While the patient is taking nirmatrelvir/ritonavir for COVID-19, he may continue saxagliptin therapy with a dose reduction to 2.5 mg daily. Other diabetes medications, such as empagliflozin, insulin, metformin, and pioglitazone, are not likely to have clinically relevant interactions with nirmatrelvir/ritonavir, but because individuals with diabetes and COVID-19 should follow "sick day rules," the patient should be advised to suspend metformin.
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Cite this: Enrico Brunetti. Skill Checkup: A 70-Year-Old Man With Loss of Smell, Dry Cough, and Headache - Medscape - Nov 07, 2022.