Richard Evan Steele

The important issue for any diabetic is to get your blood glukose and insulin to fit to each other. It is not a question of sugar/not sugar so much as it is a qusiton of total calory intake. Sugars contain approximately 4 calories per gram whereas fat contains 9 and protein 4. Eat a well balanced diet adhering to the food pyamid - and keep your caloric intake under control. That is your best bet.

It is not advisable, although it depends on the dosage. 3 200mg. Ibuprofen and 2 Tylenol would be OK, but 3 600mg. Ibuprofen and 2 Tylenol would not. Ibuprofen is a strong stomach irritant and can cause ulcers. I was unable to find your question on the site, therefore this email. Yours truly, Richard Evan (Rick) Steele, MD, MPH, PDC, BCSPHM Klinikken LIVET Address: Tyttebærvej 26, Sejs, 8600 Silkeborg, Denmark Mobile phone/Whatsapp: +45 2216 1923 Email: steele@dadlnet.dk<mailto:steele@dadlnet.dk> Web: www.klinikken-livet.dk<http://www.klinikken-livet.dk/>

HSV is the common abbreviation for heres simplex virus, which is more or less ubiquitous.. Nearly everyone has been exposed to it but very few of us get sick from it. It is normally a benign infection (like a light case of the flu) when it breaks though, and it can also affect the female reprocutive tract, but only in isolated cases. In other words, it is nothing to worry about.

This is probably more that you asked for, but here is the whole kit and kaboodle.

Indications
Treatment of COVID-19 in adults at increased risk of progressing to severe COVID-19.

Criteria for Nirmatrelvir Treatment
Confirmed SARS-CoV-2 infection via reverse transcription-polymerase chain reaction (RT-PCR), respiratory sample testing, or antigen/self-test; and
Significant COVID-19 symptoms lasting no more than 5 days; and
At-risk or high-risk patient; and
Outpatient or hospitalized for a condition other than COVID-19.
Note:
For high-risk patients, treatment may be offered based on an individual assessment, even for those with prolonged symptomatic COVID-19.

The definition of at-risk and high-risk patients can be found in the Danish Health Authority's guidelines or under disease progression. The Danish Health Authority has issued guidelines on who should receive nirmatrelvir treatment.

There are also guidelines from the Infectious Disease Society.

See also:
Antiviral agents for COVID-19
Dosage Forms
Film-coated tablets. The package contains two different types of tablets:

Pink tablets containing 150 mg nirmatrelvir
White tablets containing 100 mg ritonavir
Dosage Recommendation
Adults:

300 mg nirmatrelvir (2 tablets of 150 mg) with
100 mg ritonavir (1 tablet of 100 mg)
Every 12 hours for 5 days.
Paxlovid should be administered as soon as possible after a COVID-19 diagnosis and within 5 days of symptom onset.

Important Notes:
Safety and efficacy have not been established in children and adolescents under 18 years old.
Can be taken with or without food.
Must be swallowed whole.
If absolutely necessary, both tablets may be split/crushed, but crushing may reduce ritonavir plasma concentration (white tablet).
General Dosage Guidelines
Handling of Tablets and Capsules
Film-coated tablets (150 mg + 100 mg)
Crushing/opening: Not recommended.
Administration: Swallow whole.
Food and drink: Can be taken with or without food.
Note:
If absolutely necessary, both tablets may be split/crushed, but this may reduce the plasma concentration of ritonavir (white tablet).

Kidney Function Impairment
Caution for Reduced Kidney Function
GFR Warning
<30 ml/min Low risk of toxicity for a 5-day treatment. 150 mg nirmatrelvir / 100 mg ritonavir (1 tablet of each) every 12 hours for 5 days may be given.
30-60 ml/min Dose reduction: 150 mg nirmatrelvir / 100 mg ritonavir (1 tablet of each) every 12 hours for 5 days.
Liver Function Impairment
Contraindicated in severe liver impairment (Child-Pugh C) due to lack of experience.
Hepatitis and other liver-related effects have occurred with ritonavir treatment.
Use with caution in patients with pre-existing liver disease, liver enzyme abnormalities, or hepatitis.
Contraindications
Drug Interactions:
Paxlovid is primarily metabolized via CYP3A4, and its inhibitory effect on CYP3A4 can increase the risk of serious side effects.
Potent CYP3A4 inducers can reduce Paxlovid’s plasma concentration, affecting its virological response and possibly leading to resistance.
Refer to Interactions section and product summary for further details.
Precautions
Monitoring
Bedaquiline/Delamanid: Frequent ECG monitoring recommended.
Steroids (e.g., budesonide): Close monitoring of local and systemic side effects is advised.
Midazolam: Close clinical monitoring is necessary, along with medical intervention in case of respiratory depression or prolonged sedation.
Cases of hypertension (non-severe and temporary) have been reported. Regular blood pressure monitoring is recommended, especially in elderly patients who have a higher risk of severe complications.
Side Effects
This medication has enhanced reporting requirements. All side effects must be reported to the Danish Medicines Agency.

System Organ Class Potentially Serious Side Effects Common (1-10%) Uncommon (0.1-1%) Rare (0.01-0.1%)
Gastrointestinal - Diarrhea, nausea, vomiting, taste disorders (e.g., metallic or bitter taste) Abdominal pain -
Nervous System - Headache - -
Immune System - - Hypersensitivity Anaphylactic reaction, Stevens-Johnson syndrome
Musculoskeletal System - - Myalgia -
Skin & Subcutaneous Tissue - - Itching, rash Toxic epidermal necrolysis (TEN)
Vascular Diseases Hypertension - - -
General Symptoms - - - Malaise
Note: Symptoms like rash and itching may indicate an allergic reaction.

Drug Interactions
Nirmatrelvir is a CYP3A inhibitor and may increase plasma concentrations of drugs metabolized by CYP3A.

Ritonavir inhibits CYP3A and CYP2D6, which can lead to interactions with antidepressants, antipsychotics, and opioids.
Serious interactions with calcineurin inhibitors and mTOR inhibitors (used as immunosuppressants) can be life-threatening.
Regular monitoring of immunosuppressant serum concentrations is necessary during and after Paxlovid treatment.
Significant Interactions (Non-Exhaustive List)
Adrenergic α1-receptor antagonist: Alfuzosin
Cancer medications: Neratinib, Venetoclax
Antiarrhythmics: Amiodarone, Dronedarone, Flecainide, Propafenone
Anti-infectives: Fusidic acid, Rifampicin, Itraconazole
Antiepileptics: Carbamazepine, Phenobarbital, Phenytoin
Gout medication: Colchicine
Antipsychotics: Lurasidone, Pimozide, Clozapine, Quetiapine
Ergot alkaloids: Ergotamine
Herbal medicine: St. John’s Wort
Lipid-lowering drugs: Simvastatin, Lomitapide
PDE5 inhibitors (for erectile dysfunction): Avanafil, Sildenafil, Vardenafil
Sedatives/hypnotics: Diazepam, Oral Midazolam, Triazolam
HIV drugs: Efavirenz, Maraviroc
Immunosuppressants: Ciclosporin, Tacrolimus, Everolimus, Sirolimus
Refer to product summary section 4.5 for detailed interactions.

Pregnancy & Breastfeeding
Not recommended due to insufficient data.
No sufficient human data for nirmatrelvir to estimate risks.
Ritonavir monotherapy appears safe, as per Norvir®.
Blood Donation
Not allowed for blood donation (2-week quarantine).
No quarantine required for plasma donation for fractionation.
Doping
No restrictions.
Alcohol Consumption
No interaction between alcohol and Paxlovid.
However, always follow the Danish Health Authority’s recommendations.

Rest assured that vitamin C, which emerged-c is, has no known interactions with drugs.

It could be the flu. Give it a week and see if it doesn't pass by then. If not, see your family doc and get some tests done.

This is definitely not normal. Meanwhile, the skin condition could possibly be a simple complication from too much pressure on the skin from the inside. Your brother should be medically evaluated, but a crash weight loss program would benefit him no end. Is he on Ozempic? It sounds like a very good fit for him. He will need to get a prescription from his family doctor. Cellulitis cannot be ruled out from the pictures, and an evaluation should be done.

Your immune system should be taking care of your influenza viral load. It does not make any sense to get an immunization against a bug the one has in one's body. In general, one is advised not to get an immunization when one is sick. An untoward immunization reaction is more likely in this case than when a healthy individual is immunized.

You should go back to the hospital and get a biopsi done from one the swollen lymphs nodes, alternatively to have one removed and diagnosed. From the story, I would not rule out a malignant reason for all of this. It needs to be diagnosed sooner than later.

Nothing to worry about. It is a simple question of not closing your airway completely. Pehaps you have an anatomcial anomaly, but that is still nothing to worry about.

It sounds like you did a blowjob on your partner. If it was cunnilingus, the risk is less, but not trivail. You should go to your family doctor and get a throat swab done. That will elucidate your situation.

Looks like an allegic reaction. Have you started a new medication recently, or eaten something you are allergic to? If it does not resolve within a few days, and especially if it gets worse and you experience difficulty breating, see your family doctor forthwith, or if s/he is not there when your experience, off to the nearest emergency room.

You should have a CT scan of your chest and abdomen - with contrast, if you can stand it. If that does not give the answer, you should see a good acupunturist and/or chiropractor.

I wonder what the status of you scalene muscles are. I suspect you have tension issues that are bother you. See a low level laser therapist or an acupuncturist. Too bad you are not close to me - I could diagnose and fix it for you.

Rick Steele www.klinikken-livet.dk

Take her to your family doctor. Have a throat swab done. The tumor is most likely what is called a cold sore, which is caused by herpes simplex virus that is veru common/ It will pass, but a throat swab will give an indikation of whether a treatment can be found.

See your family doctor and get a throat swab done. That will give the answer as to whether a treatment would help.

It is very likely that your dad has a viral infection. The most likely is respiratory synctitial virus (RSV) which typcailly last 4-8 weeks. If the phlegm is yellow, go to you family doctor and get a throat swab done. That will give an answer in a matter of days.

Go to your family doctor and get a throat swab done to see if the soreness is due to a traatable disease.

Go to your family doctor and get a thorat swab done to see if you have a treatable disease.

Could be your heart. Go to your family doctor and get an ECG done, or, if s/he doesn't have such an apparatus, get a referral to the nearest cardiologist.