Altered sense of taste</li>\n <li>Headache</li>\n <li>Diarrhea</li>\n <li>Nausea</li>\n </ul>\n <p><b>Uncommon:</b> may affect up to 1 in 100 people</p>\n <ul>\n <li>Allergic reactions (such as itching or skin rash)</li>\n <li>Increased blood pressure</li>\n <li>Vomiting</li>\n <li>Abdominal pain</li>\n </ul>\n <p><b>Rare:</b> may affect up to 1 in 1,000 people</p>\n <ul>\n <li>Severe allergic reaction known as ‘anaphylaxis’ (such as\n swelling of tongue, mouth and face, trouble swallowing or\n breathing, throat tightness, or hoarseness)</li>\n <li>Feeling generally unwell</li>\n <li>Serious skin reaction with flu-like symptoms and painful\n rash or blisters affecting the skin, mouth, eyes and\n genitals (Stevens-Johnson syndrome and toxic epidermal\n necrosis)</li>\n </ul>\n <p><b>Reporting of side effects</b><br/>If you get any side\n effects, talk to your doctor or pharmacist. This includes any\n possible side effects not listed in this leaflet. By reporting\n side effects, you can help provide more information on the\n safety of this medicine.</p>\n </div>"
},
"entry": [
{
"reference": "ClinicalUseDefinition/cud-ae-01-hypersensitivity"
},
{
"reference": "ClinicalUseDefinition/cud-ae-02-anaphylaxis"
},
{
"reference": "ClinicalUseDefinition/cud-ae-03-dysgeusiaa-headache"
},
{
"reference": "ClinicalUseDefinition/cud-ae-04-hypertension"
},
{
"reference": "ClinicalUseDefinition/cud-ae-05-diarrheaa-nausea"
},
{
"reference": "ClinicalUseDefinition/cud-ae-06-vomitinga-abdominal-pain"
},
{
"reference": "ClinicalUseDefinition/cud-ae-07-toxic-epidermal-necrolysis-stevens-johnson-syndr"
},
{
"reference": "ClinicalUseDefinition/cud-ae-08-malaise"
},
{
"reference": "ClinicalUseDefinition/cud-ae-09-adverse-drug-reaction-adr-identified-post-market"
},
{
"reference": "ClinicalUseDefinition/cud-ae-10-adverse-drug-reaction-adr-identified-post-market"
},
{
"reference": "ClinicalUseDefinition/cud-ae-11-adverse-drug-reaction-adr-identified-post-market"
},
{
"reference": "ClinicalUseDefinition/cud-ae-12-adverse-drug-reaction-adr-identified-post-market"
},
{
"reference": "ClinicalUseDefinition/cud-ae-13-adverse-drug-reaction-adr-identified-post-market"
},
{
"reference": "ClinicalUseDefinition/cud-ae-14-adverse-drug-reaction-adr-identified-post-market"
}
]
},
{
"title": "5. How to store PAXLOVID",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "5",
"display": "5. How to store PAXLOVID"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Keep this medicine out of the sight and reach of children.</p>\n <p>Do not use this medicine after the expiry date which is stated on\n the carton or the blister after ‘EXP’. The expiry date refers to\n the last day of that month.</p>\n <p>Store at or below 30°C. Do not refrigerate or freeze.</p>\n <p>Do not throw away any medicines via wastewater or household\n waste. Ask your pharmacist how to throw away medicines you no\n longer use. These measures will help protect the environment.</p>\n </div>"
}
},
{
"title": "6. Contents of the pack and other information",
"code": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/section-code",
"code": "6",
"display": "6. Contents of the pack and other information"
}
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>\n <b>What PAXLOVID contains</b>\n </p>\n <ul>\n <li>The active substances in this medicine are nirmatrelvir and\n ritonavir.</li>\n <li>Each pink film-coated nirmatrelvir tablet contains 150 mg of\n nirmatrelvir.</li>\n <li>Each white to off white film-coated ritonavir tablet\n contains 100 mg of ritonavir.</li>\n <li>The other ingredients in the nirmatrelvir tablet are\n colloidal silicon dioxide; croscarmellose sodium; lactose\n monohydrate (see section 2, ‘PAXLOVID contains lactose’);\n microcrystalline cellulose and sodium stearyl fumarate. The\n film-coating contains hydroxy propyl methylcellulose; iron\n oxide red; polyethylene glycol and titanium dioxide.</li>\n <li>The other ingredients in the Hetero Ritonavir tablet are\n copovidone; sorbitan laurate; silica, colloidal anhydrous\n (E551); calcium hydrogen phosphate and sodium stearyl\n fumarate. The film coating contains hypromellose (E464);\n titanium dioxide (E171); macrogol (E1521); hydroxypropyl\n cellulose (E463); talc (E553b); silica, colloidal anhydrous\n (E551) and polysorbate 80 (E433).</li>\n </ul>\n <p><b>What PAXLOVID looks like and contents of the pack</b><br/>PAXLOVID\n film-coated tablets are available in 5 daily-dose blister cards\n with a total of 30 tablets packaged in a carton. Each daily\n blister card contains 4 nirmatrelvir tablets (150 mg each) and 2\n ritonavir tablets (100 mg each) and indicates which tablets need\n to be taken in the morning and evening (sun and moon symbols).</p>\n <p>Nirmatrelvir 150 mg film-coated tablets are pink, oval-shaped and\n debossed with ‘PFE’ on one side and ‘3CL’ on the other side.\n Hetero Ritonavir 100 mg film-coated tablets are white to off\n white, capsule shaped and debossed with ‘H’ on one side and ‘R9’\n on the other side.</p>\n <p><b>Product owner:</b> Pfizer Inc., New York, United States.</p>\n <p>PAXH-SIN-0126/PIL/0<br/>Date of last revision: January 2026</p>\n </div>"
},
"entry": [
{
"reference": "Ingredient/ingr-nirmatrelvir"
},
{
"reference": "Ingredient/ingr-ritonavir"
},
{
"reference": "Ingredient/ingr-exc-colloidal-silicon-dioxide"
},
{
"reference": "Ingredient/ingr-exc-croscarmellose-sodium"
},
{
"reference": "Ingredient/ingr-exc-lactose-monohydrate"
},
{
"reference": "Ingredient/ingr-exc-microcrystalline-cellulose"
},
{
"reference": "Ingredient/ingr-exc-sodium-stearyl-fumarate"
},
{
"reference": "Ingredient/ingr-exc-hydroxy-propyl-methylcellulose"
},
{
"reference": "Ingredient/ingr-exc-iron-oxide-red"
},
{
"reference": "Ingredient/ingr-exc-polyethylene-glycol"
},
{
"reference": "Ingredient/ingr-exc-titanium-dioxide"
},
{
"reference": "Ingredient/ingr-exc-copovidone"
},
{
"reference": "Ingredient/ingr-exc-sorbitan-laurate"
},
{
"reference": "Ingredient/ingr-exc-silica-colloidal-anhydrous-e551"
},
{
"reference": "Ingredient/ingr-exc-calcium-hydrogen-phosphate"
},
{
"reference": "Ingredient/ingr-exc-hypromellose-e464"
},
{
"reference": "Ingredient/ingr-exc-titanium-dioxide-e171"
},
{
"reference": "Ingredient/ingr-exc-macrogol-e1521"
},
{
"reference": "Ingredient/ingr-exc-hydroxypropyl-cellulose-e463"
},
{
"reference": "Ingredient/ingr-exc-talc-e553b"
},
{
"reference": "Ingredient/ingr-exc-polysorbate-80-e433"
},
{
"reference": "ManufacturedItemDefinition/mid-nirmatrelvir"
},
{
"reference": "ManufacturedItemDefinition/mid-ritonavir"
},
{
"reference": "PackagedProductDefinition/ppd-paxlovid"
}
]
}
]
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Organization/org-owner",
"resource": {
"resourceType": "Organization",
"id": "org-owner",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_org-owner\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization org-owner</b></p><a name=\"org-owner\"> </a><a name=\"hcorg-owner\"> </a><p><b>identifier</b>: <code>https://www.hsa.gov.sg/epi/organisation</code>/PFIZER-INC</p><p><b>active</b>: true</p><p><b>name</b>: Pfizer Inc.</p><h3>Contacts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Address</b></td></tr><tr><td style=\"display: none\">*</td><td>New York United States </td></tr></table></div>"
},
"identifier": [
{
"system": "https://www.hsa.gov.sg/epi/organisation",
"value": "PFIZER-INC"
}
],
"active": true,
"name": "Pfizer Inc.",
"contact": [
{
"address": {
"city": "New York",
"country": "United States"
}
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/MedicinalProductDefinition/mpd-paxlovid",
"resource": {
"resourceType": "MedicinalProductDefinition",
"id": "mpd-paxlovid",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicinalProductDefinition_mpd-paxlovid\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicinalProductDefinition mpd-paxlovid</b></p><a name=\"mpd-paxlovid\"> </a><a name=\"hcmpd-paxlovid\"> </a><p><b>identifier</b>: <code>https://www.hsa.gov.sg/epi/registration-number</code>/PAXH-SIN-0126</p><p><b>combinedPharmaceuticalDoseForm</b>: <span title=\"Codes:{https://standardterms.edqm.eu 10221000}\">Film-coated tablet</span></p><p><b>route</b>: <span title=\"Codes:{https://standardterms.edqm.eu 20053000}\">Oral use</span></p><blockquote><p><b>name</b></p><p><b>productName</b>: PAXLOVID</p><blockquote><p><b>part</b></p><p><b>part</b>: PAXLOVID</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/medicinal-product-name-part-type InventedNamePart}\">Invented name part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: nirmatrelvir/ritonavir</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/medicinal-product-name-part-type NonproprietaryNamePart}\">Nonproprietary name part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: 150 mg/100 mg</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/medicinal-product-name-part-type StrengthPart}\">Strength part</span></p></blockquote><blockquote><p><b>part</b></p><p><b>part</b>: film-coated tablets</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/medicinal-product-name-part-type DoseFormPart}\">Pharmaceutical dose form part</span></p></blockquote><h3>Usages</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Country</b></td><td><b>Jurisdiction</b></td><td><b>Language</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{urn:iso:std:iso:3166 SG}\">Singapore</span></td><td><span title=\"Codes:{urn:iso:std:iso:3166 SG}\">Singapore</span></td><td><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span></td></tr></table></blockquote></div>"
},
"identifier": [
{
"system": "https://www.hsa.gov.sg/epi/registration-number",
"value": "PAXH-SIN-0126"
}
],
"combinedPharmaceuticalDoseForm": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "10221000",
"display": "Film-coated tablet"
}
]
},
"route": [
{
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "20053000",
"display": "Oral use"
}
]
}
],
"name": [
{
"productName": "PAXLOVID",
"part": [
{
"part": "PAXLOVID",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/medicinal-product-name-part-type",
"code": "InventedNamePart",
"display": "Invented name part"
}
]
}
},
{
"part": "nirmatrelvir/ritonavir",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/medicinal-product-name-part-type",
"code": "NonproprietaryNamePart",
"display": "Nonproprietary name part"
}
]
}
},
{
"part": "150 mg/100 mg",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/medicinal-product-name-part-type",
"code": "StrengthPart",
"display": "Strength part"
}
]
}
},
{
"part": "film-coated tablets",
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/medicinal-product-name-part-type",
"code": "DoseFormPart",
"display": "Pharmaceutical dose form part"
}
]
}
}
],
"usage": [
{
"country": {
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "SG",
"display": "Singapore"
}
]
},
"jurisdiction": {
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "SG",
"display": "Singapore"
}
]
},
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en",
"display": "English"
}
]
}
}
]
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/RegulatedAuthorization/regauth-paxlovid",
"resource": {
"resourceType": "RegulatedAuthorization",
"id": "regauth-paxlovid",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RegulatedAuthorization_regauth-paxlovid\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RegulatedAuthorization regauth-paxlovid</b></p><a name=\"regauth-paxlovid\"> </a><a name=\"hcregauth-paxlovid\"> </a><p><b>identifier</b>: <code>https://www.hsa.gov.sg/epi/registration-number</code>/PAXH-SIN-0126 (draft — HSA to confirm)</p><p><b>subject</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>status</b>: <span title=\"Codes:{http://hl7.org/fhir/publication-status active}\">Active</span></p><p><b>holder</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#Organization_org-owner\">Organization Pfizer Inc.</a></p></div>"
},
"identifier": [
{
"system": "https://www.hsa.gov.sg/epi/registration-number",
"value": "PAXH-SIN-0126 (draft — HSA to confirm)"
}
],
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"status": {
"coding": [
{
"system": "http://hl7.org/fhir/publication-status",
"code": "active"
}
]
},
"holder": {
"reference": "Organization/org-owner"
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/SubstanceDefinition/subd-nirmatrelvir",
"resource": {
"resourceType": "SubstanceDefinition",
"id": "subd-nirmatrelvir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"SubstanceDefinition_subd-nirmatrelvir\"> </a><p class=\"res-header-id\"><b>Generated Narrative: SubstanceDefinition subd-nirmatrelvir</b></p><a name=\"subd-nirmatrelvir\"> </a><a name=\"hcsubd-nirmatrelvir\"> </a><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://fdasis.nlm.nih.gov 7R9A5P7H32}\">Nirmatrelvir</span></td></tr></table><h3>Names</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td>Nirmatrelvir</td></tr></table></div>"
},
"code": [
{
"code": {
"coding": [
{
"system": "http://fdasis.nlm.nih.gov",
"code": "7R9A5P7H32",
"display": "Nirmatrelvir"
}
]
}
}
],
"name": [
{
"name": "Nirmatrelvir"
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/SubstanceDefinition/subd-ritonavir",
"resource": {
"resourceType": "SubstanceDefinition",
"id": "subd-ritonavir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"SubstanceDefinition_subd-ritonavir\"> </a><p class=\"res-header-id\"><b>Generated Narrative: SubstanceDefinition subd-ritonavir</b></p><a name=\"subd-ritonavir\"> </a><a name=\"hcsubd-ritonavir\"> </a><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://fdasis.nlm.nih.gov O3J8G9O825}\">Ritonavir</span></td></tr></table><h3>Names</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td>Ritonavir</td></tr></table></div>"
},
"code": [
{
"code": {
"coding": [
{
"system": "http://fdasis.nlm.nih.gov",
"code": "O3J8G9O825",
"display": "Ritonavir"
}
]
}
}
],
"name": [
{
"name": "Ritonavir"
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/SubstanceDefinition/subd-lactose",
"resource": {
"resourceType": "SubstanceDefinition",
"id": "subd-lactose",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"SubstanceDefinition_subd-lactose\"> </a><p class=\"res-header-id\"><b>Generated Narrative: SubstanceDefinition subd-lactose</b></p><a name=\"subd-lactose\"> </a><a name=\"hcsubd-lactose\"> </a><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://fdasis.nlm.nih.gov EWQ57Q8I5X}\">Lactose monohydrate</span></td></tr></table><h3>Names</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td>Lactose monohydrate</td></tr></table></div>"
},
"code": [
{
"code": {
"coding": [
{
"system": "http://fdasis.nlm.nih.gov",
"code": "EWQ57Q8I5X",
"display": "Lactose monohydrate"
}
]
}
}
],
"name": [
{
"name": "Lactose monohydrate"
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-nirmatrelvir",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-nirmatrelvir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-nirmatrelvir\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-nirmatrelvir</b></p><a name=\"ingr-nirmatrelvir\"> </a><a name=\"hcingr-nirmatrelvir\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role active}\">active</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/substance subd-nirmatrelvir}\">Nirmatrelvir</span></td></tr></table><h3>Strengths</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Presentation[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>150 mg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codemg = 'mg')</span>/1 film-coated tablet<span style=\"background: LightGoldenRodYellow\"> (Details: standardterms.edqm.eu code10221000 = '10221000')</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "active"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/substance",
"code": "subd-nirmatrelvir",
"display": "Nirmatrelvir"
}
]
}
},
"strength": [
{
"presentationRatio": {
"numerator": {
"value": 150,
"unit": "mg",
"system": "http://unitsofmeasure.org",
"code": "mg"
},
"denominator": {
"value": 1,
"unit": "film-coated tablet",
"system": "https://standardterms.edqm.eu",
"code": "10221000"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-ritonavir",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-ritonavir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-ritonavir\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-ritonavir</b></p><a name=\"ingr-ritonavir\"> </a><a name=\"hcingr-ritonavir\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role active}\">active</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/substance subd-ritonavir}\">Ritonavir</span></td></tr></table><h3>Strengths</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Presentation[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>100 mg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codemg = 'mg')</span>/1 film-coated tablet<span style=\"background: LightGoldenRodYellow\"> (Details: standardterms.edqm.eu code10221000 = '10221000')</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "active"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/substance",
"code": "subd-ritonavir",
"display": "Ritonavir"
}
]
}
},
"strength": [
{
"presentationRatio": {
"numerator": {
"value": 100,
"unit": "mg",
"system": "http://unitsofmeasure.org",
"code": "mg"
},
"denominator": {
"value": 1,
"unit": "film-coated tablet",
"system": "https://standardterms.edqm.eu",
"code": "10221000"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-lactose",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-lactose",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-lactose\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-lactose</b></p><a name=\"ingr-lactose\"> </a><a name=\"hcingr-lactose\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/substance subd-lactose}\">Lactose monohydrate</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/substance",
"code": "subd-lactose",
"display": "Lactose monohydrate"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-colloidal-silicon-dioxide",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-colloidal-silicon-dioxide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-colloidal-silicon-dioxide\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-colloidal-silicon-dioxide</b></p><a name=\"ingr-exc-colloidal-silicon-dioxide\"> </a><a name=\"hcingr-exc-colloidal-silicon-dioxide\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance colloidal-silicon-dioxide}\">Colloidal silicon dioxide</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "colloidal-silicon-dioxide",
"display": "Colloidal silicon dioxide"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-croscarmellose-sodium",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-croscarmellose-sodium",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-croscarmellose-sodium\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-croscarmellose-sodium</b></p><a name=\"ingr-exc-croscarmellose-sodium\"> </a><a name=\"hcingr-exc-croscarmellose-sodium\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance croscarmellose-sodium}\">Croscarmellose sodium</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "croscarmellose-sodium",
"display": "Croscarmellose sodium"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-lactose-monohydrate",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-lactose-monohydrate",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-lactose-monohydrate\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-lactose-monohydrate</b></p><a name=\"ingr-exc-lactose-monohydrate\"> </a><a name=\"hcingr-exc-lactose-monohydrate\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance lactose-monohydrate}\">Lactose monohydrate</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lactose-monohydrate",
"display": "Lactose monohydrate"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-microcrystalline-cellulose",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-microcrystalline-cellulose",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-microcrystalline-cellulose\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-microcrystalline-cellulose</b></p><a name=\"ingr-exc-microcrystalline-cellulose\"> </a><a name=\"hcingr-exc-microcrystalline-cellulose\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance microcrystalline-cellulose}\">Microcrystalline cellulose</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "microcrystalline-cellulose",
"display": "Microcrystalline cellulose"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-sodium-stearyl-fumarate",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-sodium-stearyl-fumarate",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-sodium-stearyl-fumarate\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-sodium-stearyl-fumarate</b></p><a name=\"ingr-exc-sodium-stearyl-fumarate\"> </a><a name=\"hcingr-exc-sodium-stearyl-fumarate\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance sodium-stearyl-fumarate}\">Sodium stearyl fumarate</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "sodium-stearyl-fumarate",
"display": "Sodium stearyl fumarate"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-hydroxy-propyl-methylcellulose",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-hydroxy-propyl-methylcellulose",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-hydroxy-propyl-methylcellulose\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-hydroxy-propyl-methylcellulose</b></p><a name=\"ingr-exc-hydroxy-propyl-methylcellulose\"> </a><a name=\"hcingr-exc-hydroxy-propyl-methylcellulose\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance hydroxy-propyl-methylcellulose}\">Hydroxy propyl methylcellulose</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "hydroxy-propyl-methylcellulose",
"display": "Hydroxy propyl methylcellulose"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-iron-oxide-red",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-iron-oxide-red",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-iron-oxide-red\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-iron-oxide-red</b></p><a name=\"ingr-exc-iron-oxide-red\"> </a><a name=\"hcingr-exc-iron-oxide-red\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance iron-oxide-red}\">Iron oxide red</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "iron-oxide-red",
"display": "Iron oxide red"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-polyethylene-glycol",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-polyethylene-glycol",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-polyethylene-glycol\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-polyethylene-glycol</b></p><a name=\"ingr-exc-polyethylene-glycol\"> </a><a name=\"hcingr-exc-polyethylene-glycol\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance polyethylene-glycol}\">Polyethylene glycol</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "polyethylene-glycol",
"display": "Polyethylene glycol"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-titanium-dioxide",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-titanium-dioxide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-titanium-dioxide\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-titanium-dioxide</b></p><a name=\"ingr-exc-titanium-dioxide\"> </a><a name=\"hcingr-exc-titanium-dioxide\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance titanium-dioxide}\">Titanium dioxide</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "titanium-dioxide",
"display": "Titanium dioxide"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-copovidone",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-copovidone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-copovidone\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-copovidone</b></p><a name=\"ingr-exc-copovidone\"> </a><a name=\"hcingr-exc-copovidone\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance copovidone}\">Copovidone</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "copovidone",
"display": "Copovidone"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-sorbitan-laurate",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-sorbitan-laurate",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-sorbitan-laurate\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-sorbitan-laurate</b></p><a name=\"ingr-exc-sorbitan-laurate\"> </a><a name=\"hcingr-exc-sorbitan-laurate\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance sorbitan-laurate}\">Sorbitan laurate</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "sorbitan-laurate",
"display": "Sorbitan laurate"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-silica-colloidal-anhydrous-e551",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-silica-colloidal-anhydrous-e551",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-silica-colloidal-anhydrous-e551\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-silica-colloidal-anhydrous-e551</b></p><a name=\"ingr-exc-silica-colloidal-anhydrous-e551\"> </a><a name=\"hcingr-exc-silica-colloidal-anhydrous-e551\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance silica-colloidal-anhydrous-e551}\">Silica, colloidal anhydrous (E551)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "silica-colloidal-anhydrous-e551",
"display": "Silica, colloidal anhydrous (E551)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-calcium-hydrogen-phosphate",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-calcium-hydrogen-phosphate",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-calcium-hydrogen-phosphate\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-calcium-hydrogen-phosphate</b></p><a name=\"ingr-exc-calcium-hydrogen-phosphate\"> </a><a name=\"hcingr-exc-calcium-hydrogen-phosphate\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance calcium-hydrogen-phosphate}\">Calcium hydrogen phosphate</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "calcium-hydrogen-phosphate",
"display": "Calcium hydrogen phosphate"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-hypromellose-e464",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-hypromellose-e464",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-hypromellose-e464\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-hypromellose-e464</b></p><a name=\"ingr-exc-hypromellose-e464\"> </a><a name=\"hcingr-exc-hypromellose-e464\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance hypromellose-e464}\">Hypromellose (E464)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "hypromellose-e464",
"display": "Hypromellose (E464)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-titanium-dioxide-e171",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-titanium-dioxide-e171",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-titanium-dioxide-e171\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-titanium-dioxide-e171</b></p><a name=\"ingr-exc-titanium-dioxide-e171\"> </a><a name=\"hcingr-exc-titanium-dioxide-e171\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance titanium-dioxide-e171}\">Titanium dioxide (E171)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "titanium-dioxide-e171",
"display": "Titanium dioxide (E171)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-macrogol-e1521",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-macrogol-e1521",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-macrogol-e1521\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-macrogol-e1521</b></p><a name=\"ingr-exc-macrogol-e1521\"> </a><a name=\"hcingr-exc-macrogol-e1521\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance macrogol-e1521}\">Macrogol (E1521)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "macrogol-e1521",
"display": "Macrogol (E1521)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-hydroxypropyl-cellulose-e463",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-hydroxypropyl-cellulose-e463",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-hydroxypropyl-cellulose-e463\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-hydroxypropyl-cellulose-e463</b></p><a name=\"ingr-exc-hydroxypropyl-cellulose-e463\"> </a><a name=\"hcingr-exc-hydroxypropyl-cellulose-e463\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance hydroxypropyl-cellulose-e463}\">Hydroxypropyl cellulose (E463)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "hydroxypropyl-cellulose-e463",
"display": "Hydroxypropyl cellulose (E463)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-talc-e553b",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-talc-e553b",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-talc-e553b\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-talc-e553b</b></p><a name=\"ingr-exc-talc-e553b\"> </a><a name=\"hcingr-exc-talc-e553b\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance talc-e553b}\">Talc (E553b)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "talc-e553b",
"display": "Talc (E553b)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/Ingredient/ingr-exc-polysorbate-80-e433",
"resource": {
"resourceType": "Ingredient",
"id": "ingr-exc-polysorbate-80-e433",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Ingredient_ingr-exc-polysorbate-80-e433\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Ingredient ingr-exc-polysorbate-80-e433</b></p><a name=\"ingr-exc-polysorbate-80-e433\"> </a><a name=\"hcingr-exc-polysorbate-80-e433\"> </a><p><b>status</b>: Active</p><p><b>for</b>: <a href=\"Bundle-paxlovid-sgp-pil-epi.html#MedicinalProductDefinition_mpd-paxlovid\">MedicinalProductDefinition: identifier = https://www.hsa.gov.sg/epi/registration-number#PAXH-SIN-0126; combinedPharmaceuticalDoseForm = Film-coated tablet; route = Oral use</a></p><p><b>role</b>: <span title=\"Codes:{http://hl7.org/fhir/ingredient-role excipient}\">excipient</span></p><blockquote><p><b>substance</b></p><h3>Codes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Concept</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.hsa.gov.sg/epi/draft-substance polysorbate-80-e433}\">Polysorbate 80 (E433)</span></td></tr></table></blockquote></div>"
},
"status": "active",
"for": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/ingredient-role",
"code": "excipient"
}
]
},
"substance": {
"code": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "polysorbate-80-e433",
"display": "Polysorbate 80 (E433)"
}
]
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ManufacturedItemDefinition/mid-nirmatrelvir",
"resource": {
"resourceType": "ManufacturedItemDefinition",
"id": "mid-nirmatrelvir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ManufacturedItemDefinition_mid-nirmatrelvir\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ManufacturedItemDefinition mid-nirmatrelvir</b></p><a name=\"mid-nirmatrelvir\"> </a><a name=\"hcmid-nirmatrelvir\"> </a><p><b>status</b>: Active</p><p><b>name</b>: Nirmatrelvir 150 mg film-coated tablet</p><p><b>manufacturedDoseForm</b>: <span title=\"Codes:{https://standardterms.edqm.eu 10221000}\">Film-coated tablet</span></p><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig color}\">Color</span></p><p><b>value</b>: <span title=\"Codes:\">Pink</span></p></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig shape}\">Shape</span></p><p><b>value</b>: <span title=\"Codes:\">Oval</span></p></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig size}\">Size</span></p><p><b>value</b>: </p><div><p>Approximately 17.6 mm in length and 8.6 mm in width</p>\n</div></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig imprint}\">Imprint</span></p><p><b>value</b>: </p><div><p>Debossed with ‘PFE’ on one side and ‘3CL’ on the other side</p>\n</div></blockquote></div>"
},
"status": "active",
"name": "Nirmatrelvir 150 mg film-coated tablet",
"manufacturedDoseForm": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "10221000",
"display": "Film-coated tablet"
}
]
},
"property": [
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "color",
"display": "Color"
}
]
},
"valueCodeableConcept": {
"text": "Pink"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "shape",
"display": "Shape"
}
]
},
"valueCodeableConcept": {
"text": "Oval"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "size",
"display": "Size"
}
]
},
"valueMarkdown": "Approximately 17.6 mm in length and 8.6 mm in width"
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "imprint",
"display": "Imprint"
}
]
},
"valueMarkdown": "Debossed with ‘PFE’ on one side and ‘3CL’ on the other side"
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ManufacturedItemDefinition/mid-ritonavir",
"resource": {
"resourceType": "ManufacturedItemDefinition",
"id": "mid-ritonavir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ManufacturedItemDefinition_mid-ritonavir\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ManufacturedItemDefinition mid-ritonavir</b></p><a name=\"mid-ritonavir\"> </a><a name=\"hcmid-ritonavir\"> </a><p><b>status</b>: Active</p><p><b>name</b>: Ritonavir 100 mg film-coated tablet</p><p><b>manufacturedDoseForm</b>: <span title=\"Codes:{https://standardterms.edqm.eu 10221000}\">Film-coated tablet</span></p><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig color}\">Color</span></p><p><b>value</b>: <span title=\"Codes:\">White to off white</span></p></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig shape}\">Shape</span></p><p><b>value</b>: <span title=\"Codes:\">Capsule shaped</span></p></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig imprint}\">Imprint</span></p><p><b>value</b>: </p><div><p>Debossed with ‘H’ on one side and ‘R9’ on the other side</p>\n</div></blockquote></div>"
},
"status": "active",
"name": "Ritonavir 100 mg film-coated tablet",
"manufacturedDoseForm": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "10221000",
"display": "Film-coated tablet"
}
]
},
"property": [
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "color",
"display": "Color"
}
]
},
"valueCodeableConcept": {
"text": "White to off white"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "shape",
"display": "Shape"
}
]
},
"valueCodeableConcept": {
"text": "Capsule shaped"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "imprint",
"display": "Imprint"
}
]
},
"valueMarkdown": "Debossed with ‘H’ on one side and ‘R9’ on the other side"
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/AdministrableProductDefinition/apd-paxlovid",
"resource": {
"resourceType": "AdministrableProductDefinition",
"id": "apd-paxlovid",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"AdministrableProductDefinition_apd-paxlovid\"> </a><p class=\"res-header-id\"><b>Generated Narrative: AdministrableProductDefinition apd-paxlovid</b></p><a name=\"apd-paxlovid\"> </a><a name=\"hcapd-paxlovid\"> </a><p><b>status</b>: Active</p><p><b>administrableDoseForm</b>: <span title=\"Codes:{https://standardterms.edqm.eu 10221000}\">Film-coated tablet</span></p><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig color}\">Color</span></p><p><b>value</b>: <span title=\"Codes:\">Pink (nirmatrelvir tablet); white to off white (ritonavir tablet)</span></p></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig shape}\">Shape</span></p><p><b>value</b>: <span title=\"Codes:\">Oval (nirmatrelvir tablet); capsule shaped (ritonavir tablet)</span></p></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig size}\">Size</span></p><p><b>value</b>: </p><div><p>Nirmatrelvir tablet approximately 17.6 mm in length and 8.6 mm in width</p>\n</div></blockquote><blockquote><p><b>property</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig imprint}\">Imprint</span></p><p><b>value</b>: </p><div><p>Nirmatrelvir tablet debossed ‘PFE’/‘3CL’; ritonavir tablet debossed ‘H’/‘R9’</p>\n</div></blockquote><h3>RouteOfAdministrations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://standardterms.edqm.eu 20053000}\">Oral use</span></td></tr></table></div>"
},
"status": "active",
"administrableDoseForm": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "10221000",
"display": "Film-coated tablet"
}
]
},
"property": [
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "color",
"display": "Color"
}
]
},
"valueCodeableConcept": {
"text": "Pink (nirmatrelvir tablet); white to off white (ritonavir tablet)"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "shape",
"display": "Shape"
}
]
},
"valueCodeableConcept": {
"text": "Oval (nirmatrelvir tablet); capsule shaped (ritonavir tablet)"
}
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "size",
"display": "Size"
}
]
},
"valueMarkdown": "Nirmatrelvir tablet approximately 17.6 mm in length and 8.6 mm in width"
},
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/emedicinal-product-info/CodeSystem/epi-ig",
"code": "imprint",
"display": "Imprint"
}
]
},
"valueMarkdown": "Nirmatrelvir tablet debossed ‘PFE’/‘3CL’; ritonavir tablet debossed ‘H’/‘R9’"
}
],
"routeOfAdministration": [
{
"code": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "20053000",
"display": "Oral use"
}
]
}
}
]
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/PackagedProductDefinition/ppd-paxlovid",
"resource": {
"resourceType": "PackagedProductDefinition",
"id": "ppd-paxlovid",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PackagedProductDefinition_ppd-paxlovid\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PackagedProductDefinition ppd-paxlovid</b></p><a name=\"ppd-paxlovid\"> </a><a name=\"hcppd-paxlovid\"> </a><p><b>name</b>: PAXLOVID film-coated tablets — daily-dose co-pack (nirmatrelvir + ritonavir)</p><h3>Packagings</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://standardterms.edqm.eu 30007000}\">Carton</span></td><td>30</td></tr></table></div>"
},
"name": "PAXLOVID film-coated tablets — daily-dose co-pack (nirmatrelvir + ritonavir)",
"packaging": {
"quantity": 30,
"type": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "30007000",
"display": "Carton"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ind-1",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ind-1",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ind-1\"> </a>\n <p>Treatment of mild-to-moderate COVID-19 in adults at high risk of\n progression to severe disease.</p>\n </div>"
},
"type": "indication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"indication": {
"diseaseSymptomProcedure": {
"concept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "840539006",
"display": "Disease caused by SARS-CoV-2"
}
],
"text": "Mild-to-moderate COVID-19 in adults at high risk for progression to severe COVID-19"
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-hypersensitivity",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-hypersensitivity",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-hypersensitivity\"> </a>\n <p>Contraindicated in clinically significant hypersensitivity to\n nirmatrelvir or ritonavir or any excipient.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"diseaseSymptomProcedure": {
"concept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "473011001",
"display": "Allergic condition"
}
],
"text": "Hypersensitivity to the active substances (nirmatrelvir/ritonavir) or excipients"
}
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-01-alfuzosin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-01-alfuzosin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-01-alfuzosin\"> </a>\n <p>Co-administration with alfuzosin (Alpha 1-adrenoreceptor antagonist) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "alfuzosin",
"display": "alfuzosin"
}
],
"text": "Alpha 1-adrenoreceptor antagonist: alfuzosin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-02-ranolazine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-02-ranolazine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-02-ranolazine\"> </a>\n <p>Co-administration with ranolazine (Antianginal) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ranolazine",
"display": "ranolazine"
}
],
"text": "Antianginal: ranolazine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-03-amiodarone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-03-amiodarone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-03-amiodarone\"> </a>\n <p>Co-administration with amiodarone (Antiarrhythmic) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "amiodarone",
"display": "amiodarone"
}
],
"text": "Antiarrhythmic: amiodarone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-04-dronedarone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-04-dronedarone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-04-dronedarone\"> </a>\n <p>Co-administration with dronedarone (Antiarrhythmic) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "dronedarone",
"display": "dronedarone"
}
],
"text": "Antiarrhythmic: dronedarone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-05-flecainide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-05-flecainide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-05-flecainide\"> </a>\n <p>Co-administration with flecainide (Antiarrhythmic) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "flecainide",
"display": "flecainide"
}
],
"text": "Antiarrhythmic: flecainide"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-06-propafenone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-06-propafenone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-06-propafenone\"> </a>\n <p>Co-administration with propafenone (Antiarrhythmic) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "propafenone",
"display": "propafenone"
}
],
"text": "Antiarrhythmic: propafenone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-07-quinidine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-07-quinidine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-07-quinidine\"> </a>\n <p>Co-administration with quinidine (Antiarrhythmic) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "quinidine",
"display": "quinidine"
}
],
"text": "Antiarrhythmic: quinidine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-08-colchicine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-08-colchicine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-08-colchicine\"> </a>\n <p>Co-administration with colchicine (Anti-gout) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "colchicine",
"display": "colchicine"
}
],
"text": "Anti-gout: colchicine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-09-lurasidone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-09-lurasidone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-09-lurasidone\"> </a>\n <p>Co-administration with lurasidone (Antipsychotics) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lurasidone",
"display": "lurasidone"
}
],
"text": "Antipsychotics: lurasidone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-10-pimozide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-10-pimozide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-10-pimozide\"> </a>\n <p>Co-administration with pimozide (Antipsychotics) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "pimozide",
"display": "pimozide"
}
],
"text": "Antipsychotics: pimozide"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-11-silodosin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-11-silodosin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-11-silodosin\"> </a>\n <p>Co-administration with silodosin (Benign prostatic hyperplasia agents) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "silodosin",
"display": "silodosin"
}
],
"text": "Benign prostatic hyperplasia agents: silodosin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-12-eplerenone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-12-eplerenone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-12-eplerenone\"> </a>\n <p>Co-administration with eplerenone (Cardiovascular agents) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "eplerenone",
"display": "eplerenone"
}
],
"text": "Cardiovascular agents: eplerenone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-13-ivabradine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-13-ivabradine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-13-ivabradine\"> </a>\n <p>Co-administration with ivabradine (Cardiovascular agents) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ivabradine",
"display": "ivabradine"
}
],
"text": "Cardiovascular agents: ivabradine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-14-dihydroergotamine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-14-dihydroergotamine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-14-dihydroergotamine\"> </a>\n <p>Co-administration with dihydroergotamine (Ergot derivatives) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "dihydroergotamine",
"display": "dihydroergotamine"
}
],
"text": "Ergot derivatives: dihydroergotamine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-15-ergotamine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-15-ergotamine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-15-ergotamine\"> </a>\n <p>Co-administration with ergotamine (Ergot derivatives) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ergotamine",
"display": "ergotamine"
}
],
"text": "Ergot derivatives: ergotamine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-16-methylergonovine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-16-methylergonovine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-16-methylergonovine\"> </a>\n <p>Co-administration with methylergonovine (Ergot derivatives) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "methylergonovine",
"display": "methylergonovine"
}
],
"text": "Ergot derivatives: methylergonovine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-17-lovastatin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-17-lovastatin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-17-lovastatin\"> </a>\n <p>Co-administration with lovastatin (HMG-CoA reductase inhibitors) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lovastatin",
"display": "lovastatin"
}
],
"text": "HMG-CoA reductase inhibitors: lovastatin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-18-simvastatin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-18-simvastatin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-18-simvastatin\"> </a>\n <p>Co-administration with simvastatin (HMG-CoA reductase inhibitors) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "simvastatin",
"display": "simvastatin"
}
],
"text": "HMG-CoA reductase inhibitors: simvastatin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-19-voclosporin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-19-voclosporin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-19-voclosporin\"> </a>\n <p>Co-administration with voclosporin (Immunosuppressants) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "voclosporin",
"display": "voclosporin"
}
],
"text": "Immunosuppressants: voclosporin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-20-lomitapide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-20-lomitapide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-20-lomitapide\"> </a>\n <p>Co-administration with lomitapide (Microsomal triglyceride transfer\n protein inhibitor) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lomitapide",
"display": "lomitapide"
}
],
"text": "Microsomal triglyceride transfer protein inhibitor: lomitapide"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-21-eletriptan",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-21-eletriptan",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-21-eletriptan\"> </a>\n <p>Co-administration with eletriptan (Migraine medications) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "eletriptan",
"display": "eletriptan"
}
],
"text": "Migraine medications: eletriptan"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-22-ubrogepant",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-22-ubrogepant",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-22-ubrogepant\"> </a>\n <p>Co-administration with ubrogepant (Migraine medications) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ubrogepant",
"display": "ubrogepant"
}
],
"text": "Migraine medications: ubrogepant"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-23-finerenone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-23-finerenone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-23-finerenone\"> </a>\n <p>Co-administration with finerenone (Mineralocorticoid receptor\n antagonists) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "finerenone",
"display": "finerenone"
}
],
"text": "Mineralocorticoid receptor antagonists: finerenone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-24-suzetrigine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-24-suzetrigine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-24-suzetrigine\"> </a>\n <p>Co-administration with suzetrigine (Non-opioid analgesic (selective\n blocker of Nav1.8 sodium channels)) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "suzetrigine",
"display": "suzetrigine"
}
],
"text": "Non-opioid analgesic (selective blocker of Nav1.8 sodium channels): suzetrigine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-25-naloxegol",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-25-naloxegol",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-25-naloxegol\"> </a>\n <p>Co-administration with naloxegol (Opioid antagonists) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "naloxegol",
"display": "naloxegol"
}
],
"text": "Opioid antagonists: naloxegol"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-26-sildenafil-when-used-for-pulmonary-arterial-hype",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-26-sildenafil-when-used-for-pulmonary-arterial-hype",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-26-sildenafil-when-used-for-pulmonary-arterial-hype\"> </a>\n <p>Co-administration with sildenafil when used for pulmonary arterial\n hypertension (PAH) (PDE5 inhibitor) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "sildenafil-when-used-for-pulmonary-arterial-hype",
"display": "sildenafil when used for pulmonary arterial hypertension (PAH)"
}
],
"text": "PDE5 inhibitor: sildenafil when used for pulmonary arterial hypertension (PAH)"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-27-triazolam",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-27-triazolam",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-27-triazolam\"> </a>\n <p>Co-administration with triazolam (Sedative/hypnotics) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "triazolam",
"display": "triazolam"
}
],
"text": "Sedative/hypnotics: triazolam"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-28-oral-midazolam",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-28-oral-midazolam",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-28-oral-midazolam\"> </a>\n <p>Co-administration with oral midazolam (Sedative/hypnotics) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "oral-midazolam",
"display": "oral midazolam"
}
],
"text": "Sedative/hypnotics: oral midazolam"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-29-flibanserin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-29-flibanserin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-29-flibanserin\"> </a>\n <p>Co-administration with flibanserin (Serotonin receptor 1A\n agonist/serotonin receptor 2A antagonist) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "flibanserin",
"display": "flibanserin"
}
],
"text": "Serotonin receptor 1A agonist/serotonin receptor 2A antagonist: flibanserin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-30-tolvaptan",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-30-tolvaptan",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-30-tolvaptan\"> </a>\n <p>Co-administration with tolvaptan (Vasopressin receptor antagonists) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "tolvaptan",
"display": "tolvaptan"
}
],
"text": "Vasopressin receptor antagonists: tolvaptan"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-31-apalutamide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-31-apalutamide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-31-apalutamide\"> </a>\n <p>Co-administration with apalutamide (Anticancer drugs) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "apalutamide",
"display": "apalutamide"
}
],
"text": "Anticancer drugs: apalutamide"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-32-enzalutamide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-32-enzalutamide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-32-enzalutamide\"> </a>\n <p>Co-administration with enzalutamide (Anticancer drugs) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "enzalutamide",
"display": "enzalutamide"
}
],
"text": "Anticancer drugs: enzalutamide"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-33-carbamazepine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-33-carbamazepine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-33-carbamazepine\"> </a>\n <p>Co-administration with carbamazepine (Anticonvulsant) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "carbamazepine",
"display": "carbamazepine"
}
],
"text": "Anticonvulsant: carbamazepine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-34-phenobarbital",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-34-phenobarbital",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-34-phenobarbital\"> </a>\n <p>Co-administration with phenobarbital (Anticonvulsant) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "phenobarbital",
"display": "phenobarbital"
}
],
"text": "Anticonvulsant: phenobarbital"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-35-primidone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-35-primidone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-35-primidone\"> </a>\n <p>Co-administration with primidone (Anticonvulsant) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "primidone",
"display": "primidone"
}
],
"text": "Anticonvulsant: primidone"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-36-phenytoin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-36-phenytoin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-36-phenytoin\"> </a>\n <p>Co-administration with phenytoin (Anticonvulsant) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "phenytoin",
"display": "phenytoin"
}
],
"text": "Anticonvulsant: phenytoin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-37-rifampin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-37-rifampin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-37-rifampin\"> </a>\n <p>Co-administration with rifampin (Antimycobacterials) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "rifampin",
"display": "rifampin"
}
],
"text": "Antimycobacterials: rifampin"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-38-rifapentine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-38-rifapentine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-38-rifapentine\"> </a>\n <p>Co-administration with rifapentine (Antimycobacterials) is\n contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "rifapentine",
"display": "rifapentine"
}
],
"text": "Antimycobacterials: rifapentine"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-39-lumacaftor-ivacaftor",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-39-lumacaftor-ivacaftor",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-39-lumacaftor-ivacaftor\"> </a>\n <p>Co-administration with lumacaftor/ivacaftor (Cystic fibrosis\n transmembrane conductance regulator potentiators) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lumacaftor-ivacaftor",
"display": "lumacaftor/ivacaftor"
}
],
"text": "Cystic fibrosis transmembrane conductance regulator potentiators: lumacaftor/ivacaftor"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-contra-40-st-john-s-wort-hypericum-perforatum",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-contra-40-st-john-s-wort-hypericum-perforatum",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-contra-40-st-john-s-wort-hypericum-perforatum\"> </a>\n <p>Co-administration with St. John’s Wort (Hypericum perforatum) (Herbal\n products) is contraindicated.</p>\n </div>"
},
"type": "contraindication",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"contraindication": {
"otherTherapy": [
{
"relationshipType": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-category",
"code": "Contraindicated"
}
]
},
"treatment": {
"concept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "st-john-s-wort-hypericum-perforatum",
"display": "St. John’s Wort (Hypericum perforatum)"
}
],
"text": "Herbal products: St. John’s Wort (Hypericum perforatum)"
}
}
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-01-alfuzosin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-01-alfuzosin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-01-alfuzosin\"> </a>\n <p><b>Alpha 1-adrenoreceptor antagonist</b> (alfuzosin): ↑ alfuzosin.\n Co-administration contraindicated due to potential hypotension (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "alfuzosin",
"display": "alfuzosin"
}
],
"text": "Alpha 1-adrenoreceptor antagonist: alfuzosin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ alfuzosin"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential hypotension (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-02-tamsulosin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-02-tamsulosin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-02-tamsulosin\"> </a>\n <p><b>Alpha 1-adrenoreceptor antagonist</b> (tamsulosin): ↑ tamsulosin.\n Avoid concomitant use with PAXLOVID.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "tamsulosin",
"display": "tamsulosin"
}
],
"text": "Alpha 1-adrenoreceptor antagonist: tamsulosin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ tamsulosin"
}
},
"management": [
{
"text": "Avoid concomitant use with PAXLOVID."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-03-ranolazine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-03-ranolazine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-03-ranolazine\"> </a>\n <p><b>Antianginal</b> (ranolazine): ↑ ranolazine. Co-administration\n contraindicated due to potential for serious and/or life-threatening\n reactions (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ranolazine",
"display": "ranolazine"
}
],
"text": "Antianginal: ranolazine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ ranolazine"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for serious and/or life-threatening reactions (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-04-amiodarone-dronedarone-flecainide-propafenone-qu",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-04-amiodarone-dronedarone-flecainide-propafenone-qu",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-04-amiodarone-dronedarone-flecainide-propafenone-qu\"> </a>\n <p><b>Antiarrhythmics</b> (amiodarone, dronedarone, flecainide, propafenone,\n quinidine): ↑ antiarrhythmic. Co-administration contraindicated due to\n potential for cardiac arrhythmias (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "amiodarone-dronedarone-flecainide-propafenone-qu",
"display": "amiodarone, dronedarone, flecainide, propafenone, quinidine"
}
],
"text": "Antiarrhythmics: amiodarone, dronedarone, flecainide, propafenone, quinidine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ antiarrhythmic"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for cardiac arrhythmias (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-05-lidocaine-systemic-disopyramide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-05-lidocaine-systemic-disopyramide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-05-lidocaine-systemic-disopyramide\"> </a>\n <p><b>Antiarrhythmics</b> (lidocaine (systemic), disopyramide): ↑\n antiarrhythmic. Caution is warranted and therapeutic concentration\n monitoring is recommended for antiarrhythmics if available.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lidocaine-systemic-disopyramide",
"display": "lidocaine (systemic), disopyramide"
}
],
"text": "Antiarrhythmics: lidocaine (systemic), disopyramide"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ antiarrhythmic"
}
},
"management": [
{
"text": "Caution is warranted and therapeutic concentration monitoring is recommended for antiarrhythmics if available."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-06-apalutamide-enzalutamide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-06-apalutamide-enzalutamide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-06-apalutamide-enzalutamide\"> </a>\n <p><b>Anticancer drugs</b> (apalutamide, enzalutamide): ↓\n nirmatrelvir/ritonavir. Co-administration contraindicated due to\n potential loss of virologic response and possible resistance (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "apalutamide-enzalutamide",
"display": "apalutamide, enzalutamide"
}
],
"text": "Anticancer drugs: apalutamide, enzalutamide"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ nirmatrelvir/ritonavir"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential loss of virologic response and possible resistance (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-07-abemaciclib-ceritinib-dasatinib-encorafenib-ibru",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-07-abemaciclib-ceritinib-dasatinib-encorafenib-ibru",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-07-abemaciclib-ceritinib-dasatinib-encorafenib-ibru\"> </a>\n <p><b>Anticancer drugs</b> (abemaciclib, ceritinib, dasatinib, encorafenib,\n ibrutinib, ivosidenib, neratinib, nilotinib, venetoclax, vinblastine,\n vincristine): ↑ anticancer drug. Avoid co-administration of encorafenib\n or ivosidenib due to potential risk of serious adverse events such as QT\n interval prolongation. Avoid use of neratinib, venetoclax or ibrutinib.\n Co-administration of vincristine and vinblastine may lead to significant\n hematologic or gastrointestinal side effects. For further information,\n refer to the individual product label for anticancer drug.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "abemaciclib-ceritinib-dasatinib-encorafenib-ibru",
"display": "abemaciclib, ceritinib, dasatinib, encorafenib, ibrutinib, ivosidenib, neratinib, nilotinib, venetoclax, vinblastine, vincristine"
}
],
"text": "Anticancer drugs: abemaciclib, ceritinib, dasatinib, encorafenib, ibrutinib, ivosidenib, neratinib, nilotinib, venetoclax, vinblastine, vincristine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ anticancer drug"
}
},
"management": [
{
"text": "Avoid co-administration of encorafenib or ivosidenib due to potential risk of serious adverse events such as QT interval prolongation. Avoid use of neratinib, venetoclax or ibrutinib. Co-administration of vincristine and vinblastine may lead to significant hematologic or gastrointestinal side effects. For further information, refer to the individual product label for anticancer drug."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-08-warfarin-rivaroxaban-dabigatrana-apixaban",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-08-warfarin-rivaroxaban-dabigatrana-apixaban",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-08-warfarin-rivaroxaban-dabigatrana-apixaban\"> </a>\n <p><b>Anticoagulants</b> (warfarin rivaroxaban dabigatrana apixaban): ↑↓\n warfarin ↑ rivaroxaban ↑ dabigatran ↑ apixaban. Closely monitor INR if\n co-administration with warfarin is necessary. Increased bleeding risk\n with rivaroxaban. Avoid concomitant use. Increased bleeding risk with\n dabigatran. Depending on dabigatran indication and renal function,\n reduce dose of dabigatran or avoid concomitant use. Refer to the\n dabigatran product label for further information. Combined P-gp and\n strong CYP3A4 inhibitors increase blood levels of apixaban and increase\n the risk of bleeding. Dosing recommendations for co-administration of\n apixaban with PAXLOVID depend on the apixaban dose. Refer to the\n apixaban product label for more information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "warfarin-rivaroxaban-dabigatrana-apixaban",
"display": "warfarin rivaroxaban dabigatrana apixaban"
}
],
"text": "Anticoagulants: warfarin rivaroxaban dabigatrana apixaban"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑↓ warfarin ↑ rivaroxaban ↑ dabigatran ↑ apixaban"
}
},
"management": [
{
"text": "Closely monitor INR if co-administration with warfarin is necessary. Increased bleeding risk with rivaroxaban. Avoid concomitant use. Increased bleeding risk with dabigatran. Depending on dabigatran indication and renal function, reduce dose of dabigatran or avoid concomitant use. Refer to the dabigatran product label for further information. Combined P-gp and strong CYP3A4 inhibitors increase blood levels of apixaban and increase the risk of bleeding. Dosing recommendations for co-administration of apixaban with PAXLOVID depend on the apixaban dose. Refer to the apixaban product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-09-carbamazepinea-phenobarbital-phenytoin-primidone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-09-carbamazepinea-phenobarbital-phenytoin-primidone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-09-carbamazepinea-phenobarbital-phenytoin-primidone\"> </a>\n <p><b>Anticonvulsants</b> (carbamazepinea, phenobarbital, phenytoin,\n primidone): ↓ nirmatrelvir/ritonavir. Co-administration contraindicated\n due to potential loss of virologic response and possible resistance (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "carbamazepinea-phenobarbital-phenytoin-primidone",
"display": "carbamazepinea, phenobarbital, phenytoin, primidone"
}
],
"text": "Anticonvulsants: carbamazepinea, phenobarbital, phenytoin, primidone"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ nirmatrelvir/ritonavir"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential loss of virologic response and possible resistance (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-10-clonazepam",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-10-clonazepam",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-10-clonazepam\"> </a>\n <p><b>Anticonvulsants</b> (clonazepam): ↑ anticonvulsant. A dose decrease\n may be needed for clonazepam when co-administered with PAXLOVID and\n clinical monitoring is recommended.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "clonazepam",
"display": "clonazepam"
}
],
"text": "Anticonvulsants: clonazepam"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ anticonvulsant"
}
},
"management": [
{
"text": "A dose decrease may be needed for clonazepam when co-administered with PAXLOVID and clinical monitoring is recommended."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-11-bupropion-trazodone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-11-bupropion-trazodone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-11-bupropion-trazodone\"> </a>\n <p><b>Antidepressants</b> (bupropion trazodone): ↓ bupropion and active\n metabolite hydroxy-bupropion ↑ trazodone. Monitor for an adequate\n clinical response to bupropion. Adverse reactions of nausea, dizziness,\n hypotension, and syncope have been observed following co-administration\n of trazodone and ritonavir. A lower dose of trazodone should be\n considered. Refer to the trazadone product label for further\n information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "bupropion-trazodone",
"display": "bupropion trazodone"
}
],
"text": "Antidepressants: bupropion trazodone"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ bupropion and active metabolite hydroxy-bupropion ↑ trazodone"
}
},
"management": [
{
"text": "Monitor for an adequate clinical response to bupropion. Adverse reactions of nausea, dizziness, hypotension, and syncope have been observed following co-administration of trazodone and ritonavir. A lower dose of trazodone should be considered. Refer to the trazadone product label for further information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-12-voriconazole-ketoconazole-isavuconazonium-sulfat",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-12-voriconazole-ketoconazole-isavuconazonium-sulfat",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-12-voriconazole-ketoconazole-isavuconazonium-sulfat\"> </a>\n <p><b>Antifungals</b> (voriconazole ketoconazole, isavuconazonium sulfate,\n itraconazolea): ↓ voriconazole ↑ ketoconazole ↑ isavuconazonium sulfate\n ↑ itraconazole ↑ nirmatrelvir/ritonavir. Avoid concomitant use of\n voriconazole. Refer to the ketoconazole, isavuconazonium sulfate, and\n itraconazole product labels for further information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "voriconazole-ketoconazole-isavuconazonium-sulfat",
"display": "voriconazole ketoconazole, isavuconazonium sulfate, itraconazolea"
}
],
"text": "Antifungals: voriconazole ketoconazole, isavuconazonium sulfate, itraconazolea"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ voriconazole ↑ ketoconazole ↑ isavuconazonium sulfate ↑ itraconazole ↑ nirmatrelvir/ritonavir"
}
},
"management": [
{
"text": "Avoid concomitant use of voriconazole. Refer to the ketoconazole, isavuconazonium sulfate, and itraconazole product labels for further information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-13-colchicine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-13-colchicine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-13-colchicine\"> </a>\n <p><b>Anti-gout</b> (colchicine): ↑ colchicine. Co-administration\n contraindicated due to potential for serious and/or life-threatening\n reactions in patients with renal and/or hepatic impairment (see section\n 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "colchicine",
"display": "colchicine"
}
],
"text": "Anti-gout: colchicine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ colchicine"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for serious and/or life-threatening reactions in patients with renal and/or hepatic impairment (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-14-atazanavir-darunavir-tipranavir",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-14-atazanavir-darunavir-tipranavir",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-14-atazanavir-darunavir-tipranavir\"> </a>\n <p><b>Anti-HIV protease inhibitors</b> (atazanavir, darunavir, tipranavir):\n ↑ protease inhibitor. For further information, refer to the respective\n protease inhibitors’ product labels. Patients on ritonavir- or\n cobicistat-containing HIV regimens should continue their treatment as\n indicated. Monitor for increased PAXLOVID or protease inhibitor adverse\n events (see section 4.2).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "atazanavir-darunavir-tipranavir",
"display": "atazanavir, darunavir, tipranavir"
}
],
"text": "Anti-HIV protease inhibitors: atazanavir, darunavir, tipranavir"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ protease inhibitor"
}
},
"management": [
{
"text": "For further information, refer to the respective protease inhibitors’ product labels. Patients on ritonavir- or cobicistat-containing HIV regimens should continue their treatment as indicated. Monitor for increased PAXLOVID or protease inhibitor adverse events (see section 4.2)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-15-efavirenz-maraviroc-nevirapine-zidovudine-bicteg",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-15-efavirenz-maraviroc-nevirapine-zidovudine-bicteg",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-15-efavirenz-maraviroc-nevirapine-zidovudine-bicteg\"> </a>\n <p><b>Anti-HIV</b> (efavirenz, maraviroc, nevirapine, zidovudine,\n bictegravir/ emtricitabine/ tenofovir): ↑ efavirenz ↑ maraviroc ↑\n nevirapine ↓ zidovudine ↑ bictegravir ↔ emtricitabine ↑ tenofovir. For\n further information, refer to the respective anti-HIV drugs’ product\n label.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "efavirenz-maraviroc-nevirapine-zidovudine-bicteg",
"display": "efavirenz, maraviroc, nevirapine, zidovudine, bictegravir/ emtricitabine/ tenofovir"
}
],
"text": "Anti-HIV: efavirenz, maraviroc, nevirapine, zidovudine, bictegravir/ emtricitabine/ tenofovir"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ efavirenz ↑ maraviroc ↑ nevirapine ↓ zidovudine ↑ bictegravir ↔ emtricitabine ↑ tenofovir"
}
},
"management": [
{
"text": "For further information, refer to the respective anti-HIV drugs’ product label."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-16-clarithromycin-erythromycin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-16-clarithromycin-erythromycin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-16-clarithromycin-erythromycin\"> </a>\n <p><b>Anti-infective</b> (clarithromycin, erythromycin): ↑ clarithromycin ↑\n erythromycin. Refer to the respective product label for anti-infective\n dose adjustment.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "clarithromycin-erythromycin",
"display": "clarithromycin, erythromycin"
}
],
"text": "Anti-infective: clarithromycin, erythromycin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ clarithromycin ↑ erythromycin"
}
},
"management": [
{
"text": "Refer to the respective product label for anti-infective dose adjustment."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-17-rifampin-rifapentine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-17-rifampin-rifapentine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-17-rifampin-rifapentine\"> </a>\n <p><b>Antimycobacterial</b> (rifampin, rifapentine): ↓\n nirmatrelvir/ritonavir. Co-administration contraindicated due to\n potential loss of virologic response and possible resistance. Alternate\n antimycobacterial drugs such as rifabutin should be considered (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "rifampin-rifapentine",
"display": "rifampin, rifapentine"
}
],
"text": "Antimycobacterial: rifampin, rifapentine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ nirmatrelvir/ritonavir"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential loss of virologic response and possible resistance. Alternate antimycobacterial drugs such as rifabutin should be considered (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-18-bedaquiline-rifabutin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-18-bedaquiline-rifabutin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-18-bedaquiline-rifabutin\"> </a>\n <p><b>Antimycobacterial</b> (bedaquiline rifabutin): ↑ bedaquiline ↑\n rifabutin. Refer to the bedaquiline product label for further\n information. Refer to the rifabutin product label for further\n information on rifabutin dose reduction.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "bedaquiline-rifabutin",
"display": "bedaquiline rifabutin"
}
],
"text": "Antimycobacterial: bedaquiline rifabutin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ bedaquiline ↑ rifabutin"
}
},
"management": [
{
"text": "Refer to the bedaquiline product label for further information. Refer to the rifabutin product label for further information on rifabutin dose reduction."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-19-albendazole",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-19-albendazole",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-19-albendazole\"> </a>\n <p><b>Antiparasitic agent</b> (albendazole): ↓ albendazole. Significant\n decreases in plasma concentrations of albendazole and its active\n metabolite may occur due to induction by ritonavir, with a risk of\n decreased albendazole efficacy. Clinical monitoring of therapeutic\n response and possible adjustment of albendazole dosage during treatment\n with PAXLOVID and following discontinuation is recommended.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "albendazole",
"display": "albendazole"
}
],
"text": "Antiparasitic agent: albendazole"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ albendazole"
}
},
"management": [
{
"text": "Significant decreases in plasma concentrations of albendazole and its active metabolite may occur due to induction by ritonavir, with a risk of decreased albendazole efficacy. Clinical monitoring of therapeutic response and possible adjustment of albendazole dosage during treatment with PAXLOVID and following discontinuation is recommended."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-20-lurasidone-pimozide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-20-lurasidone-pimozide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-20-lurasidone-pimozide\"> </a>\n <p><b>Antipsychotics</b> (lurasidone, pimozide): ↑ lurasidone ↑ pimozide.\n Co-administration contraindicated due to serious and/or life-threatening\n reactions such as cardiac arrhythmias (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lurasidone-pimozide",
"display": "lurasidone, pimozide"
}
],
"text": "Antipsychotics: lurasidone, pimozide"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ lurasidone ↑ pimozide"
}
},
"management": [
{
"text": "Co-administration contraindicated due to serious and/or life-threatening reactions such as cardiac arrhythmias (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-21-quetiapine-clozapine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-21-quetiapine-clozapine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-21-quetiapine-clozapine\"> </a>\n <p><b>Antipsychotics</b> (quetiapine clozapine): ↑ quetiapine ↑ clozapine.\n If co-administration is necessary, reduce quetiapine dose and monitor\n for quetiapine-associated adverse reactions. Refer to the quetiapine\n product label for recommendations. If co-administration is necessary,\n consider reducing the clozapine dose and monitor for adverse reactions.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "quetiapine-clozapine",
"display": "quetiapine clozapine"
}
],
"text": "Antipsychotics: quetiapine clozapine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ quetiapine ↑ clozapine"
}
},
"management": [
{
"text": "If co-administration is necessary, reduce quetiapine dose and monitor for quetiapine-associated adverse reactions. Refer to the quetiapine product label for recommendations. If co-administration is necessary, consider reducing the clozapine dose and monitor for adverse reactions."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-22-silodosin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-22-silodosin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-22-silodosin\"> </a>\n <p><b>Benign prostatic hyperplasia agents</b> (silodosin): ↑ silodosin.\n Co-administration contraindicated due to potential for postural\n hypotension (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "silodosin",
"display": "silodosin"
}
],
"text": "Benign prostatic hyperplasia agents: silodosin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ silodosin"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for postural hypotension (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-23-amlodipine-diltiazem-felodipine-nicardipine-nife",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-23-amlodipine-diltiazem-felodipine-nicardipine-nife",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-23-amlodipine-diltiazem-felodipine-nicardipine-nife\"> </a>\n <p><b>Calcium channel blockers</b> (amlodipine, diltiazem, felodipine,\n nicardipine, nifedipine, verapamil): ↑ calcium channel blocker. Caution\n is warranted and clinical monitoring of patients is recommended. A dose\n decrease may be needed for these drugs when co-administered with\n PAXLOVID. If co-administered, refer to the individual product label for\n calcium channel blocker for further information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "amlodipine-diltiazem-felodipine-nicardipine-nife",
"display": "amlodipine, diltiazem, felodipine, nicardipine, nifedipine, verapamil"
}
],
"text": "Calcium channel blockers: amlodipine, diltiazem, felodipine, nicardipine, nifedipine, verapamil"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ calcium channel blocker"
}
},
"management": [
{
"text": "Caution is warranted and clinical monitoring of patients is recommended. A dose decrease may be needed for these drugs when co-administered with PAXLOVID. If co-administered, refer to the individual product label for calcium channel blocker for further information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-24-digoxin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-24-digoxin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-24-digoxin\"> </a>\n <p><b>Cardiac glycosides</b> (digoxin): ↑ digoxin. Caution should be\n exercised when co-administering PAXLOVID with digoxin, with appropriate\n monitoring of serum digoxin levels. Refer to the digoxin product label\n for further information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "digoxin",
"display": "digoxin"
}
],
"text": "Cardiac glycosides: digoxin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ digoxin"
}
},
"management": [
{
"text": "Caution should be exercised when co-administering PAXLOVID with digoxin, with appropriate monitoring of serum digoxin levels. Refer to the digoxin product label for further information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-25-eplerenone-ivabradine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-25-eplerenone-ivabradine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-25-eplerenone-ivabradine\"> </a>\n <p><b>Cardiovascular agents</b> (eplerenone ivabradine): ↑ eplerenone ↑\n ivabradine. Co-administration with eplerenone is contraindicated due to\n potential for hyperkalemia (see section 4.3). Co-administration with\n ivabradine is contraindicated due to potential for bradycardia or\n conduction disturbances (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "eplerenone-ivabradine",
"display": "eplerenone ivabradine"
}
],
"text": "Cardiovascular agents: eplerenone ivabradine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ eplerenone ↑ ivabradine"
}
},
"management": [
{
"text": "Co-administration with eplerenone is contraindicated due to potential for hyperkalemia (see section 4.3). Co-administration with ivabradine is contraindicated due to potential for bradycardia or conduction disturbances (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-26-aliskiren-ticagrelor-vorapaxar-clopidogrel-cilos",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-26-aliskiren-ticagrelor-vorapaxar-clopidogrel-cilos",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-26-aliskiren-ticagrelor-vorapaxar-clopidogrel-cilos\"> </a>\n <p><b>Cardiovascular agents</b> (aliskiren, ticagrelor, vorapaxar\n clopidogrel cilostazol mavacamten): ↑ aliskiren ↑ ticagrelor ↑ vorapaxar\n ↓ clopidogrel active metabolite ↑ cilostazol ↑ mavacamten. Avoid\n concomitant use with PAXLOVID. Dosage adjustment of cilostazol is\n recommended. Refer to the cilostazol product label for more information.\n Co-administration with mavacamten may increase mavacamten plasma\n concentration and increase the risk of heart failure. Discontinue\n mavacamten for the duration of PAXLOVID treatment. Resumption of\n mavacamten within 5 days of completing PAXLOVID may result in higher\n exposure of mavacamten. Refer to the mavacamten product label for more\n information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "aliskiren-ticagrelor-vorapaxar-clopidogrel-cilos",
"display": "aliskiren, ticagrelor, vorapaxar clopidogrel cilostazol mavacamten"
}
],
"text": "Cardiovascular agents: aliskiren, ticagrelor, vorapaxar clopidogrel cilostazol mavacamten"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ aliskiren ↑ ticagrelor ↑ vorapaxar ↓ clopidogrel active metabolite ↑ cilostazol ↑ mavacamten"
}
},
"management": [
{
"text": "Avoid concomitant use with PAXLOVID. Dosage adjustment of cilostazol is recommended. Refer to the cilostazol product label for more information. Co-administration with mavacamten may increase mavacamten plasma concentration and increase the risk of heart failure. Discontinue mavacamten for the duration of PAXLOVID treatment. Resumption of mavacamten within 5 days of completing PAXLOVID may result in higher exposure of mavacamten. Refer to the mavacamten product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-27-betamethasone-budesonide-ciclesonide-dexamethaso",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-27-betamethasone-budesonide-ciclesonide-dexamethaso",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-27-betamethasone-budesonide-ciclesonide-dexamethaso\"> </a>\n <p><b>Corticosteroids primarily metabolized by CYP3A</b> (betamethasone,\n budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone,\n mometasone, triamcinolone): ↑ corticosteroid. Co-administration with\n corticosteroids (all routes of administration) of which exposures are\n significantly increased by strong CYP3A inhibitors can increase the risk\n for Cushing’s syndrome and adrenal suppression. However, the risk of\n Cushing’s syndrome and adrenal suppression associated with short-term\n use of a strong CYP3A4 inhibitor is low. Alternative corticosteroids\n including beclomethasone, prednisone, and prednisolone should be\n considered.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "betamethasone-budesonide-ciclesonide-dexamethaso",
"display": "betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, triamcinolone"
}
],
"text": "Corticosteroids primarily metabolized by CYP3A: betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, triamcinolone"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ corticosteroid"
}
},
"management": [
{
"text": "Co-administration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing’s syndrome and adrenal suppression. However, the risk of Cushing’s syndrome and adrenal suppression associated with short-term use of a strong CYP3A4 inhibitor is low. Alternative corticosteroids including beclomethasone, prednisone, and prednisolone should be considered."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-28-lumacaftor-ivacaftor",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-28-lumacaftor-ivacaftor",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-28-lumacaftor-ivacaftor\"> </a>\n <p><b>Cystic fibrosis transmembrane conductance regulator potentiators</b>\n (lumacaftor/ivacaftor): ↓ nirmatrelvir/ritonavir. Co-administration\n contraindicated due to potential loss of virologic response and possible\n resistance (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lumacaftor-ivacaftor",
"display": "lumacaftor/ivacaftor"
}
],
"text": "Cystic fibrosis transmembrane conductance regulator potentiators: lumacaftor/ivacaftor"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ nirmatrelvir/ritonavir"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential loss of virologic response and possible resistance (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-29-ivacaftor-elexacaftor-tezacaftor-ivacaftor-tezac",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-29-ivacaftor-elexacaftor-tezacaftor-ivacaftor-tezac",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-29-ivacaftor-elexacaftor-tezacaftor-ivacaftor-tezac\"> </a>\n <p><b>Cystic fibrosis transmembrane conductance regulator potentiators</b>\n (ivacaftor elexacaftor/ tezacaftor/ivacaftor tezacaftor/ivacaftor): ↑\n ivacaftor ↑ elexacaftor/ tezacaftor/ivacaftor ↑ tezacaftor/ivacaftor.\n Reduce dosage when co-administered with PAXLOVID. Refer to the\n individual product labels for more information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ivacaftor-elexacaftor-tezacaftor-ivacaftor-tezac",
"display": "ivacaftor elexacaftor/ tezacaftor/ivacaftor tezacaftor/ivacaftor"
}
],
"text": "Cystic fibrosis transmembrane conductance regulator potentiators: ivacaftor elexacaftor/ tezacaftor/ivacaftor tezacaftor/ivacaftor"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ ivacaftor ↑ elexacaftor/ tezacaftor/ivacaftor ↑ tezacaftor/ivacaftor"
}
},
"management": [
{
"text": "Reduce dosage when co-administered with PAXLOVID. Refer to the individual product labels for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-30-saxagliptin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-30-saxagliptin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-30-saxagliptin\"> </a>\n <p><b>Dipeptidyl peptidase 4 (DPP4) inhibitors</b> (saxagliptin): ↑\n saxagliptin. Dosage adjustment of saxagliptin is recommended. Refer to\n the saxagliptin product label for more information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "saxagliptin",
"display": "saxagliptin"
}
],
"text": "Dipeptidyl peptidase 4 (DPP4) inhibitors: saxagliptin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ saxagliptin"
}
},
"management": [
{
"text": "Dosage adjustment of saxagliptin is recommended. Refer to the saxagliptin product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-31-bosentan",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-31-bosentan",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-31-bosentan\"> </a>\n <p><b>Endothelin receptor antagonists</b> (bosentan): ↑ bosentan.\n Discontinue use of bosentan at least 36 hours prior to initiation of\n PAXLOVID. Refer to the bosentan product label for further information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "bosentan",
"display": "bosentan"
}
],
"text": "Endothelin receptor antagonists: bosentan"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ bosentan"
}
},
"management": [
{
"text": "Discontinue use of bosentan at least 36 hours prior to initiation of PAXLOVID. Refer to the bosentan product label for further information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-32-dihydroergotamine-ergotamine-methylergonovine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-32-dihydroergotamine-ergotamine-methylergonovine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-32-dihydroergotamine-ergotamine-methylergonovine\"> </a>\n <p><b>Ergot derivatives</b> (dihydroergotamine, ergotamine,\n methylergonovine): ↑ dihydroergotamine ↑ ergotamine ↑ methylergonovine.\n Co-administration contraindicated due to potential for acute ergot\n toxicity characterized by vasospasm and ischemia of the extremities and\n other tissues including the central nervous system (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "dihydroergotamine-ergotamine-methylergonovine",
"display": "dihydroergotamine, ergotamine, methylergonovine"
}
],
"text": "Ergot derivatives: dihydroergotamine, ergotamine, methylergonovine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ dihydroergotamine ↑ ergotamine ↑ methylergonovine"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for acute ergot toxicity characterized by vasospasm and ischemia of the extremities and other tissues including the central nervous system (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-33-elbasvir-grazoprevir-glecaprevir-pibrentasvir-om",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-33-elbasvir-grazoprevir-glecaprevir-pibrentasvir-om",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-33-elbasvir-grazoprevir-glecaprevir-pibrentasvir-om\"> </a>\n <p><b>Hepatitis C direct acting antivirals</b> (elbasvir/grazoprevir,\n glecaprevir/ pibrentasvir ombitasvir/ paritaprevir/ritonavir and\n dasabuvir sofosbuvir/ velpatasvir/ voxilaprevir): ↑ antiviral. Increased\n grazoprevir concentrations can result in ALT elevations. Avoid\n concomitant use of glecaprevir/pibrentasvir with PAXLOVID. Refer to the\n ombitasvir/paritaprevir/ ritonavir and dasabuvir label for further\n information. Refer to the sofosbuvir/velpatasvir/ voxilaprevir product\n label for further information. Patients on ritonavir-containing HCV\n regimens should continue their treatment as indicated. Monitor for\n increased PAXLOVID or HCV drug adverse events with concomitant use (see\n section 4.2).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "elbasvir-grazoprevir-glecaprevir-pibrentasvir-om",
"display": "elbasvir/grazoprevir, glecaprevir/ pibrentasvir ombitasvir/ paritaprevir/ritonavir and dasabuvir sofosbuvir/ velpatasvir/ voxilaprevir"
}
],
"text": "Hepatitis C direct acting antivirals: elbasvir/grazoprevir, glecaprevir/ pibrentasvir ombitasvir/ paritaprevir/ritonavir and dasabuvir sofosbuvir/ velpatasvir/ voxilaprevir"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ antiviral"
}
},
"management": [
{
"text": "Increased grazoprevir concentrations can result in ALT elevations. Avoid concomitant use of glecaprevir/pibrentasvir with PAXLOVID. Refer to the ombitasvir/paritaprevir/ ritonavir and dasabuvir label for further information. Refer to the sofosbuvir/velpatasvir/ voxilaprevir product label for further information. Patients on ritonavir-containing HCV regimens should continue their treatment as indicated. Monitor for increased PAXLOVID or HCV drug adverse events with concomitant use (see section 4.2)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-34-st-john-s-wort-hypericum-perforatum",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-34-st-john-s-wort-hypericum-perforatum",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-34-st-john-s-wort-hypericum-perforatum\"> </a>\n <p><b>Herbal products</b> (St. John’s Wort (Hypericum perforatum)): ↓\n nirmatrelvir/ritonavir. Co-administration contraindicated due to\n potential loss of virologic response and possible resistance (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "st-john-s-wort-hypericum-perforatum",
"display": "St. John’s Wort (Hypericum perforatum)"
}
],
"text": "Herbal products: St. John’s Wort (Hypericum perforatum)"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ nirmatrelvir/ritonavir"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential loss of virologic response and possible resistance (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-35-lovastatin-simvastatin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-35-lovastatin-simvastatin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-35-lovastatin-simvastatin\"> </a>\n <p><b>HMG-CoA reductase inhibitors</b> (lovastatin, simvastatin): ↑\n lovastatin ↑ simvastatin. Co-administration contraindicated due to\n potential for myopathy including rhabdomyolysis (see section 4.3).\n Discontinue use of lovastatin and simvastatin at least 12 hours prior to\n initiation of PAXLOVID, during the 5 days of PAXLOVID treatment and for\n 5 days after completing PAXLOVID.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lovastatin-simvastatin",
"display": "lovastatin, simvastatin"
}
],
"text": "HMG-CoA reductase inhibitors: lovastatin, simvastatin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ lovastatin ↑ simvastatin"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for myopathy including rhabdomyolysis (see section 4.3). Discontinue use of lovastatin and simvastatin at least 12 hours prior to initiation of PAXLOVID, during the 5 days of PAXLOVID treatment and for 5 days after completing PAXLOVID."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-36-atorvastatin-rosuvastatina",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-36-atorvastatin-rosuvastatina",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-36-atorvastatin-rosuvastatina\"> </a>\n <p><b>HMG-CoA reductase inhibitors</b> (atorvastatin, rosuvastatina): ↑\n atorvastatin ↑ rosuvastatin. Consider temporary discontinuation of\n atorvastatin and rosuvastatin during treatment with PAXLOVID.\n Atorvastatin and rosuvastatin do not need to be held prior to or after\n completing PAXLOVID.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "atorvastatin-rosuvastatina",
"display": "atorvastatin, rosuvastatina"
}
],
"text": "HMG-CoA reductase inhibitors: atorvastatin, rosuvastatina"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ atorvastatin ↑ rosuvastatin"
}
},
"management": [
{
"text": "Consider temporary discontinuation of atorvastatin and rosuvastatin during treatment with PAXLOVID. Atorvastatin and rosuvastatin do not need to be held prior to or after completing PAXLOVID."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-37-ethinyl-estradiol",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-37-ethinyl-estradiol",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-37-ethinyl-estradiol\"> </a>\n <p><b>Hormonal contraceptive</b> (ethinyl estradiol): ↓ ethinyl estradiol.\n An additional, non-hormonal method of contraception should be considered\n during the 5 days of PAXLOVID treatment and until one menstrual cycle\n after stopping PAXLOVID.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "ethinyl-estradiol",
"display": "ethinyl estradiol"
}
],
"text": "Hormonal contraceptive: ethinyl estradiol"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↓ ethinyl estradiol"
}
},
"management": [
{
"text": "An additional, non-hormonal method of contraception should be considered during the 5 days of PAXLOVID treatment and until one menstrual cycle after stopping PAXLOVID."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-38-voclosporin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-38-voclosporin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-38-voclosporin\"> </a>\n <p><b>Immunosuppressants</b> (voclosporin): ↑ voclosporin. Co-administration\n contraindicated due to potential for acute and/or chronic nephrotoxicity\n (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "voclosporin",
"display": "voclosporin"
}
],
"text": "Immunosuppressants: voclosporin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ voclosporin"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for acute and/or chronic nephrotoxicity (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-39-calcineurin-inhibitors-cyclosporine-tacrolimus-m",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-39-calcineurin-inhibitors-cyclosporine-tacrolimus-m",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-39-calcineurin-inhibitors-cyclosporine-tacrolimus-m\"> </a>\n <p><b>Immunosuppressants</b> (Calcineurin inhibitors: cyclosporine,\n tacrolimus mTOR inhibitors: everolimus, sirolimus): ↑ cyclosporine ↑\n tacrolimus ↑ everolimus ↑ sirolimus. Avoid concomitant use of\n calcineurin inhibitors and mTOR inhibitors during treatment with\n PAXLOVID. If the co-administration cannot be avoided, dose adjustment of\n the immunosuppressant and close and regular monitoring for\n immunosuppressant concentrations and immunosuppressant-associated\n adverse reactions are recommended during and after treatment with\n PAXLOVID. Refer to the individual immunosuppressant product label and\n latest guidelines for further information and obtain expert consultation\n of a multidisciplinary group (see section 4.4).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "calcineurin-inhibitors-cyclosporine-tacrolimus-m",
"display": "Calcineurin inhibitors: cyclosporine, tacrolimus mTOR inhibitors: everolimus, sirolimus"
}
],
"text": "Immunosuppressants: Calcineurin inhibitors: cyclosporine, tacrolimus mTOR inhibitors: everolimus, sirolimus"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ cyclosporine ↑ tacrolimus ↑ everolimus ↑ sirolimus"
}
},
"management": [
{
"text": "Avoid concomitant use of calcineurin inhibitors and mTOR inhibitors during treatment with PAXLOVID. If the co-administration cannot be avoided, dose adjustment of the immunosuppressant and close and regular monitoring for immunosuppressant concentrations and immunosuppressant-associated adverse reactions are recommended during and after treatment with PAXLOVID. Refer to the individual immunosuppressant product label and latest guidelines for further information and obtain expert consultation of a multidisciplinary group (see section 4.4)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-40-tofacitinib-upadacitinib",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-40-tofacitinib-upadacitinib",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-40-tofacitinib-upadacitinib\"> </a>\n <p><b>Janus kinase (JAK) inhibitors</b> (tofacitinib upadacitinib): ↑\n tofacitinib ↑ upadacitinib. Dosage adjustment of tofacitinib is\n recommended. Refer to the tofacitinib product label for more\n information. Dosing recommendations for co‑administration of\n upadacitinib with PAXLOVID depends on the upadacitinib indication. Refer\n to the upadacitinib product label for more information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "tofacitinib-upadacitinib",
"display": "tofacitinib upadacitinib"
}
],
"text": "Janus kinase (JAK) inhibitors: tofacitinib upadacitinib"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ tofacitinib ↑ upadacitinib"
}
},
"management": [
{
"text": "Dosage adjustment of tofacitinib is recommended. Refer to the tofacitinib product label for more information. Dosing recommendations for co‑administration of upadacitinib with PAXLOVID depends on the upadacitinib indication. Refer to the upadacitinib product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-41-salmeterol",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-41-salmeterol",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-41-salmeterol\"> </a>\n <p><b>Long-acting beta-adrenoceptor agonist</b> (salmeterol): ↑ salmeterol.\n Avoid concomitant use with PAXLOVID. The combination may result in\n increased risk of cardiovascular adverse events associated with\n salmeterol, including QT prolongation, palpitations, and sinus\n tachycardia.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "salmeterol",
"display": "salmeterol"
}
],
"text": "Long-acting beta-adrenoceptor agonist: salmeterol"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ salmeterol"
}
},
"management": [
{
"text": "Avoid concomitant use with PAXLOVID. The combination may result in increased risk of cardiovascular adverse events associated with salmeterol, including QT prolongation, palpitations, and sinus tachycardia."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-42-lomitapide",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-42-lomitapide",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-42-lomitapide\"> </a>\n <p><b>Microsomal triglyceride transfer protein (MTTP) inhibitor</b>\n (lomitapide): ↑ lomitapide. Co-administration contraindicated due to\n potential for hepatotoxicity and gastrointestinal adverse reactions (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "lomitapide",
"display": "lomitapide"
}
],
"text": "Microsomal triglyceride transfer protein (MTTP) inhibitor: lomitapide"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ lomitapide"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for hepatotoxicity and gastrointestinal adverse reactions (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-43-eletriptan-ubrogepant",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-43-eletriptan-ubrogepant",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-43-eletriptan-ubrogepant\"> </a>\n <p><b>Migraine medications</b> (eletriptan ubrogepant): ↑ eletriptan ↑\n ubrogepant. Co-administration of eletriptan within at least 72 hours of\n PAXLOVID is contraindicated due to potential for serious adverse\n reactions including cardiovascular and cerebrovascular events (see\n section 4.3). Co-administration of ubrogepant with PAXLOVID is\n contraindicated due to potential for serious adverse reactions (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "eletriptan-ubrogepant",
"display": "eletriptan ubrogepant"
}
],
"text": "Migraine medications: eletriptan ubrogepant"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ eletriptan ↑ ubrogepant"
}
},
"management": [
{
"text": "Co-administration of eletriptan within at least 72 hours of PAXLOVID is contraindicated due to potential for serious adverse reactions including cardiovascular and cerebrovascular events (see section 4.3). Co-administration of ubrogepant with PAXLOVID is contraindicated due to potential for serious adverse reactions (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-44-rimegepant",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-44-rimegepant",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-44-rimegepant\"> </a>\n <p><b>Migraine medications</b> (rimegepant): ↑ rimegepant. Avoid concomitant\n use with PAXLOVID.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "rimegepant",
"display": "rimegepant"
}
],
"text": "Migraine medications: rimegepant"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ rimegepant"
}
},
"management": [
{
"text": "Avoid concomitant use with PAXLOVID."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-45-finerenone",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-45-finerenone",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-45-finerenone\"> </a>\n <p><b>Mineralocorticoid receptor antagonists</b> (finerenone): ↑ finerenone.\n Co-administration contraindicated due to potential for serious adverse\n reactions including hyperkalemia, hypotension, and hyponatremia (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "finerenone",
"display": "finerenone"
}
],
"text": "Mineralocorticoid receptor antagonists: finerenone"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ finerenone"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for serious adverse reactions including hyperkalemia, hypotension, and hyponatremia (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-46-darifenacin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-46-darifenacin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-46-darifenacin\"> </a>\n <p><b>Muscarinic receptor antagonists</b> (darifenacin): ↑ darifenacin. The\n darifenacin daily dose should not exceed 7.5 mg when co-administered\n with PAXLOVID. Refer to the darifenacin product label for more\n information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "darifenacin",
"display": "darifenacin"
}
],
"text": "Muscarinic receptor antagonists: darifenacin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ darifenacin"
}
},
"management": [
{
"text": "The darifenacin daily dose should not exceed 7.5 mg when co-administered with PAXLOVID. Refer to the darifenacin product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-47-fentanyl-hydrocodone-oxycodone-meperidine-methad",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-47-fentanyl-hydrocodone-oxycodone-meperidine-methad",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-47-fentanyl-hydrocodone-oxycodone-meperidine-methad\"> </a>\n <p><b>Narcotic analgesics</b> (fentanyl, hydrocodone, oxycodone, meperidine\n methadone): ↑ fentanyl ↑ hydrocodone ↑ oxycodone ↑ meperidine ↓\n methadone. Careful monitoring of therapeutic and adverse effects\n (including potentially fatal respiratory depression) is recommended when\n fentanyl, hydrocodone, oxycodone, or meperidine is concomitantly\n administered with PAXLOVID. If concomitant use with PAXLOVID is\n necessary, consider a dosage reduction of the narcotic analgesic and\n monitor patients closely at frequent intervals. Refer to the individual\n product label for more information. Monitor methadone-maintained\n patients closely for evidence of withdrawal effects and adjust the\n methadone dose accordingly.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "fentanyl-hydrocodone-oxycodone-meperidine-methad",
"display": "fentanyl, hydrocodone, oxycodone, meperidine methadone"
}
],
"text": "Narcotic analgesics: fentanyl, hydrocodone, oxycodone, meperidine methadone"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ fentanyl ↑ hydrocodone ↑ oxycodone ↑ meperidine ↓ methadone"
}
},
"management": [
{
"text": "Careful monitoring of therapeutic and adverse effects (including potentially fatal respiratory depression) is recommended when fentanyl, hydrocodone, oxycodone, or meperidine is concomitantly administered with PAXLOVID. If concomitant use with PAXLOVID is necessary, consider a dosage reduction of the narcotic analgesic and monitor patients closely at frequent intervals. Refer to the individual product label for more information. Monitor methadone-maintained patients closely for evidence of withdrawal effects and adjust the methadone dose accordingly."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-48-suvorexant-aripiprazole-brexpiprazole-cariprazin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-48-suvorexant-aripiprazole-brexpiprazole-cariprazin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-48-suvorexant-aripiprazole-brexpiprazole-cariprazin\"> </a>\n <p><b>Neuropsychiatric agents</b> (suvorexant aripiprazole, brexpiprazole,\n cariprazine, iloperidone, lumateperone, pimavanserin): ↑ suvorexant ↑\n aripiprazole ↑ brexpiprazole ↑ cariprazine ↑ iloperidone ↑ lumateperone\n ↑ pimavanserin. Avoid concomitant use of suvorexant with PAXLOVID.\n Dosage adjustment of aripiprazole, brexpiprazole, cariprazine,\n iloperidone, lumateperone, and pimavanserin is recommended. Refer to the\n individual product label for more information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "suvorexant-aripiprazole-brexpiprazole-cariprazin",
"display": "suvorexant aripiprazole, brexpiprazole, cariprazine, iloperidone, lumateperone, pimavanserin"
}
],
"text": "Neuropsychiatric agents: suvorexant aripiprazole, brexpiprazole, cariprazine, iloperidone, lumateperone, pimavanserin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ suvorexant ↑ aripiprazole ↑ brexpiprazole ↑ cariprazine ↑ iloperidone ↑ lumateperone ↑ pimavanserin"
}
},
"management": [
{
"text": "Avoid concomitant use of suvorexant with PAXLOVID. Dosage adjustment of aripiprazole, brexpiprazole, cariprazine, iloperidone, lumateperone, and pimavanserin is recommended. Refer to the individual product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-49-suzetrigine",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-49-suzetrigine",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-49-suzetrigine\"> </a>\n <p><b>Non-opioid analgesic (selective blocker of Nav1.8 sodium channels)</b>\n (suzetrigine): ↑ suzetrigine and active metabolite M6-SUZ.\n Co-administration contraindicated due to potential for serious and/or\n life-threatening suzetrigine adverse reactions (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "suzetrigine",
"display": "suzetrigine"
}
],
"text": "Non-opioid analgesic (selective blocker of Nav1.8 sodium channels): suzetrigine"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ suzetrigine and active metabolite M6-SUZ"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for serious and/or life-threatening suzetrigine adverse reactions (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-50-sildenafil",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-50-sildenafil",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-50-sildenafil\"> </a>\n <p><b>Pulmonary hypertension agents (PDE5 inhibitors)</b> (sildenafil): ↑\n sildenafil. Co-administration of sildenafil with PAXLOVID is\n contraindicated due to the potential for sildenafil associated adverse\n events, including visual abnormalities, hypotension, prolonged erection,\n and syncope (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "sildenafil",
"display": "sildenafil"
}
],
"text": "Pulmonary hypertension agents (PDE5 inhibitors): sildenafil"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ sildenafil"
}
},
"management": [
{
"text": "Co-administration of sildenafil with PAXLOVID is contraindicated due to the potential for sildenafil associated adverse events, including visual abnormalities, hypotension, prolonged erection, and syncope (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-51-tadalafil-riociguat",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-51-tadalafil-riociguat",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-51-tadalafil-riociguat\"> </a>\n <p><b>Pulmonary hypertension agents (PDE5 inhibitors) Pulmonary hypertension\n agents (sGC stimulators)</b> (tadalafil riociguat): ↑ tadalafil ↑\n riociguat. Avoid concomitant use of tadalafil with PAXLOVID. Dosage\n adjustment is recommended for riociguat. Refer to the riociguat product\n label for more information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "tadalafil-riociguat",
"display": "tadalafil riociguat"
}
],
"text": "Pulmonary hypertension agents (PDE5 inhibitors) Pulmonary hypertension agents (sGC stimulators): tadalafil riociguat"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ tadalafil ↑ riociguat"
}
},
"management": [
{
"text": "Avoid concomitant use of tadalafil with PAXLOVID. Dosage adjustment is recommended for riociguat. Refer to the riociguat product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-52-avanafil-sildenafil-tadalafil-vardenafil",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-52-avanafil-sildenafil-tadalafil-vardenafil",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-52-avanafil-sildenafil-tadalafil-vardenafil\"> </a>\n <p><b>Erectile dysfunction agents (PDE5 inhibitors)</b> (avanafil\n sildenafil, tadalafil, vardenafil): ↑ avanafil ↑ sildenafil ↑ tadalafil\n ↑ vardenafil. Do not use PAXLOVID with avanafil because a safe and\n effective avanafil dosage regimen has not been established. Dosage\n adjustment is recommended for use of sildenafil, tadalafil, or\n vardenafil with PAXLOVID. Refer to the individual product label for more\n information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "avanafil-sildenafil-tadalafil-vardenafil",
"display": "avanafil sildenafil, tadalafil, vardenafil"
}
],
"text": "Erectile dysfunction agents (PDE5 inhibitors): avanafil sildenafil, tadalafil, vardenafil"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ avanafil ↑ sildenafil ↑ tadalafil ↑ vardenafil"
}
},
"management": [
{
"text": "Do not use PAXLOVID with avanafil because a safe and effective avanafil dosage regimen has not been established. Dosage adjustment is recommended for use of sildenafil, tadalafil, or vardenafil with PAXLOVID. Refer to the individual product label for more information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-53-naloxegol",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-53-naloxegol",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-53-naloxegol\"> </a>\n <p><b>Opioid antagonists</b> (naloxegol): ↑ naloxegol. Co-administration\n contraindicated due to the potential for opioid withdrawal symptoms (see\n section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "naloxegol",
"display": "naloxegol"
}
],
"text": "Opioid antagonists: naloxegol"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ naloxegol"
}
},
"management": [
{
"text": "Co-administration contraindicated due to the potential for opioid withdrawal symptoms (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-54-triazolam-oral-midazolama",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-54-triazolam-oral-midazolama",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-54-triazolam-oral-midazolama\"> </a>\n <p><b>Sedative/hypnotics</b> (triazolam, oral midazolama): ↑ triazolam ↑\n midazolam. Co-administration contraindicated due to potential for\n extreme sedation and respiratory depression (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "triazolam-oral-midazolama",
"display": "triazolam, oral midazolama"
}
],
"text": "Sedative/hypnotics: triazolam, oral midazolama"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ triazolam ↑ midazolam"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for extreme sedation and respiratory depression (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-55-buspirone-clorazepate-diazepam-estazolam-fluraze",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-55-buspirone-clorazepate-diazepam-estazolam-fluraze",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-55-buspirone-clorazepate-diazepam-estazolam-fluraze\"> </a>\n <p><b>Sedative/hypnotics</b> (buspirone, clorazepate, diazepam, estazolam,\n flurazepam, zolpidem midazolam (administered parenterally)): ↑\n sedative/hypnotic ↑ midazolam. A dose decrease may be needed for these\n drugs when co-administered with PAXLOVID and monitoring for adverse\n events is recommended. Co-administration of midazolam (parenteral)\n should be done in a setting which ensures close clinical monitoring and\n appropriate medical management in case of respiratory depression and/or\n prolonged sedation. Dosage reduction for midazolam should be considered,\n especially if more than a single dose of midazolam is administered.\n Refer to the midazolam product label for further information.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "buspirone-clorazepate-diazepam-estazolam-fluraze",
"display": "buspirone, clorazepate, diazepam, estazolam, flurazepam, zolpidem midazolam (administered parenterally)"
}
],
"text": "Sedative/hypnotics: buspirone, clorazepate, diazepam, estazolam, flurazepam, zolpidem midazolam (administered parenterally)"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ sedative/hypnotic ↑ midazolam"
}
},
"management": [
{
"text": "A dose decrease may be needed for these drugs when co-administered with PAXLOVID and monitoring for adverse events is recommended. Co-administration of midazolam (parenteral) should be done in a setting which ensures close clinical monitoring and appropriate medical management in case of respiratory depression and/or prolonged sedation. Dosage reduction for midazolam should be considered, especially if more than a single dose of midazolam is administered. Refer to the midazolam product label for further information."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-56-flibanserin",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-56-flibanserin",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-56-flibanserin\"> </a>\n <p><b>Serotonin receptor 1A agonist/ serotonin receptor 2A antagonist</b>\n (flibanserin): ↑ flibanserin. Co-administration contraindicated due to\n potential for hypotension, syncope, and CNS depression (see section\n 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "flibanserin",
"display": "flibanserin"
}
],
"text": "Serotonin receptor 1A agonist/ serotonin receptor 2A antagonist: flibanserin"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ flibanserin"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for hypotension, syncope, and CNS depression (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-57-tolvaptan",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-57-tolvaptan",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-57-tolvaptan\"> </a>\n <p><b>Vasopressin receptor antagonists</b> (tolvaptan): ↑ tolvaptan.\n Co-administration contraindicated due to potential for dehydration,\n hypovolemia and hyperkalemia (see section 4.3).</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "tolvaptan",
"display": "tolvaptan"
}
],
"text": "Vasopressin receptor antagonists: tolvaptan"
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "↑ tolvaptan"
}
},
"management": [
{
"text": "Co-administration contraindicated due to potential for dehydration, hypovolemia and hyperkalemia (see section 4.3)."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-int-58-a-see-section-5-2-drug-interaction-studies-condu",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-int-58-a-see-section-5-2-drug-interaction-studies-condu",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-int-58-a-see-section-5-2-drug-interaction-studies-condu\"> </a>\n <p><b>a. See section 5.2 Drug interaction studies conducted with\n nirmatrelvir/ritonavir.</b> (a. See section 5.2 Drug interaction studies\n conducted with nirmatrelvir/ritonavir.): a. See section 5.2 Drug\n interaction studies conducted with nirmatrelvir/ritonavir.. a. See\n section 5.2 Drug interaction studies conducted with\n nirmatrelvir/ritonavir.</p>\n </div>"
},
"type": "interaction",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"interaction": {
"interactant": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/draft-substance",
"code": "a-see-section-5-2-drug-interaction-studies-condu",
"display": "a. See section 5.2 Drug interaction studies conducted with nirmatrelvir/ritonavir."
}
],
"text": "a. See section 5.2 Drug interaction studies conducted with nirmatrelvir/ritonavir.: a. See section 5.2 Drug interaction studies conducted with nirmatrelvir/ritonavir."
}
}
],
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/CodeSystem/clinical-use-definition-type",
"code": "interaction"
}
]
},
"effect": {
"concept": {
"text": "a. See section 5.2 Drug interaction studies conducted with nirmatrelvir/ritonavir."
}
},
"management": [
{
"text": "a. See section 5.2 Drug interaction studies conducted with nirmatrelvir/ritonavir."
}
]
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-warn-interactions",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-warn-interactions",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-warn-interactions\"> </a>\n <p>Risk of serious adverse reactions due to drug interactions</p>\n </div>"
},
"type": "warning",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"warning": {
"description": "Risk of serious adverse reactions due to drug interactions"
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-warn-hypersensitivity",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-warn-hypersensitivity",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-warn-hypersensitivity\"> </a>\n <p>Hypersensitivity reactions including anaphylaxis have been reported</p>\n </div>"
},
"type": "warning",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"warning": {
"description": "Hypersensitivity reactions including anaphylaxis have been reported"
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-warn-hepatotoxicity",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-warn-hepatotoxicity",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-warn-hepatotoxicity\"> </a>\n <p>Hepatotoxicity; caution in pre-existing liver disease</p>\n </div>"
},
"type": "warning",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"warning": {
"description": "Hepatotoxicity; caution in pre-existing liver disease"
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-warn-hiv-resistance",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-warn-hiv-resistance",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-warn-hiv-resistance\"> </a>\n <p>Risk of HIV-1 resistance development in uncontrolled HIV-1 infection</p>\n </div>"
},
"type": "warning",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"warning": {
"description": "Risk of HIV-1 resistance development in uncontrolled HIV-1 infection"
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-01-hypersensitivity",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-01-hypersensitivity",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-01-hypersensitivity\"> </a>\n <p>Hypersensitivity — Immune system disorders (Uncommon ≥1/1,000 to\n <1/100)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Hypersensitivity"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Immune system disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "uncommon",
"display": "Uncommon ≥1/1,000 to <1/100"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-02-anaphylaxis",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-02-anaphylaxis",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-02-anaphylaxis\"> </a>\n <p>Anaphylaxis — Immune system disorders (Rare ≥1/10,000 to <1/1,000)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Anaphylaxis"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Immune system disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "rare",
"display": "Rare ≥1/10,000 to <1/1,000"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-03-dysgeusiaa-headache",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-03-dysgeusiaa-headache",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-03-dysgeusiaa-headache\"> </a>\n <p>Dysgeusiaa Headache — Nervous system disorders (Common ≥1/100 to\n <1/10)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Dysgeusiaa Headache"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Nervous system disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "common",
"display": "Common ≥1/100 to <1/10"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-04-hypertension",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-04-hypertension",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-04-hypertension\"> </a>\n <p>Hypertension — Vascular disorders (Uncommon ≥1/1,000 to <1/100)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Hypertension"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Vascular disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "uncommon",
"display": "Uncommon ≥1/1,000 to <1/100"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-05-diarrheaa-nausea",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-05-diarrheaa-nausea",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-05-diarrheaa-nausea\"> </a>\n <p>Diarrheaa Nausea — Gastrointestinal disorders (Common ≥1/100 to <1/10)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Diarrheaa Nausea"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Gastrointestinal disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "common",
"display": "Common ≥1/100 to <1/10"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-06-vomitinga-abdominal-pain",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-06-vomitinga-abdominal-pain",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-06-vomitinga-abdominal-pain\"> </a>\n <p>Vomitinga Abdominal pain — Gastrointestinal disorders (Uncommon ≥1/1,000\n to <1/100)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Vomitinga Abdominal pain"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Gastrointestinal disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "uncommon",
"display": "Uncommon ≥1/1,000 to <1/100"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-07-toxic-epidermal-necrolysis-stevens-johnson-syndr",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-07-toxic-epidermal-necrolysis-stevens-johnson-syndr",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-07-toxic-epidermal-necrolysis-stevens-johnson-syndr\"> </a>\n <p>Toxic epidermal necrolysis Stevens-Johnson syndrome — Skin and\n subcutaneous tissue disorders (Rare ≥1/10,000 to <1/1,000)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Toxic epidermal necrolysis Stevens-Johnson syndrome"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "Skin and subcutaneous tissue disorders"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "rare",
"display": "Rare ≥1/10,000 to <1/1,000"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-08-malaise",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-08-malaise",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-08-malaise\"> </a>\n <p>Malaise — General disorders and administration site conditions (Rare\n ≥1/10,000 to <1/1,000)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Malaise"
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "General disorders and administration site conditions"
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "rare",
"display": "Rare ≥1/10,000 to <1/1,000"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-09-adverse-drug-reaction-adr-identified-post-market",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-09-adverse-drug-reaction-adr-identified-post-market",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-09-adverse-drug-reaction-adr-identified-post-market\"> </a>\n <p>Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a\n ≥1% frequency in the PAXLOVID group and at a greater frequency than in\n the placebo group and/or likely associated with PAXLOVID based on\n available data and causality assessment. — * Adverse drug reaction (ADR)\n identified post-marketing. a. Occurring at a ≥1% frequency in the\n PAXLOVID group and at a greater frequency than in the placebo group\n and/or likely associated with PAXLOVID based on available data and\n causality assessment. (Very Common ≥1/10)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "* Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "very-common",
"display": "Very Common ≥1/10"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-10-adverse-drug-reaction-adr-identified-post-market",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-10-adverse-drug-reaction-adr-identified-post-market",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-10-adverse-drug-reaction-adr-identified-post-market\"> </a>\n <p>Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a\n ≥1% frequency in the PAXLOVID group and at a greater frequency than in\n the placebo group and/or likely associated with PAXLOVID based on\n available data and causality assessment. — * Adverse drug reaction (ADR)\n identified post-marketing. a. Occurring at a ≥1% frequency in the\n PAXLOVID group and at a greater frequency than in the placebo group\n and/or likely associated with PAXLOVID based on available data and\n causality assessment. (Common ≥1/100 to <1/10)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "* Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "common",
"display": "Common ≥1/100 to <1/10"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-11-adverse-drug-reaction-adr-identified-post-market",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-11-adverse-drug-reaction-adr-identified-post-market",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-11-adverse-drug-reaction-adr-identified-post-market\"> </a>\n <p>Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a\n ≥1% frequency in the PAXLOVID group and at a greater frequency than in\n the placebo group and/or likely associated with PAXLOVID based on\n available data and causality assessment. — * Adverse drug reaction (ADR)\n identified post-marketing. a. Occurring at a ≥1% frequency in the\n PAXLOVID group and at a greater frequency than in the placebo group\n and/or likely associated with PAXLOVID based on available data and\n causality assessment. (Uncommon ≥1/1,000 to <1/100)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "* Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "uncommon",
"display": "Uncommon ≥1/1,000 to <1/100"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-12-adverse-drug-reaction-adr-identified-post-market",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-12-adverse-drug-reaction-adr-identified-post-market",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-12-adverse-drug-reaction-adr-identified-post-market\"> </a>\n <p>Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a\n ≥1% frequency in the PAXLOVID group and at a greater frequency than in\n the placebo group and/or likely associated with PAXLOVID based on\n available data and causality assessment. — * Adverse drug reaction (ADR)\n identified post-marketing. a. Occurring at a ≥1% frequency in the\n PAXLOVID group and at a greater frequency than in the placebo group\n and/or likely associated with PAXLOVID based on available data and\n causality assessment. (Rare ≥1/10,000 to <1/1,000)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "* Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "rare",
"display": "Rare ≥1/10,000 to <1/1,000"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-13-adverse-drug-reaction-adr-identified-post-market",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-13-adverse-drug-reaction-adr-identified-post-market",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-13-adverse-drug-reaction-adr-identified-post-market\"> </a>\n <p>Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a\n ≥1% frequency in the PAXLOVID group and at a greater frequency than in\n the placebo group and/or likely associated with PAXLOVID based on\n available data and causality assessment. — * Adverse drug reaction (ADR)\n identified post-marketing. a. Occurring at a ≥1% frequency in the\n PAXLOVID group and at a greater frequency than in the placebo group\n and/or likely associated with PAXLOVID based on available data and\n causality assessment. (Very Rare <1/10,000)</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "* Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "very-rare",
"display": "Very Rare <1/10,000"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/ClinicalUseDefinition/cud-ae-14-adverse-drug-reaction-adr-identified-post-market",
"resource": {
"resourceType": "ClinicalUseDefinition",
"id": "cud-ae-14-adverse-drug-reaction-adr-identified-post-market",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClinicalUseDefinition_cud-ae-14-adverse-drug-reaction-adr-identified-post-market\"> </a>\n <p>Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a\n ≥1% frequency in the PAXLOVID group and at a greater frequency than in\n the placebo group and/or likely associated with PAXLOVID based on\n available data and causality assessment. — * Adverse drug reaction (ADR)\n identified post-marketing. a. Occurring at a ≥1% frequency in the\n PAXLOVID group and at a greater frequency than in the placebo group\n and/or likely associated with PAXLOVID based on available data and\n causality assessment. (Frequency Not Known (cannot be estimated from the\n available data))</p>\n </div>"
},
"type": "undesirable-effect",
"subject": [
{
"reference": "MedicinalProductDefinition/mpd-paxlovid"
}
],
"undesirableEffect": {
"symptomConditionEffect": {
"concept": {
"text": "Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
},
"classification": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/soc",
"display": "* Adverse drug reaction (ADR) identified post-marketing. a. Occurring at a ≥1% frequency in the PAXLOVID group and at a greater frequency than in the placebo group and/or likely associated with PAXLOVID based on available data and causality assessment."
}
]
},
"frequencyOfOccurrence": {
"coding": [
{
"system": "https://www.hsa.gov.sg/epi/adr-frequency",
"code": "not-known",
"display": "Frequency Not Known (cannot be estimated from the available data)"
}
]
}
}
}
},
{
"fullUrl": "https://www.hsa.gov.sg/epi/MedicationKnowledge/mk-paxlovid",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "mk-paxlovid",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationKnowledge_mk-paxlovid\"> </a>\n <p>PAXLOVID (ATC J05AE30). Standard dose: nirmatrelvir 300 mg + ritonavir\n 100 mg every 12 hours for 5 days. eGFR 30 to <60 mL/min: reduce\n nirmatrelvir to 150 mg with ritonavir 100 mg every 12 hours. eGFR <30\n mL/min: not recommended.</p>\n </div>"
},
"code": {
"coding": [
{
"system": "http://www.whocc.no/atc",
"code": "J05AE30",
"display": "nirmatrelvir and ritonavir"
}
]
},
"status": "active",
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{
"indication": [
{
"concept": {
"text": "Treatment of mild-to-moderate COVID-19 in adults at high risk of progression to severe COVID-19"
}
}
],
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{
"treatmentIntent": {
"text": "Standard dose (normal to mild renal impairment)"
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{
"type": {
"text": "Nirmatrelvir"
},
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{
"text": "Nirmatrelvir 300 mg (two 150 mg tablets) orally every 12 hours for 5 days",
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"boundsDuration": {
"value": 5,
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},
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"system": "https://standardterms.edqm.eu",
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"display": "Oral use"
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]
},
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{
"doseQuantity": {
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"code": "mg"
}
}
]
}
]
},
{
"type": {
"text": "Ritonavir"
},
"dosage": [
{
"text": "Ritonavir 100 mg (one 100 mg tablet) orally every 12 hours for 5 days",
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"repeat": {
"boundsDuration": {
"value": 5,
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},
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{
"system": "https://standardterms.edqm.eu",
"code": "20053000",
"display": "Oral use"
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]
},
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{
"doseQuantity": {
"value": 100,
"unit": "mg",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
]
}
],
"patientCharacteristic": [
{
"type": {
"coding": [
{
"system": "http://loinc.org",
"code": "62238-1",
"display": "Glomerular filtration rate/1.73 sq M.predicted"
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]
},
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"value": 60,
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"system": "http://unitsofmeasure.org",
"code": "mL/min/{1.73_m2}"
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}
}
]
},
{
"treatmentIntent": {
"text": "Reduced dose for moderate renal impairment (eGFR 30 to <60 mL/min)"
},
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{
"type": {
"text": "Nirmatrelvir"
},
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{
"text": "Nirmatrelvir 150 mg (one 150 mg tablet) orally every 12 hours for 5 days",
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"repeat": {
"boundsDuration": {
"value": 5,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
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"frequency": 1,
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"periodUnit": "h"
}
},
"route": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "20053000",
"display": "Oral use"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 150,
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"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
]
},
{
"type": {
"text": "Ritonavir"
},
"dosage": [
{
"text": "Ritonavir 100 mg (one 100 mg tablet) orally every 12 hours for 5 days",
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"repeat": {
"boundsDuration": {
"value": 5,
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"system": "http://unitsofmeasure.org",
"code": "d"
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"frequency": 1,
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}
},
"route": {
"coding": [
{
"system": "https://standardterms.edqm.eu",
"code": "20053000",
"display": "Oral use"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 100,
"unit": "mg",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
]
}
],
"patientCharacteristic": [
{
"type": {
"coding": [
{
"system": "http://loinc.org",
"code": "62238-1",
"display": "Glomerular filtration rate/1.73 sq M.predicted"
}
]
},
"valueRange": {
"low": {
"value": 30,
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"system": "http://unitsofmeasure.org",
"code": "mL/min/{1.73_m2}"
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"high": {
"value": 60,
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"system": "http://unitsofmeasure.org",
"code": "mL/min/{1.73_m2}"
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}
}
]
},
{
"treatmentIntent": {
"text": "Severe renal impairment (eGFR <30 mL/min)"
},
"dosage": [
{
"type": {
"text": "PAXLOVID"
},
"dosage": [
{
"text": "PAXLOVID is not recommended in patients with severe renal impairment (eGFR <30 mL/min)"
}
]
}
],
"patientCharacteristic": [
{
"type": {
"coding": [
{
"system": "http://loinc.org",
"code": "62238-1",
"display": "Glomerular filtration rate/1.73 sq M.predicted"
}
]
},
"valueRange": {
"high": {
"value": 30,
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"system": "http://unitsofmeasure.org",
"code": "mL/min/{1.73_m2}"
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}
}
]
}
]
}
]
}
}
]
}