Paxlovid: A Promising New Antiviral Therapy for COVID-19 Available at Your Local Pharmacy

May 02, 2022

Illustration of a capsule killing the coronavirus

Early studies of Paxlovid – a new antiviral medication for the treatment of COVID-19 – have shown significant reductions in hospitalization and death in people with mild to moderate COVID-19 who are at high risk for progression to severe illness. In fact, if taken within five days of symptom onset, experts estimate it to be 88 percent effective in preventing hospitalization and/or death in adults.

Paxlovid is approved for use in people aged 12 years and older, weighing at least 88 pounds who have tested positive for the virus. It is not currently authorized as a preventive medication, either pre- or post-exposure to COVID-19. However, clinical trials are underway to study these potential uses.

How Does it Work?

Paxlovid is a combination of two drugs that work together to treat COVID-19:

Nirmatrelvir. Works by blocking the action of a certain protein that the virus needs to make copies of itself and spread. By quickly reducing the amount of virus, nirmatrelvir may also lower the chance of passing the disease to others.
Ritonavir. Works to slow the breakdown (metabolism) of nirmatrelvir, allowing it to stay in your body longer so it can continue to prevent replication of the virus.

Paxlovid comes prepackaged in individual doses, with each dose consisting of two nirmatrelvir tablets and one ritonavir tablet. A full course of treatment is two doses a day - twelve hours apart - for five days.

How Can I Get Paxlovid?

Because Paxlovid is most effective when taken within five days of symptom onset, it’s important to start the medication as soon as possible after testing positive. In addition to requesting a prescription from your primary care doctor, patients also have access to a program called Test-to-Treat which provides Paxlovid free of charge.

Under this program, patients with COVID-19 symptoms can go to a participating pharmacy, get tested, and, if positive, receive a five-day course of Paxlovid on-the-spot at no cost. This program was introduced in December 2021 and there are limited pharmacy locations with the required prescriber on-site, but access is expected to grow as the public’s knowledge of and demand for Paxlovid increases.

“Paxlovid and other medications are not the silver bullet we need to get past COVID-19 but they are great new tools in our toolbox,” says Elie Saade, MD, Medical Director of Infection Prevention and Control at University Hospitals. “Now that we have medications that can prevent one from getting very sick or dying from COVID-19, testing when symptoms arise is even more important. COVID-19 is still with us but we now have an excellent way to prevent it with vaccines, and effective ways to treat it with medications.”

Can Paxlovid Be Used to Treat Long COVID?

Experts estimate that up to 30 percent of people who have had COVID-19 may experience persistent symptoms of fatigue, brain fog, breathing difficulty and generalized pain for months or even years after the initial infection has cleared. This is known as COVID Long-Haul or Long COVID and there are millions of people in the U.S. currently suffering with this post-viral syndrome.

Researchers are looking into potential treatments for Long COVID, one of which may be antiviral medications such as Paxlovid. To date, however, there are only anecdotal reports of Paxlovid being successful in alleviating symptoms of Long COVID and further investigation and clinical trials are needed before any conclusions can be drawn.

Long COVID is a complicated syndrome that can affect nearly all major bodily systems. Given the relative newness of COVID and Long COVID, patients should talk to their healthcare provider about their symptoms and discuss the treatment options available, which may include participation in a clinical trial.