Pharm

Ensitrelvir

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Ensitrelvir, Xocova

  • Indications
  1. Covid19 Exposure within last 72 hours in high risk patients (e.g, advanced age, Immunocompromised patients)
  • Contraindications
  1. Age <12 years
  • Background
  1. Expensive ($1400/course), oral Antiviral, SARS-CoV-2 Protease Inhibitor, approved for age >=12 years
  • Mechanism
  1. SARS-CoV-2 Protease Inhibitor
  • Dosing
  1. Ensitrelvir taken for five day course, and started within 72 hours of exposure
    1. Day 1: Take 3 tablets
    2. Day 2-5: Take 1 tablet daily
  • Efficacy
  1. NNT 17 to prevent 1 case of symptomatic Covid19 (NNT 14 in high risk patients)
  • Safety
  1. Avoid in pregnancy
  2. Avoid in Lactation (pump and dump for 2 weeks after treatment)
  • Adverse Effects
  1. Headache
  2. Diarrhea
  3. Cough
  • Drug Interactions
  1. Strong CYP3A Inducer (Carbamazepine, Phenytoin)
    1. Decreases Ensitrelvir doses and efficacy
  2. Statins
    1. Statin serum concentrations increased
  • References
  1. (2026) Presc Lett 33(9): 3-4