nirmatrelvir + ritonavir + remdesivir

A combination antiviral therapy for COVID-19 that combines three different antiviral mechanisms. 1. **Nirmatrelvir** inhibits viral replication by inactivating the SARS-CoV-2 3-chymotrypsin-like cysteine protease enzyme (Mpro)[6]. 2. **Ritonavir** is co-formulated with nirmatrelvir and functions as a potent inhibitor of CYP3A4, which increases the bioavailability of nirmatrelvir[6]. 3. **Remdesivir** is a nucleotide prodrug that inhibits the RNA-dependent RNA polymerase of SARS-CoV-2, blocking viral replication[6]. This combination has shown synergistic activity in vitro against SARS-CoV-2, including Omicron variants and has been used successfully in immunocompromised patients with COVID-19, particularly those with positive SARS-CoV-2 RNAemia.