On Dec. 22, 2021, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for Pfizer’s Paxlovid for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (12 years and older weighing at least 88 pounds). This is the first of two oral drugs with emergency use authorization for treatment of COVID-19 in the outpatient setting.
In November 2021, Pfizer released data from the EPIC-HR clinical trials of their experimental antiviral pill, Paxlovid. Paxlovid reduced hospitalizations and deaths from COVID-19 by up to 89% among high-risk patients, Pfizer said in a news release.
What is Paxlovid?
Pediatric Infectious Disease Physician Dr. Thomas Boyce explained that Paxlovid works differently from another antiviral medication, like Tamiflu, given for influenza symptoms, but there also are similarities.
Similar to other antiviral medications, Paxlovid needs to be given early on in the illness to be effective and it is targeted for people who are at high risk for severe illness. The longer the COVID-19 virus has time to multiply, the more it is going to spread. Whereas, if the virus is stopped early from treatment, complications will be less severe.
Paxlovid consists of two components, nirmatrelvir and an existing drug called ritonavir. Both components are protease inhibitors, meaning they block an enzyme called a protease that cuts apart long strands of nonfunctional viral proteins into smaller, functional proteins. Ritonavir is used in some antiretroviral drug combinations to treat HIV.
Who is eligible for Paxlovid?
Under the EUA, Paxlovid is for the treatment of mild-to-moderate COVID-19 in adults and children (12 years of age and older weighing at least 88 pounds) with a positive test for the virus that causes COVID-19, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Patients should have symptoms for five or fewer days to be eligible for treatment.
Paxlovid is administered as three tablets (two tablets of nirmatrelvir and one tablet of ritonavir) taken together orally twice daily for five days, for a total of 30 tablets. Paxlovid is not authorized for use for longer than five consecutive days.
Paxlovid is currently available at most pharmacies and is the drug of choice for outpatient treatment of COVID-19. If you or a family member are high risk for severe COVID-19 and have respiratory symptoms, consider getting tested for COVID-19. If you have either a home antigen test or a PCR test that is positive for COVID-19, ask your provider to consider prescribing Paxlovid. They will check to make sure there are no interactions with other medications you may be on.
For more information about COVID-19 treatment options available, visit marshfieldclinic.org/covidtreatments.