{"doi":"10.1002/phar.2860","title":"Potential drug–drug interactions among U.S. adults treated with nirmatrelvir/ritonavir: A cross‐sectional study of the National Covid Cohort Collaborative (N3C)","abstract":"STUDY OBJECTIVE: To estimate the prevalence of potential moderate to severe drug-drug interactions (DDIs) involving nirmatrelvir/ritonavir, identify interacting medications, and evaluate risk factors associated with potential DDIs. DESIGN: Cross-sectional study. DATA SOURCE: Electronic health records from the National COVID Cohort Collaborative Enclave, one of the largest COVID-19 data resources in the United States. PATIENTS: Outpatients aged ≥18 years and started nirmatrelvir/ritonavir between December 23, 2021 and March 31, 2022. INTERVENTION: Nirmatrelvir/ritonavir. MEASUREMENTS: The outcome is potential moderate to severe DDIs, defined as starting interacting medications reported by National Institutes of Health 30 days before or 10 days after starting nirmatrelvir/ritonavir. MAIN RESULTS: Of 3214 outpatients who started nirmatrelvir/ritonavir, the mean age was 56.8 ± 17.1 years, 39.5% were male, and 65.8% were non-Hispanic white. Overall, 521 (16.2%) were potentially exposed to at least one moderate to severe DDI, most commonly to atorvastatin (19.2% of all DDIs), hydrocodone (14.0%), or oxycodone (14.0%). After adjustment for covariates, potential DDIs were more likely among individuals who were older (odds ratio [OR] 1.16 per 10-year increase, 95% confidence interval [CI] 1.08-1.25), male (OR 1.36, CI 1.09-1.71), smokers (OR 1.38, CI 1.10-1.73), on more co-medications (OR 1.35, CI 1.31-1.39), and with a history of solid organ transplant (OR 3.63, CI 2.05-6.45). CONCLUSIONS: One in six of individuals receiving nirmatrelvir/ritonavir were at risk of a potential moderate or severe DDI, underscoring the importance of clinical and pharmacy systems to mitigate such risks.","journal":"Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy","year":2023,"id":361024,"datarank":0.5971111180261248,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.25172335407701785,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.25172335407701785,"corpus_percentile":66.96836079523479,"corpus_rank":4271,"citation_count":9,"citer_count":6,"citers_with_citation_signal":6,"citers_with_endowment":6,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5119,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":369851,"name":"Hemalkumar B. Mehta","orcid":"0000-0001-9134-6370","position":1,"is_corresponding":false},{"id":1113207,"name":"Jill Curran","orcid":null,"position":2,"is_corresponding":false},{"id":106955,"name":"Brian T. Garibaldi","orcid":"0000-0001-8632-5567","position":3,"is_corresponding":false},{"id":247849,"name":"G. Caleb Alexander","orcid":"0000-0002-5622-2986","position":4,"is_corresponding":false},{"id":1112823,"name":"Xuya Xiao","orcid":"0000-0003-4198-7502","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-19T01:14:06.433417Z","pmid":"37539477","pmcid":"PMC10838345","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}