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Paxlovid is an antiviral prescription medication intended for the treatment of mild to moderate COVID-19 (coronavirus disease 2019) infections. It should be given only to persons who test positive for SARS-CoV-2, and not as a preventive medication.
Paxlovid consists of two different medications:
● Nirmatrelvir, which inhibits the SARS-CoV-2 protein to stop the virus from replicating.
● Ritonavir, which slows the breakdown of nirmatrelvir to help it remain in the body longer at a higher concentration.
Paxlovid medication is recommended for symptomatic patients with mild to moderate COVID-19 who also have one or more serious risk factors for progression to severe disease. The medication is taken orally, either with or without food. Treatment normally begins within five days of the patient's first COVID symptoms, and continues for five days afterward.
In May 2023, the U.S. Food and Drug Administration (FDA) granted full approval to Paxlovid as an antiviral drug for treating COVID-19 in adults.
Paxlovid is NOT authorized in the following setting:
Patient is not currently infected with COVID-19.
Patient is under 30 years with no risk factors or underlying medical conditions.
Patient has no high-risk factors for progression to severe disease.
Patient requires hospitalization due to severe COVID-19.
Patient has SARS-CoV-2 infection but DOES NOT have symptoms of COVID.
Patient wishes to use Paxlovid as a substitute for a COVID-19 vaccine.
Possible side effects of Paxlovid include muscle aches, diarrhea, high blood pressure, and impaired sense of taste.
May result in dangerous drug interactions if used with certain other medications.
May cause HIV-1 drug resistance in persons with an uncontrolled HIV-1 infection.
May cause health complications in patients with severe liver or kidney impairment.
NOTE: Paxlovid tablets can only be prescribed if you meet ALL of the following requirements:
● You have tested positive for COVID-19.
● You are at least 30 years of age.
● You are a high-risk patient due to a serious underlying medical condition such as diabetes, hypertension, heart condition, or lung disease.
Only about 1 percent of patients experience significant side effects from Paxlovid. The most common side effects reported are dysgeusia (alteration in the sense of taste) and diarrhea. More severe reactions are possible. If you experience any uncomfortable side effects from Paxlovid, contact your doctor immediately.
Treatment consists of three tables: two 150 mg tablets of nirmatrelvir and one 100 mg tablet of ritonavir. All three tablets are taken orally at the same time, twice per day for five days.
Use of Paxlovid as a Covid medication is not authorized for longer than five consecutive days.
There are more than a few medications that are contraindicated with Paxlovid, and may lead to serious and even life-threatening reactions when the two drugs are used together. These medications include but are not limited to certain antipsychotics (such as pimozide), migraine medications (such as eletriptan), PDE5 inhibitors (such as sildenafil), sedatives (such as triazolam and oral midazolam), and St. John’s wort. Be sure to tell your medical provider about all medications you are currently taking.
In addition, patients should not use Paxlovid if they are hypersensitive to either of its active ingredients, nirmatrelvir and ritonavir