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Nearly four years into the pandemic, dodging COVID-19 has become increasingly difficult. In many settings, masks are no longer required and in-person events are back in full swing.
And while vaccines and newly updated boosters can help to curb the worst of a coronavirus infection, people at increased risk for severe illness due to their age or a range of health conditions have an additional tool to help ensure their symptoms don’t progress to a critical state: an antiviral pill.
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In December of 2021, the Food and Drug Administration (FDA) authorized the prescription medication Paxlovid for the treatment of COVID-19, along with another oral antiviral known as molnupiravir (Lagevrio), though guidelines specify Paxlovid is the preferred at-home treatment.
Conditions that increase risk for severe COVID-19
- Chronic kidney disease
- Chronic liver disease
- Chronic lung diseases
- Cystic fibrosis
- Dementia or other neurological conditions
- Diabetes (type 1 or type 2)
- Some types of disabilities
- Heart conditions
- HIV infection
- Immunocompromised conditions
- Mental health conditions
- Overweight and obesity
- Physical inactivity
- Sickle cell disease or thalassemia
- Smoking, current or former
- Solid organ or blood stem cell transplant
- Stroke or cerebrovascular disease
- Substance use disorders
In recent studies, it’s been shown to the reduce the risk of hospitalization or death by nearly half in highly vaccinated adults, and its effect has been shown to be even greater in high-risk individuals, including older adults and immunosuppressed patients. Still, physicians and public health experts say many people who could benefit from Paxlovid aren’t receiving it. Here’s what you need to know about the coronavirus treatment.
Who should be seeking it?
With COVID-19 cases once again on the rise, physicians and public health experts have a message for adults who come down with the illness: If you are 50 or older, have certain health conditions (heart disease, lung disease and diabetes are a few examples) or are unvaccinated, talk to a health care provider about getting treated as soon as your test strip turns positive.
With Paxlovid now widely available throughout the U.S., the approach at this phase in the pandemic should be, “Why shouldn’t you take this?” says William Garneau, M.D., an assistant professor of medicine at Johns Hopkins Medicine.
Of course, not everyone is a good candidate for Paxlovid, which is authorized for individuals 12 and older who are at high risk of getting seriously sick from COVID-19. People with severe liver and kidney problems should not take it. There are also several medications that can interact with Paxlovid, some of which preclude a patient from getting it.
“And there are other drugs that are what we would consider to be warning drugs, that we can adjust the dose of or we can withhold for a few days,” says Kelly Gebo, M.D., a professor of medicine at Johns Hopkins Medicine. Examples include certain statins, antidepressants and anticoagulants (blood thinners), so be sure the doctor or pharmacist prescribing Paxlovid is aware of every medication you are taking.
If you’re not eligible for Paxlovid, your health care provider may recommend another treatment option.
“I think the biggest take-home point is don’t just blow it off. Talk to somebody about whether you’re eligible for [Paxlovid] and could be treated,” says Steven Lawrence, M.D., a professor of medicine in the Division of Infectious Diseases at Washington University School of Medicine in St. Louis.