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Simnotrelvir/ritonavir

Simnotrelvir/ritonavir (trade name Xiannuoxin) is a pharmaceutical drug used for the treatment of COVID-19. Simnotrelvir/ritonavir is a combination drug of simnotrelvir, an inhibitor of SARS-CoV-2 3CLpro, and ritonavir, a CYP3A inhibitor.


Column 1
Chemical structures of simnotrelvir (top) and ritonavir (bottom)
SARS-CoV-2 3CLpro inhibitor
Protease inhibitor
先诺欣 (Xiannuoxin)
.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}
Contraindicated (CN)
Oral
Rx in China
Clinical data
SIM0417, SSD8432
Oral
SARS-CoV-2 3CLpro inhibitor
Not approved on its own
72.5%
hepatic (CYP3A)
3.1 h; 4.1 h with ritonavir
urine (55.4%), feces (36.7%)
IUPAC name
(8S)-N-[(1S)-1-cyano-2-[(3S)-2-oxopyrrolidin-3-yl]ethyl]-7-[(2S)-3,3-dimethyl-2-[(2,2,2-trifluoroacetyl)amino]butanoyl]-1,4-dithia-7-azaspiro[4.4]nonane-8-carboxamide
168476146
C22H30F3N5O4S2
549.63 g·mol−1
Interactive image
SMILES
CC(C)(C)C@@HNC(=O)C(F)(F)F
InChI
InChI=InChI=1S/C22H30F3N5O4S2/c1-20(2,3)15(29-19(34)22(23,24)25)18(33)30-11-21(35-6-7-36-21)9-14(30)17(32)28-13(10-26)8-12-4-5-27-16(12)31/h12-15H,4-9,11H2,1-3H3,(H,27,31)(H,28,32)(H,29,34)/t12-,13-,14-,15+/m0/s1Key:LQBRGTAIBBFUJJ-ZQDZILKHSA-N

Simnotrelvir/ritonavir (trade name Xiannuoxin) is a pharmaceutical drug used for the treatment of COVID-19. Simnotrelvir/ritonavir is a combination drug of simnotrelvir, an inhibitor of SARS-CoV-2 3CLpro, and ritonavir, a CYP3A inhibitor.

It was developed by Simcere Pharmaceutical and conditionally approved in China by the National Medical Products Administration (NMPA) in January 2023. Results for the phase Ib trial are available. In a phase II/III trial, it reduced the duration of symptoms by a median of 36 hours compared to placebo.

  • Nirmatrelvir/ritonavir

  • NHSA slideshow, also shows adverse effect data from phase II/III

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