@CTTC The standard Paxlovid dose pack includes 300 mg nirmatrelvir and 100 mg ritonavir; the renal dose pack drops to 150 mg nirmatrelvir and 100 mg ritonavir. Both are to be taken twice a day for 5 days. Those with a GFR greater than, or equal to 30, and less than 60, are prescribed the renal dose pack. If GFR is less than 30, Paxlovid is not recommended.
If only the standard dose pack was available, a renal patient could still get that, and not take one of the 150mg nirmatrelvir tablets each time, assuming it was prescribed that way. Paxlovid is packed in a blister pack with the day and dosage marked, so it would be easy to just depose of the extra nirmatrelvir tablet; of course best to get the correct pack to avoid any confusion.
Thank you @compmom and @Mwfan1921 with additional info concerning amiodarone. FIL is on it for hypertension not arrythmias. Given he is in an assisted living facility at the highest level care, medication is approved and over seen by a doc/NP team. Also the pharmacist approved the Paxlovid order but FIL is not allowed to take amiodarone for 8 days. After another call with the NP this morning, I was told again the benefits of Paxlovid is more important right now and they will continue to monitor his vitals daily. I asked if a cardiologist consult should be considered and was told given that itās a holiday weekend, it will not be possible and we need to be mindful of the 5 day window for taking Paxlovid. At this point, we have to rely on his medical team. None of this makes me feel confident though am going to worry about it.
Interesting. I had no idea what GRF is, so I looked it up (in case anyone else wants to know):
GFR - Glomerular filtration rate
"What is a normal GFR?
According to the National Kidney Foundation, normal results range from 90 to 120 mL/min/1.73 m2. Older people will have lower than normal GFR levels, because GFR decreases with age. Normal value ranges may vary slightly among different laboratories."
@compmom I guess that would depend on your provider. As I have kidney disease, I have labs drawn at least every 6 months with my nephrologist. My numbers fluctuate within the mid 40s, so I fall into the renal dose of Paxlovid. I had actually ask her about this maybe a year ago, wondering if Paxlovid was an option for me if I contracted Covid; she was absolutely, and start it as soon as possible!
My 91 year old motherās GFR is under 30, so the nephrologist will not let mom take Paxlovid.
I would think a discussion with your provider would be worth having. My results from the renal dose of Paxlovid was no different from my husbandās regular dose; glad I could take it and not harm my kidneys by taking a smaller dose!
@snowball I might ask my PCP for a test and hydrate. I still might fall in the higher 50ās. (I think my last one was actually 49.) Good to know the renal pack worked well!
Just want to report that FIL is doing well on Paxlovid. He finished his last dosage this morning. His vitals were closely monitored by the AS facility staff and I have updated that heās doing well. His PCP also visited him yesterday to check in on him. After the visit, the PCP also called me to give me assurances not to worry. That call was a nice surprise, because itās rare that PCP follows up with a family member, esp a DIL. My H is the POA. I guess it helps to be a real nudge/advocate : ). Iām keeping my fingers crossed that FIL wonāt get rebound symptoms.
I now have another person I personally know who has died of Covid. This guy was 93 and had another totally unrelated health issue going on, so went to the hospital for that. In the hospital he caught Covid and passed away.
It sure gives me pause before heading to the hospital for something - what a choice folks have to make.
I hope 94 year old FIL can stay away from it. Heāll be going to this guyās funeral soon. They were friends.
As all of us age Iām afraid Covid will rank up there among things that kill folks. I donāt see it going away.
My brother was admitted to the hospital for one night due to seizures. He caught Covid there. Hospitals used to be very safe when the pandemic started. They were fanatics about clean. I guess it has slipped. Also, heās in FL and doesnāt believe in masks or vaccine.
Iām sorry about your brother. I will say though that hospital-aquired infections have always been a huge problem, well before COVID. Iāve seen ranges from 600,000 to 1.7 million per year (pre-COVID) with up to 100,000 deaths per year. My father used to always say he didnāt want to go into the hospital because heād just catch some infection there. So, itās definitely not a new problem.
I was at the store today and there was a woman who seemed sick in the same aisle as me looking for cold medicine as I was looking for a protein shake. She was wearing a high quality mask, but she told me it was good her husband and son were a couple aisles down from me because they werenāt wearing masks. It sounded like the whole family was sick. Why, people?!!
Vaccination is very helpful in preventing severe illness ( though less for the elderly) but almost no one in the hospital will remain masked all the time. 24 hrs a day is just more than most people can stand. According to my daughter most will pull on their mask in their sleep. And unlike when those people who are wearing an oxygen mask there is no alarm for it being off and no longer effective. And itās much easier to displace it.
Well, sure re: sleeping. And as someone who works in a hospital setting, I can say with unfortunate confidence that both patients and the public seem to feel that masking is not their bag in a hospital setting anymore. They - patients and the public - have gotten much more lax in mask compliance even in health care settings.
Iām bothered by the remarks (not yours) that seem to indicate that hospitals arenāt as clean or careful or whatever and perhaps are contributing to spread. How many fires would we like health care to put out?
