How to Know If You Are Eligible for Paxlovid, an Oral Antiviral for COVID
With COVID cases on the rise again (are we on the fifth wave? Seventh?), it’s important to know that there is a cure that can prevent serious illness in people at high risk of complications. It’s called Paxlovid. But not everyone is eligible to receive it. Here’s how to find out if you qualify.
What is Paxlovid?
Paxlovid is a brand name for a combination of two generic drugs. One of them is nirmatrelvir, which blocks an enzyme that the COVID virus needs to replicate. The other is ritonavir, which blocks one of our own enzymes that would otherwise break down nirmatrelvir. (Ritonavir is also used in the same way with antivirals to treat HIV.)
In December 2021, Paxlovid was granted an Emergency Use Authorization by the Food and Drug Administration. This makes it relatively new, and if you haven’t heard of it, you’re not alone. Many people who could claim it don’t realize they can ask for it and not all doctors will recommend it.
When can I take Paxlovid?
The most important thing to know about taking Paxlovid is that it must be started within five days of you first experiencing symptoms. If a week passes before you decide to seek treatment, Paxlovid will no longer be able to help you.
The drug is also not approved for people who are already hospitalized with severe COVID-19.
Who can take Paxlovid?
Paxlovid is approved for people over the age of 12 and weighing at least 88 pounds. Since there are not many drugs available, they are currently only approved for people at high risk of developing severe illness. This includes:
- All 65 years and older
- people with cancer
- People with certain chronic diseases
- People with heart disease
- people with diabetes
- People with weakened immune systems
- Physically inactive people
- People who are considered “overweight” or “obese”
- Current and former smokers
This is not a complete list; The CDC has a list of conditions that make people more susceptible to severe COVID-19. It also doesn’t work as a strict checklist. If your doctor decides that you are at high enough risk to benefit from a course of Paxlovid, then you are eligible for the drug.
What are the risks associated with taking Paxlovid?
Because ritonavir interacts with an important liver enzyme, you should not take it if you are also taking a medicine that depends on or inhibits this enzyme. Here is a list of drugs that are incompatible with Paxlovid. These include certain medicines for heart disease, high blood pressure, and psychiatric drugs, as well as St. John’s wort. It is important to discuss all of your medications and supplements with the doctor prescribing Paxlovid for you.
Paxlovid is usually “well tolerated”, meaning it does not cause serious health problems. But side effects can include diarrhea, high blood pressure, muscle pain, and a temporary change in taste (usually causing a metallic taste).
There are also indications that Paxlovid may cause a “rebound”, in which virus levels increase after you complete a five-day course. This is still being studied. We don’t yet know how often this happens and whether it will help to take a longer course of the drug or take it a second time.
How can you get Paxlovid?
Paxlovid is a prescription drug and you should be eligible for it, so you need to talk to your doctor. If you have a family doctor that you can go to, this would be a good place to start.
Otherwise, use the Test-to-Treat locator to find pharmacies and clinics where you can get tested for COVID (or show them your test results at home) and get a prescription the same day. You can also call 1-800-232-0233 (TTY 1-888-720-7489) or call the Disability Information and Access Line at 1-888-677-1199 or DIAL@usaginganddisability.org. Check your local options too: for example, New York City has a program that can deliver Paxlovid to your door if you qualify.