May 2023 update: Ontario Health is advising that Paxlovid™ can cause severe interactions with some transplant medications and solid organ transplant recipients should not take Paxlovid™ without first speaking to their transplant care team. Solid organ transplant recipients who test positive for COVID-19 should be directed to contact their transplant care team to receive the appropriate COVID-19 therapeutics and follow-up care.
As announced by the Ontario government, as of December 12, 2022, O. Reg.107/96 – Controlled Acts, under the Regulated Health Professions Act (RHPA), was amended to authorize a Part A pharmacist to prescribe Paxlovid™ (nirmatrelvir/ritonavir) antiviral treatment for COVID-19 in accordance with section 16 of the regulation and the eligibility criteria set out by the Ministry of Health.
Pharmacists must possess the required clinical knowledge, skills and competency to prescribe and/or dispense Paxlovid™ for eligible individuals. A comprehensive patient assessment is required to identify and manage potential drug therapy problems (such as drug interactions, contraindications, the need for dosage adjustments, etc.) or to determine whether a referral to a primary care provider is necessary. Pharmacists offering this service must follow expectations outlined in the Initiating, Adapting and Renewing Prescriptions Guideline.
Additional resources to support pharmacists with clinical decision-making and links to the Ministry of Health Executive Officer notices can be found below. Resources related to screening protocols and IPAC measures can be found under Pharmacy Operations – Infection Prevention and Control Measures.
No other registrant (i.e., Part B pharmacist, registered pharmacy student, intern, pharmacy technician, pharmacist (emergency assignment), or pharmacy technician (emergency assignment)) is authorized to prescribe Paxlovid™.
For more information, please reference the resources below:
- Ontario COVID-19 Science Advisory Table
- University of Waterloo School of Pharmacy / University of Toronto Leslie Dan Faculty of Pharmacy
- Canadian Pharmacists Association
- Centre for Effective Practice (CEP)
- Government of Canada
- Renal function (eGFR) calculators (examples):