cliot (version 1.0.0)

paxlovid_eligibility_check: Indications for Paxlovid Prescribing

Description

Determines eligibility and appropriate dosing for Paxlovid (nirmatrelvir/ritonavir) therapy in patients with mild-to-moderate COVID-19. The function evaluates inclusion criteria (age, weight, risk factors, timing) and exclusion criteria (renal/hepatic impairment, drug interactions) based on FDA Emergency Use Authorization guidelines.

Usage

paxlovid_eligibility_check(covid_positive, symptom_onset_days, age_years,
                           weight_kg, has_risk_factors, egfr_ml_min,
                           severe_hepatic_impairment, significant_drug_interactions)

Value

A list containing:

Status

"Eligible" or "Not Eligible / Contraindicated".

Recommendation

Specific dosing instructions (Standard vs. Renal dose) or "None".

Reason_for_Ineligibility

Explanation if the patient is not eligible.

Arguments

covid_positive

Numeric (0 or 1). Confirmed positive SARS-CoV-2 test. (1 = Yes).

symptom_onset_days

Numeric. Days since symptom onset. (Must be <= 5 days for eligibility).

age_years

Numeric. Patient age in years. (Must be >= 12 for eligibility).

weight_kg

Numeric. Patient weight in kilograms. (Must be >= 40 kg for eligibility).

has_risk_factors

Numeric (0 or 1). Does the patient have one or more risk factors for progression to severe COVID-19 (e.g., age >= 50, cancer, diabetes, obesity, cardiovascular disease)? (1 = Yes).

egfr_ml_min

Numeric. Estimated Glomerular Filtration Rate (mL/min). Used for dosing adjustment. (<30 is contraindicated).

severe_hepatic_impairment

Numeric (0 or 1). Presence of severe hepatic impairment (Child-Pugh Class C). (1 = Yes).

significant_drug_interactions

Numeric (0 or 1). Use of medications that are highly dependent on CYP3A for clearance or are potent CYP3A inducers, where interactions cannot be managed. (1 = Yes).

References

FDA Fact Sheet for Healthcare Providers: Emergency Use Authorization for Paxlovid. U.S. Food and Drug Administration.

Examples

# Example 1: Eligible Standard Dose
# Positive, Day 3, 50yo, 80kg, Risk Factors, eGFR 90, No issues
paxlovid_eligibility_check(1, 3, 50, 80, 1, 90, 0, 0)

# Example 2: Eligible Renal Dose
# Positive, Day 4, 65yo, 70kg, Risk Factors, eGFR 45, No issues
paxlovid_eligibility_check(1, 4, 65, 70, 1, 45, 0, 0)

# Example 3: Contraindicated (eGFR)
# Positive, Day 2, 70yo, 70kg, Risk Factors, eGFR 20
paxlovid_eligibility_check(1, 2, 70, 70, 1, 20, 0, 0)