How are individuals with COVID-19 referred and assessed for Paxlovid™ (nirmatrelvir/ritonavir)?

• Use the Report and Support Screening Tool when a positive result is obtained from a rapid antigen test or when a PCR test is booked. The form can be completed by a patient, family member, pharmacist, or other healthcare provider. Completing the screening form is how patients are assessed for COVID-19 medications and other supports, including pulse oximeters, if needed.

Who will be considered for Paxlovid™ (nirmatrelvir/ritonavir) treatment?

• Individuals who complete the Report and Support Screening Tool and who are determined through the screening tool to meet the eligibility criteria as described on the Paxlovid™ (nirmatrelvir/ritonavir) checklist.

What if I believe an individual is eligible to receive Paxlovid™ (nirmatrelvir/ritonavir) treatment and needs expedited consideration for treatment?

• Pharmacists can email COVIDTreatment@nshealth.ca if they identify a patient that meets eligibility criteria or to recommend an assessment on a case-by-case basis outside of the eligibility criteria. Using this email is a faster way to initiate an assessment of the patient. Please note: This email should not be shared with patients.

• The Report and Support Screening Tool must still be completed in order for the patient to access other important COVID-19 supports (e.g., pulse oximeters) if needed.

Who can prescribe and dispense Paxlovid™ (nirmatrelvir/ritonavir)?

• Paxlovid™ (nirmatrelvir/ritonavir) can only be prescribed by NS Health designated prescribers (Please note: All Paxlovid™ (nirmatrelvir/ritonavir) prescriptions written by a designated prescriber are assessed by a NS Health pharmacist using both the NS Health Pharmacist Assessment Protocol and the NS Health Nirmatrelvir/Ritonavir (Paxlovid®) Drug Interaction Assessment Tool); AND

• Paxlovid™ (nirmatrelvir/ritonavir) can only be dispensed by NS Health designated pharmacies and hospitals.

How can I confirm that a designated prescriber prescribed Paxlovid™ (nirmatrelvir/ritonavir)?

• Designated prescribers are listed on the PANS Resources for Outpatient COVID-19 Pharmacotherapy site under “Additional Resources for Pharmacies.” The list will be updated as additional prescribers are authorized.

• Valid prescriptions for Paxlovid™ (nirmatrelvir/ritonavir) will be on the NS Health Oral Antiviral for COVID-19 order set.

Pharmacists are also welcome to call the COVID-19 Non-Severe Therapy Pharmacist Consult Service at 1-833-714-2784 between 9 am and 5 pm, 7 days a week if they have COVID-19 antiviral medication or drug interaction questions.

Budesonide Use for the Treatment of Covid-19

Resources

PANS Prescribing Tool for the NSH Prescribing Protocol for Inhaled Budesonide for the Treatment of Covid-19

PANS Prescribing Inhaled Budesonide for Treatment of Covid-19 Brief Training Video (optional 12 minute training video)

NSH Medication Treatment Summary: Inhaled Budesonide

NSCP Professional Memo - Prescribing Inhaled Budesonide for Covid-19 - May 10th

Pharmacists may now prescribe inhaled budesonide for the treatment of mild SARS-CoV-2 respiratory symptoms in accordance with the Standards of Practice: Prescribing Drugs, Appendix G – Prescribing for a Diagnosis Supported by a Protocol.  Nova Scotia Health is looking to improve access to inhaled budesonide across the province given ongoing high rates of SARS-CoV-2 infection.

What does this new prescribing authority enable?

This authority enables pharmacists to prescribe inhaled budesonide for the treatment of mild SARS-CoV-2 respiratory symptoms when using the Nova Scotia Health Inhaled Budesonide Prescribing Protocol.

Can another protocol be used when prescribing inhaled budesonide for the treatment of mild SARS-CoV-2 respiratory symptoms?

Pharmacists can only prescribe inhaled budesonide for the treatment of SARS-CoV-2 when they do so in accordance with the Nova Scotia Health Inhaled Budesonide Prescribing Protocol. Please note:

Inhaled budesonide may only be prescribed by pharmacists for the treatment of SARS-CoV-2 (no other indications)

The dose for the treatment of SARS-CoV-2 is 800 mcg twice daily

Therapeutic substitutions for nebules, other inhaled corticosteroids, or oral/IV corticosteroids are not permitted within the protocol

What if I have questions about the use of inhaled budesonide in the treatment of mild SARS-CoV-2 respiratory symptoms?

Pharmacists are welcome to call the COVID-19 Non-Severe Therapy Pharmacist Consult Service at 1-833-714-2784 between 9 am and 5 pm, 7 days a week if they have COVID-19 medication or drug interaction questions, including questions about the inhaled budesonide prescribing protocol.

How do I respond to questions from my patients about Paxlovid™ (nirmatrelvir/ritonavir)?

Please see the Paxlovid™ (nirmatrelvir/ritonavir) Information and Resources notice for answers to frequently asked questions.