Frequently asked questions about antiviral treatment of COVID-19
At this time there are two oral antiviral pills, nirmatrelvir-ritonavir (PaxlovidTM) (Pfizer) and molnupiravir (Merck), that have been approved for emergency use authorizations by the U.S. Food and Drug Administration. These pills are for the treatment of mild to moderate COVID-19 in outpatients with risk factors for progression to severe COVID-19. These pills can be prescribed only if your symptoms of COVID-19 started within the past five days. Both antiviral pills may only be prescribed for a patient by doctors, advance practice registered nurses, and physician’s assistants. Due to the limited availability of this medication, health care providers will need to determine the best course of treatment for their patients based on eligibility criteria and medication availability. Getting vaccinated and taking measures to avoid getting COVID-19 are still your best methods of protection.
In addition to the pill, there is also an intravenous treatment called remdesivir. This medication is not FDA approved for outpatients, and it is available only for inpatients with moderate to severe COVID-19 at this time.
Antiviral medications help your body fight off viruses that cause disease, reduce the symptoms of an infection, and shorten the length of illness. It’s important to note that the pills are meant to be taken after you’ve experienced COVID-19 symptoms. They cannot be used to prevent COVID-19 or in people who test positive for COVID-19, but do not have symptoms. When the drugs enter your bloodstream, they block the ability of the SARS-CoV-2 virus to replicate it. In most cases, the virus clears up without these drugs, but when your infection is chronic or life-threatening, your doctor may want to treat you with the COVID antiviral medications.
Antiviral pills are not recommended for everyone who tests positive for COVID. The pills are intended for those who have symptoms from COVID-19 and who are not in the hospital, but who are more likely to become seriously ill. That includes older people and those with other health conditions like heart disease, cancer, or diabetes that make them more vulnerable. Both pills have been approved for adults and the Paxlovid pill is authorized for children ages 12 and older. These medications can be prescribed only if your symptoms of COVID-19 started within the past five days.
Neither medication can be used in patients hospitalized due to COVID-19, so you are not able to get these medications in the hospital. However, there are other treatments available for people who need to be hospitalized due to more severe COVID-19 symptoms.
The COVID antiviral treatments are available only to patients at highest risk of developing severe COVID-19 illness, including people older than 65 and those with other health conditions like heart disease, cancer, or diabetes, that make them more vulnerable to severe illness. Patients can be prescribed these medications only if symptoms developed in the past five days and they tested positive for COVID-19. Contact your healthcare provider and get tested as soon as possible if you develop symptoms.
These medications cannot be prescribed to prevent COVID-19. They are available only for patients who have an active infection. Vaccination and taking measures to avoid getting COVID-19 are still your best methods of protection.
Both medicines can reduce hospitalizations and deaths from COVID-19 when given within three days of symptom onset. In an interim analysis, Paxlovid reduced the risk of Covid-19-associated hospitalization or death by 88 percent in those who received treatment within five days of symptom onset. In its Phase II/III clinical trial, 1 percent of patients who received Paxlovid were hospitalized through day 28 compared to 6.7% of placebo participants. Ten deaths were reported among patients in the placebo arm, while none occurred among patients taking Paxlovid.
Molnupiravir reduced the risk of hospitalization or death by 30 percent in the final analysis of its Phase III trial. Nine deaths were reported in the placebo group, and one in the molnupiravir group. However, in the second half of the trial data when newer COVID-19 variants were present, there was no difference between molnupiravir and placebo. So it’s possible that molnupiravir may be less effective against newer variants.
While these are effective treatments for people with COVID-19, they’re not meant to replace the COVID-19 vaccine.