When To Take Paxlovid For COVID-19?

Paxlovid, an oral COVID-19 medication, can reduce the duration and lessen the likelihood of hospitalization from the coronavirus, but only if taken within five days of COVID symptoms beginning. 

“What we’re seeing is a lot of patients who test positive, then a week later call their physicians saying they still don’t feel well. By then, it’s too late to start taking the antivirals,” said Erica Kaufman West, MD, a Franciscan Health infectious disease specialist.

“Patients need to understand that they have to start taking the antivirals within five days of symptom onset. Being informed so they can advocate for themselves or their family members will benefit all of us.”

As soon as you get a positive COVID-19 test, Dr. Kaufman West urges that you ask your healthcare provider if antiviral medications like Paxlovid are right for you.

Key Takeaways: Medications For COVID-19

• Paxlovid only works if started within five days of your first COVID-19 symptom, so don’t wait to get tested and talk to your provider.
• Paxlovid is no longer free for everyone, but cost-assistance programs are still available through Pfizer's PAXCESS program and government assistance for Medicare, Medicaid and uninsured patients.
• If Paxlovid isn’t right for you, oral molnupiravir is an alternative.

What Is Pavloxid?

Paxlovid, an oral antiviral medication, treats mild-to-moderate cases of COVID in patients who are at high risk for severe complications. In clinical trials, Paxlovid reduced the risk of hospitalization or death by 87% in unvaccinated outpatients with COVID-19 at higher risk of severe disease.

Paxlovid is approved for adults and for children ages 12 years and up who weigh at least 88 pounds. Paxlovid is no longer free for everyone. Eligible patients with commercial insurance may pay as little as $0 through Pfizer’s PAXCESS Co-Pay Savings Program, and eligible patients with Medicare, Medicaid or no insurance may still qualify for the medication at no cost through the U.S. Government Patient Assistance Program (USG PAP). Ask your provider or pharmacist about current eligibility and enrollment, since program terms can change. 

Will Paxlovid Prevent COVID Complications?

While antiviral drugs such as Paxlovid and other treatments for COVID-19 are an important advancement, they aren’t 100% effective in reducing the risk of hospitalization or death from COVID-19, and they are no substitute for getting vaccinated. Getting COVID-19 still causes serious health impacts for some people, especially those who aren’t vaccinated.

“Step one is to be vaccinated,” Dr. Kaufman West said. “For the most part, those people don’t have serious complications if they get infected. Step two, if you feel sick, test earlier rather than later. If you do test positive at home on your own, contact your doctor right away and ask if antivirals are right for you.”

What Are Potential Side Effects Of Paxlovid?

Potential side effects of Paxlovid include:

• Abdominal pain
• Allergic reactions
• Altered or impaired sense of taste
• Diarrhea
• Increased blood pressure
• Muscle aches
• Nausea 

In addition to potential side effects, Paxlovid can interact with some other drugs. Dr. Kaufman West said patients should share their medication lists, including over-the-counter medications and herbal supplements, with their healthcare provider and pharmacist to ask if there are any risks. 

How Can I Get Paxlovid?

A person must have a positive at-home rapid antigen test or a positive polymerase chain reaction (PCR) test to get Paxlovid. Pharmacists can dispense Paxlovid without a prescription, but they require a patient’s medical records within the last 12 months, copies of most recent blood tests and a full list of medications. Working directly with your physician or within your physician network makes the process faster and easier, allowing you to get the antivirals within the required five days of your first symptom.

Is Paxlovid Rebound Common?

COVID-19 can sometimes make a comeback after an infected person has gone through a round of the antiviral pills. In these cases of “COVID-19 rebound,” the illness improved or resolved within an average of three days, without additional treatment, the CDC advised in May.

Are There Treatment Alternatives To Paxlovid?

For patients who can’t take Paxlovid, intravenous remdesivir (Veklury) is the preferred next option, given as a three-day course starting within seven days of symptom onset. If remdesivir isn’t accessible or appropriate, the oral antiviral molnupiravir can be used, though it has lower efficacy against severe illness and isn’t recommended for pregnant women.

Dr. Kaufman West said her hope is with increased education, more patients will be able to advocate for themselves and their loved ones. Doing so can help them get the antiviral medications they need to reduce the duration and severity of symptoms and keep patients out of the hospital.

“Education is power,” Dr. Kaufman West said. “Just making sure people know what’s out there so they can ask and make informed decisions is really key.”

Vaccination is the best line of defense against COVID-19 and can prevent serious infection. Getting vaccinated, staying home when you’re sick and taking other precautions like masking and distancing when respiratory virus activity is elevated in your area, are the best ways to protect your health and that of your loved ones.