6 facts about Paxlovid, a COVID-19 medication

Since the beginning of the pandemic, thousands of San Diegans have been infected with COVID-19. While getting vaccines and boosters is important for protection against the virus that causes the disease, a medication called Paxlovid can help individuals with COVID-19 who are at risk for severe complications avoid hospitalization and death.

Ashkan Khabazian, PharmD, an emergency medicine clinical pharmacist at Sharp Memorial Hospital, answers some common questions about Paxlovid, an oral antiviral medication that can be taken at home.

1. What is Paxlovid?
   Paxlovid is an investigational drug (a drug being studied in clinical trials) that was authorized by the U.S. Food and Drug Administration (FDA) in December 2021. It is an oral treatment composed of two medications: nirmatrelvir and ritonavir.
   “You take both of these pills together,” says Khabazian. “Nirmatrelvir helps stop the COVID-19 virus from making copies of itself inside the body, while ritonavir helps to increase and maintain enough levels of nirmatrelvir to fight the virus.”

2. Who can take Paxlovid?
   The FDA approved the use of Paxlovid for individuals who tested positive for COVID-19, are age 12 or older, weigh at least 88 pounds, and who are at high risk for severe COVID-19. This includes those with an underlying condition.
   Examples of underlying conditions include Type 1 and Type 2 diabetes, chronic kidney disease, asthma, pregnancy, heart conditions and immune system disorders.

3. When can I take Paxlovid?
   Paxlovid works best when taken within five days of experiencing symptoms, says Khabazian. If you get a positive COVID-19 test result, contact your doctor to see if getting a prescription is right for you.
   “Many pharmacies now carry Paxlovid,” he says. “And it’s helpful to start taking it immediately once you confirm that you have COVID-19.”

4. How often do I take Paxlovid?
   There are three Paxlovid pills that you take twice a day for five days. “It’s important to take the pills for the entire treatment course and self-isolate while you do so,” says Khabazian.

5. Does Paxlovid have side effects?
   Some common side effects of Paxlovid are diarrhea, dysgeusia (altered taste) and muscle aches. However, most patients tolerate Paxlovid pretty well. “These possible side effects are less impactful than severe COVID-19 side effects, which can lead to death,” says Khabazian.
   He recommends you inform your doctor of medications you may already be taking before starting Paxlovid. Your doctor should also check for any negative interactions Paxlovid may have with other medications you may take and can confirm that you have no history of allergies to Paxlovid’s active ingredients.

6. Can Paxlovid cause a rebound case of COVID-19? If so, how can I avoid it?
   Some people infected with COVID-19 who recovered using Paxlovid have experienced rebound cases, which usually occur two to eight days after completing the five-day course of the medication. They may have mild, recurrent COVID-19 symptoms or a positive test result, but there have been no reports of severe disease.
   If this happens, you should isolate again for five days and monitor your symptoms, Khabazian says.

“After the fifth day, if you do not have a fever for more than 24 hours without taking any fever-reducing medicine, you can stop self-isolating,” he says. “But you should wear a mask for 10 days after rebounding and contact your doctor if rebound symptoms develop or worsen.”

Get COVID-19 vaccine information and access to COVID-19 resources from Sharp.