Call Text Chat Email Refer a Patient Join a Study

Search

MotherToBaby

Medications and More during pregnancy and breastfeeding

Nirmatrelvir/Ritonavir (Paxlovid®)

Selected References:

  • American College of Obstetricians and Gynecologists (ACOG). 2026. COVID-19 FAQs for obstetrician-gynecologists, obstetrics. https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics.  Accessed June 2026 
  • Anderson PO. 2022. COVID-19 drugs and breastfeeding update. Breastfeed Med; 17:377–9. 
  • Chourasia P, et al. 2023. Paxlovid (nirmatrelvir and ritonavir) use in pregnant and lactating woman: Current evidence and practice guidelines-a scoping review. Vaccines (Basel); 11:107.  
  • Chuang MT, et al. 2024. Transplacental passage of nirmatrelvir in pregnant women with COVID-19. Int J Gynaecol Obstet; 164(1):351-353.  
  • Corbett AH, al. 2014. Antiretroviral pharmacokinetics in mothers and breastfeeding infants from 6 to 24 weeks post-partum: Results of the BAN Study. Antivir Ther; 19:587–595.  
  • Dai J, et al. 2024. Low Nirmatrelvir and Ritonavir Exposure through Breastmilk: Analyzing Milk Concentrations and Infant Risk. Clin Pharmacol Ther; 116(5):1217-1221.  
  • Gandhi M, et al. 2013. Hair and plasma data show that lopinavir, ritonavir, and efavirenz all transfer from mother to infant in utero, but only efavirenz transfers via breastfeeding. J Acquir Immune Defic Syndr; 63:578-584.  
  • Garneau WM, et al. 2022. Analysis of clinical outcomes of pregnant patients treated with nirmatrelvir and ritonavir for acute SARS-CoV-2 infection. JAMA Netw Open; 5(11):e2244141. 
  • Lin CY, et al. 2023. Nirmatrelvir-ritonavir (Paxlovid) for mild coronavirus disease 2019 (COVID-19) in pregnancy and lactation. Obstet Gynecol; 141:957–60.  
  • Lin CW, et al. 2023. Clinical outcomes of nirmatrelvir-ritonavir use in pregnant women during the Omicron wave of the coronavirus disease 2019 pandemic. J Infect Public Health; 16(12):1942-1946. 
  • Loza A, et al. 2022. Short-term pregnancy outcomes after nirmatrelvir-ritonavir treatment for mild-to-moderate coronavirus disease 2019 (COVID-19). Obstet Gynecol; 140(3):447-449.  
  • Palombi L, et al. 2012. Antiretroviral prophylaxis for breastfeeding transmission in Malawi: drug concentrations, virological efficacy and safety. Antivir Ther; 17:1511–1519.  
  • Ramírez-Ramírez A, et al. 2018. Simultaneous quantification of four antiretroviral drugs in breast milk samples from HIV-positive women by an ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method. PLoS One; 13:e0191236.  
  • Rezk NL, et al. 2008. Studies on antiretroviral drug concentrations in breast milk: Validation of a liquid chromatography-tandem mass spectrometric method for the determination of 7 anti-human immunodeficiency virus medications. Ther Drug Monit; 30:611–9.  
  • Yang H, et al. 2025. Birth Outcomes Following Anti-viral Therapy for Treatment of COVID-19 During Pregnancy. Matern Child Health J; 29(5):599-603.  

This website is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,200,000 with zero percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. Government.