Clarifications in JAMA Clinical Guidelines Synopsis

The article presents clarifications to JAMA Clinical Guidelines Synopsis recommendations on antiviral therapies for adults with mild to moderate COVID-19 infection, published June 30, 2026. Specifications were clarified regarding contraindications of coadministration of nirmatrelvir-ritonavir with certain medications including amiodarone, statins, phosphodiesterase 5 inhibitors, alpha-blockers, and benzodiazepines, as well as strong CYP3A inducers. Additional clarifications were provided regarding molnupiravir, which is available in the US only through Emergency Use Authorization, with the authorization to be terminated effective June 29, 2027. For patients who can become pregnant, contraception is required during molnupiravir use and for 4 days after the last dose if their partner did not use molnupiravir. With a male partner using molnupiravir, effective contraception is needed for 3 months after the last dose. Breastfeeding patients should consider interrupting breastfeeding and instead pump and discard breast milk during molnupiravir treatment and for 4 days after the last dose.