Pharm Report Issue No. 21

Issue XXII (February 2026)

A woman in a striped sweater examines a prescription bottle, focusing intently on the label. Natural light filters in.

Paxlovid & Tamiflu Available During Peak Respiratory Season

Respiratory illness activity remains elevated this winter, with ongoing circulation of COVID-19 and seasonal influenza alongside common cold viruses.

Timely antiviral treatment remains a key tool to reduce disease severity and complications in high-risk patients. Forward Pharmacy is happy to report that both Paxlovid (nirmatrelvir/ritonavir) and Tamiflu (oseltamivir) are in stock and ready to dispense to eligible patients.

Paxlovid (nirmatrelvir/ritonavir) – COVID-19

Indicated for mild to moderate COVID-19 treatment in adults and pediatric patients (≥12 years, ≥40 kg) at high risk for progression to severe disease. Therapy should be initiated within 5 days of symptom onset.

Renal Dose Adjustment

  • eGFR ≥30 to <60 mL/min → nirmatrelvir 150 mg + ritonavir 100 mg, administered together, twice daily for 5 days.
  • eGFR <30 mL/min → nirmatrelvir 300 mg + ritonavir 100 mg, administered together, once on day 1, then nirmatrelvir 150 mg and ritonavir 100 mg, administered together, once daily for 4 more days to complete a 5-day course.

Prescription Tips

  1. Significant drug-drug interactions due to ritonavir (CYP3A4 inhibition).
  2. Patients should complete the full 5-day course, even as symptoms improve.
  3. COVID rebound has been reported, but typically does not require re-treatment.

Standard Dosing (eGFR ≥ 60mL/min)

300 mg nirmatrelvir + 100 mg ritonavir, administered together, twice daily for 5 days.

Tamiflu (oseltamivir) – Influenza A & B

Indicated for mild to moderate COVID-19 treatment in adults and pediatric patients (≥12 years, ≥40 kg) at high risk for progression to severe disease. Therapy should be initiated within 5 days of symptom onset.

Standard Pediatric Treatment Dosing (oral suspension or capsules)

  • ≤15 kg → 30 mg twice daily
  • >15 to 23 kg → 45 mg twice daily
  • >23 to 40 kg → 60 mg twice daily
  • >40 kg → 75 mg twice daily

All pediatric treatment courses are for 5 days.

Prescription Tips

  1. Oseltamivir is not a substitute for annual influenza vaccination. 
  2. Common adverse effects include nausea and vomiting; taking with food may improve tolerability

Prophylaxis Dosing

  • Adults → 75 mg once daily for 10 days.
  • Pediatric → weight-based for around 1-2 weeks when appropriate.

Renal Dose Adjustment

Oseltamivir 75 mg orally twice daily for 5 days.

What This Means for Your Practice

While in the midst of the cold season, Forward Pharmacy is prepared to support your patients with immediate access to Paxlovid and Tamiflu (both capsule and suspension).

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Published on Feb 03 2026

Categories: Pharm Report