Janet writes:

Hello Daniel/Dr Griffin,

I work at a rural Urgent Care Clinic.  We offer outpatient Covid therapy.  Until this fall we offered MAB therapy and now offer Remdesivir infusions.  Our guidelines have a hard stop for a CrCl <30.  We are unable to offer these patients paxlovid or remdesivir.  Yet these patients are at high risk for complications of covid.  When I search for data about remdesivir/covid/<30gfr/outpatient prophylaxis I am mainly finding data about severely ill, hospitalized patients not ones who need prophylaxis.  What do you think?  If you think that remdesivir (3 day infusion) is safe for this patient population do you have references to share with my admin?

thank you,

janet fowle md

Linda writes:

Should a high risk individual (elderly elderly- 85 years old) who tests positive for COVID but is asymptomatic (tested due to exposure from a family member who was positive and symptomatic), should that elderly person pursue Paxlovid or Remdesivir?  Is this person who is asymptomatic still at risk to progress to hospitalization on week 2?

Linda Hall, DVM

Roman writes:

Dear Daniel and Vincent,

      I enjoy listening to TWiV on Saturday morning. Washing breakfast dishes is less of a chore!

      Daniel, the advice that I give clients about restarting medications after Paxlovid is different. With Justin’s question, I would have had him restarting atorvastatin two days after completing Paxlovid. This recommendation would be based on the Science Table COVID-19 Advisory for Ontario. 


The University of Liverpool Drug Interaction Checker would have me restarting atorvastatin three days after completing Paxlovid. 


It is interesting that we have three sources giving different restart dates!

Thanks for your great podcast and keep up the good work!

Take care,

Roman Moretti, B.Sc.(Pharm.)