When To Take Paxlovid For COVID-19?

Paxlovid, a common COVID-19 medication, can reduce the duration and lessens 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 are calling their physicians saying they still don’t feel well, and by then, it’s too late to start taking the antivirals,” said Erica Kaufman West, MD, a Franciscan Health infectious disease specialist.

“We need to educate patients to understand that they have to start taking the antivirals within five days of symptom onset. If we can get patients informed so they can advocate for themselves or their family members, it will benefit all of us.”

Dr. Kaufman West urges COVID-19 patients ask their healthcare providers upon receiving a positive test if antiviral medications like Paxlovid are right for them.

What Is Pavloxid?

Paxlovid, an oral antiviral medication, is used to treat 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 89%.

Paxlovid is approved for adults and for children ages 12 and up who weigh at least 88 pounds. The medication is available free of charge.

Will Paxlovid Prevent COVID Complications?

While antiviral drugs such as Paxlovid and other treatments for COVID-19 are an important advancement, they are not 100% effective in reducing 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 are not vaccinated.

“Step one is to be vaccinated and boosted,” Dr. Kaufman West said. “Those people for the most part don’t have serious consequences if they are 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 and ask if antivirals are right for you.”

What Are Potential Side Effects of Paxlovid?

Potential side effects of Paxlovid include:

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

In addition to potential side effects, Paxlovid has some drug interactions. 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 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 patients to get the antivirals within the required five days of symptom onset.

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 or other oral antivirals, monoclonal antibody treatments may be an option. Those intravenous treatments are an “absolute last resort,” Dr. Kaufman West said, and also must be started within seven days, making early testing key.

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 infection altogether. Preventing serious infection by getting vaccinated (and boosted, if you’re eligible) and taking other precautions, like masking and distancing — particularly if your COVID-19 Community Level is high — are the best ways to protect your health.