What’s the deal with Paxlovid?

We’re all sick of COVID. The good news is that the medication Paxlovid can help those who are at higher risk for severe outcomes from getting too sick from COVID. But, it can be confusing to figure out who is eligible for its use, how to access it, and if you should take it. Here we answer some of your most common questions.

What is Paxlovid? 

Paxlovid is a series of pills that you can take to treat mild-to-moderate COVID. In order to be effective, it must be taken within five days of when symptoms start.  

Who is eligible to take Paxlovid?

Paxlovid is available for anyone over the age of 12 years old (and weighs more than 88 pounds) under the FDA’s Emergency Use Authorization. Its target use is for anyone at higher risk for developing severe COVID. This includes people who are: 

• Over 50 years old, but especially over 65 years old
• Unvaccinated against COVID-19, or not up-to-date on vaccinations

Have specific medical conditions like cancer, diabetes, heart conditions, HIV, immunocompromised state, being overweight/obese, asthma, and more. See the full list here.

How effective is Paxlovid?

Initial clinical trials showed that Paxlovid reduced the risk of hospitalization by 89% among unvaccinated people at high risk for severe COVID outcomes prior to the Omicron variant’s circulation.

Now, additional studies have been conducted to see how Paxlovid works in the “real world” (outside of a clinical trial setting) and against the more recent variants. Age seems to be the most important indicator of how effective the medicine is at preventing hospitalization: the older you are, the more you benefit from taking Paxlovid. For people 65 years and older, Paxlovid reduces risk of hospitalization by about 70%. Other studies show that people ages 50 years and over were three times less likely to get hospitalized if they took Paxlovid. Talking to your doctor about your risk factors and illness is the best way to decide if Paxlovid is the right treatment for you.

What about "rebound" or other side effects?

Paxlovid rebound is when, after finishing the five-day course of treatment, a patient either experiences symptoms of COVID again or tests positive after a previous negative test. Generally, these rebound cases are more mild than the initial infection. If you experience Paxlovid rebound, you’ll need to re-start the isolation timeline. Exact numbers are hard to nail down, but about 2-10% of people taking Paxlovid may experience a rebound. 

One possible side effect of a Paxlovid is a metallic taste in your mouth - it’s estimated that this happens in about 6% of people who take it, and should go away after the medication is out of your system. Other possible side effects include diarrhea, nausea, abdominal pain, and muscle aches.

How can I access it? 

It is only available by prescription, so you’ll need to either:

• Call your primary care physician. 
• Call a nearby urgent care center to see if they’re able to prescribe. 
• Visit a ‘Test-to-Treat’ center, where you can get tested, and if positive, receive and fill a prescription in one visit. These are available at pharmacies across the country - find locations near you with supply in stock here. 

Paxlovid can interact with some common medications (some blood thinners, birth controls, seizure and blood pressure medications) and may not be recommended for people who have certain diagnoses (such as low kidney function), so discuss all of this with a provider.

How does Paxlovid work?

Ah, you know we love a molecular moment here! Paxlovid is made of two antivirals. The first (Nirmatrelvir) does the heavy lifting: it works by cutting up one of the enzymes that SARS-CoV-2 needs to copy itself. Without the ability to replicate, the virus and the disease progression it causes are stopped in their tracks. The other antiviral is called Ritonavir, and it wins the award for best supporting actor. Its role is to boost the levels of Nirmatrelvir (the first antiviral) to levels needed to effectively do its job.

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