Talk:Nirmatrelvir/Archive 1

Page name should be INN
Now that the drug has "nirmatrelvir" as INN, shouldn't this article be renamed? I would do it, but the nirmatrelvir redirect has a history so it's a non-trivial move. Figure I'd ask here first to confirm this is noncontroversial. &mdash; soupvector (talk) 01:37, 15 December 2021 (UTC)
 * Agreed, . Not controversial following announcements of the INN, for example here from Bloomberg. The nirmatrelvir page has only ever been a redirect (although WP:AfC was used by yesterday to create it) so there's no real history to worry about. Note that the moving process should automatically leave PF-07321332 as a new redirect. Mike Turnbull (talk) 11:53, 15 December 2021 (UTC)
 * ✅ Now renamed/moved, thanks to . Mike Turnbull (talk) 12:31, 16 December 2021 (UTC)

Paxlovid
Is not a brand name? Then what is it? 1 2 Artem S. Tashkinov (talk) 14:47, 19 December 2021 (UTC)
 * It is exactly what it says in the lede of the article, namely the Pfizer brand name for the combination of two drugs, nirmatrelvir and ritonavir that they have used in trials and will sell. AFAIK, nirmatrelvir will not be sold on its own, only in combination, for the reasons explained in the article. Mike Turnbull (talk) 15:08, 19 December 2021 (UTC)

this page should be protected soon
hey this page should be locked from easy editing soon. i have seen some misleading trends leading to conspiracy theories based on this already. with this drug likely getting approved this week i think we should be proactive in locking it. I am unsure how to do this. — Preceding unsigned comment added by Ubiquitinateme (talk • contribs) 15:35, 22 December 2021 (UTC)
 * you can request protection at WP:RFP but it is not accepted practice to do so until persistent vandalism or edit-warring occurs. There are about 40 people watching this page, so it is likely someone will intervene if necessary. Mike Turnbull (talk) 15:59, 22 December 2021 (UTC)

Name
"Nirmatrelvir" is the new INN, does anyone have the origin of this name? "-vir" means antiviral drug, but where does the rest of the name originate? That should be added to the article -- 65.92.246.142 (talk) 15:46, 23 December 2021 (UTC)

Paxlovid (Nirmatrelvir/Ritonavir)
There should be a separate section for the combination drug "paxlovid" or a separate article on that. -- 65.92.246.142 (talk) 15:48, 23 December 2021 (UTC)

Language
Nirmatrelvir has not been falsely promoted. It has actually been promoted. The grammar on this wording is wrong. Secondly, while ivermection may or may not have antiviral activity, it is not inherently dangerous when used in correct amounts. It already has indicated use in humans. I changed to more neutral (WP:Neutral)language. MartinezMD (talk) 03:20, 26 December 2021 (UTC)

Comparison to GC-373
The similarity of GC-373 and nirmatrelvir is potentially overstated. Both are 3C-like protease inhibitors with a P1 pyrrolidone, however, other than that they are chemically dissimilar (dipeptide vs tripeptide; different N-terminal modification, different P2 residue, different C-terminal electrophilic moiety). I suggest a more experienced user could perhaps help changing the wording 'analogue' used within the text. Exaltedyeti (talk) 13:19, 3 January 2022 (UTC)

Split Paxlovid (nirmatrelvir, co-packaged with ritonavir) to its own article
--Bawanio (talk) 19:12, 31 December 2021 (UTC)
 * I agree this should be done. --Fernando Trebien (talk) 19:57, 31 December 2021 (UTC)
 * This is a difficult call, I think, but well worth discussing here. My personal starting point is the advice at WP:DRUGGUIDE and MOS:MED. According to the former guidance, we would not create an article called "Paxlovid" (which is a trade name) but rather an article called "Nirmatrelvir/ritonavir", similar to that at Isosorbide dinitrate/hydralazine and mentioned as an example in the guide. Such a (third) article would, of course be the target of the redirect from Paxlovid and should contain most of the subsections which are relevant to its clinical use, including contraindications, adverse effects or side effects and overdose. In this recent diff, recently removed most of what the nirmatrelvir article contained on these topics with an edit summary of "remove text for wrong audience" and citing MOS:MED, despite this explicitly stating that such subsections are appropriate (we could have a separate discussion about the details of the content in this case). With all this in mind, it might be thought that splitting out the combination is an easy decision but the contrary view is that nirmatrelvir is not licensed for use on its own and that it is the "active" antiviral ingredient in Paxlovid, with ritonavir's role merely to slow its metabolism. Comments welcome! Mike Turnbull (talk) 13:59, 1 January 2022 (UTC)
 * Some related examples are bamlanivimab, bamlanivimab/etesevimab, casirivimab/imdevimab, and tixagevimab/cilgavimab. For the last two examples either component redirects to the combination article. --Whywhenwhohow (talk) 19:13, 1 January 2022 (UTC)
 * I added them to Combination_drug, thanks! --Bawanio (talk) 05:12, 2 January 2022 (UTC)
 * ✅. As nirmatrelvir is not given by itself, it may make sense to merge it with nirmatrelvir/ritonavir someday. --Fernando Trebien (talk) 17:58, 5 January 2022 (UTC)
 * Please don't merge either the current stand-alone nirmatrelvir or ritonavir into anything else. They are perfectly acceptable articles with appropriate notability and the individual articles are good place to describe the chemistry, which may not be appropriate in any combination article. I've added a chemistry section to ritonavir today, for example. Mike Turnbull (talk) 18:08, 5 January 2022 (UTC)
 * Thank you very much. --Bawanio (talk) 22:53, 10 January 2022 (UTC)

Production difficulties
At a UCSF grand rounds on COVID-19, which was posted on Youtube, Eric Topol said that Paxlovid was the second most important treatment after the vaccine, but it was complex to make, and would take months. The "rate-limiting step" was the raw materials, which are supplied by China. It would be nice to have in this article, but I'd like to confirm it with WP:RS. Opinions?

https://www.youtube.com/watch?v=lCAvFHd3B38 UCSF Department of Medicine The Omicron Whirlwind: A Conversation with Eric Topol - The Current and Future State of the Pandemic Jan 13, 2022

--Nbauman (talk) 19:47, 16 January 2022 (UTC)
 * Irrespective of Topol's expertise, what he says in the video is just anecdote. For example, he also mentions that chemists in Bangladesh are doing scale-up and that might overcome supply issues. Pfizer themselves have large efforts on this that Topol is unlikely to know about. As to "second most important treatment", that's clearly a guess given that Paxlovid is not yet in extensive use. Currently, I would say that in terms of cost-effectiveness in saving lives dexamethasone is second only to the vaccines. Mike Turnbull (talk) 12:04, 17 January 2022 (UTC)