Should I take the antiviral Paxlovid if I have mild COVID?

Should I take the antiviral Paxlovid if I have mild COVID?

Paxlovid, a COVID drug, has been accessible on the Pharmaceutical Benefits Scheme (PBS) in Australia since the beginning of May, with eligible patients being instructed to speak with their GP for a prescription.

Paxlovid is a tablet-based oral COVID therapy that contains two active ingredients: nirmatrelvir and ritonavir. They work together to stop SARS-CoV-2, the virus that causes COVID, from multiplying in your body.

With tens of thousands of COVID-19 cases being reported each week, scientists say a large public awareness effort is needed to ensure that those who are at risk are aware of extremely effective medicines that can help them avoid serious disease.

So, who should be able to use Paxlovid? What are the advantages and disadvantages of using this medicine for mild COVID?

Read more: What is Paxlovid and how will it aid in the coronavirus fight? A physician specialising in infectious diseases answers questions about the COVID-19 tablet.

Is it really that effective?

A research comparing Paxlovid to a placebo (an inactive medication) in 2,246 unvaccinated individuals with mild to moderate COVID provided evidence for its effectiveness. They had risk factors for serious disease but did not require hospitalisation.

With an admission rate of eight per 1,000 patients, those who took Paxlovid had a lower likelihood of being admitted to the hospital. This contrasts to 63 per 1,000 in the control group who did not get Paxlovid: a significant decrease.

Paxlovid may also help patients avoid dying from COVID, albeit this is less obvious because the study only included a small number of deaths.

Children, teenagers, pregnant or breastfeeding women, or persons who had been vaccinated were not included in the trial, therefore the safety and effectiveness of Paxlovid in these categories is unknown. More research in these populations, as well as comparisons to other treatments, would be extremely beneficial.

The research was also done before the Omicron variety became popular. There is no data on Paxlovid's effectiveness against Omicron in particular, although there are no compelling grounds to believe it would be less effective.

What are the drawbacks?

Paxlovid's major drawback is that it can have serious adverse effects when used with a variety of different medications for a variety of ailments.

People using these medications should not take Paxlovid in certain situations; in others, it may be possible to stop or adjust the amount of the other medication for the five days you're taking Paxlovid.

Before starting Paxlovid, talk to your doctor and pharmacist about all of your medications, including herbal and non-prescription treatments, as well as any plans to modify them.

Drug interaction checkers can assist in determining which medications are likely to interact with it. Paxlovid's product datasheet from the Therapeutic Goods Administration includes detailed information on potential medication interactions.

Headache, diarrhoea, vomiting, and dysgeusia, or "Paxlovid mouth," when meals taste metallic, sour, or bitter, are all common adverse effects.

There have been a few instances of persons developing COVID symptoms again after ending their Paxlovid treatment. Researchers and health officials are constantly on the lookout for new evidence of side effects from using the medication.

Read more: COVID changed the flavour of things, and now 'Paxlovid mouth' sounds revolting. What is the cause of dysgeusia?

What are the elements that put you at risk for a severe case of COVID?

Paxlovid is most beneficial for patients who have modest COVID symptoms but are at risk of developing severe disease. Because it works by preventing the virus from replicating itself, it must be started within five days of the onset of COVID symptoms.

Unvaccinated patients with one or more of these risk factors for severe COVID disease were included in the trial that proved Paxlovid's effectiveness:

60 years old or older (though the Australian cut-off is 65)

Medication is required for diabetes.

Obesity (defined as a BMI of 25 kg/m2 or higher in the study)

illness of the heart

blood pressure that is too high

Chronic obstructive pulmonary disease (COPD).

Other people may benefit from Paxlovid if they are at a higher risk of severe COVID sickness. Some persons with impaired renal function, impaired immunological function as a result of medications or HIV infection, severe disability, some malignancies, and blood problems fall into this category.

If you have mild COVID in the first few days of symptoms and are unvaccinated or partially vaccinated, or completely vaccinated but have a mix of these risk factors, your doctor may consider Paxlovid.

What is the procedure for gaining access to Paxlovid?

Paxlovid is only available with a doctor's or nurse practitioner's prescription.

It's on the PBS for people with mild or moderate COVID, as determined by PCR or a positive fast antigen test result certified by a physician or nurse practitioner, and who can begin therapy within five days of symptom onset. This implies the prescription will set you back A$42.50 (or $6.80 if you have a health-care card).

If you match the following criteria, your doctor or nurse practitioner can write you a prescription for PBS-subsidised Paxlovid:

have two other risk factors for serious illness and are 65 years old or older

If you're 50 years old or older and have two other risk factors for serious disease, you're Aboriginal or Torres Strait Islander.

are immunocompromised in a moderate to severe way

Other drugs can be used to treat mild COVID in those who are at risk of developing the condition more seriously. Each medicine has advantages and disadvantages. Your doctor will talk to you about the best treatment alternatives.

Paxlovid is not a treatment for COVID patients who are extremely ill. If you're in the hospital with COVID, your medical team will talk to you about additional treatment options.

Continue reading: COVID and I are at home. When should I see a doctor? And what are the options for treatment?

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