From the Guidelines
Paxlovid is a highly effective treatment for COVID-19 in high-risk patients, reducing the risk of severe illness, hospitalization, and death by approximately 89%. According to the latest evidence from the American College of Physicians 1, nirmatrelvir–ritonavir combination therapy, also known as Paxlovid, is supported for use in treating symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease. The treatment regimen consists of nirmatrelvir (300mg) and ritonavir (100mg) taken together twice daily for five days 1. It is essential to initiate treatment within five days of symptom onset for maximum effectiveness. Paxlovid works by preventing the virus from replicating in the body, thereby reducing the risk of severe illness, hospitalization, and death. Some key points to consider when prescribing Paxlovid include:
- It is primarily recommended for those at higher risk of severe COVID-19, including older adults (especially those over 65), people with underlying medical conditions like heart disease, diabetes, obesity, or compromised immune systems 1.
- Common side effects include altered taste, diarrhea, muscle aches, and high blood pressure.
- Paxlovid interacts with many medications, so it is crucial to inform healthcare providers about all medications being taken 1.
- Some patients may experience "Paxlovid rebound," where symptoms return after completing treatment, but this does not necessarily mean the medication has failed or that additional treatment is needed 1.
From the FDA Drug Label
PAXLOVID which includes nirmatrelvir, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro: also referred to as 3CLpro or nsp5 protease) inhibitor, and ritonavir, an HIV-1 protease inhibitor and CYP3A inhibitor, is indicated for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.
Paxlovid is used to treat mild-to-moderate COVID-19 in adults at high risk for severe illness. The treatment should be initiated as soon as possible after diagnosis and within 5 days of symptom onset 2.
- Key points:
- Indication: Treatment of mild-to-moderate COVID-19 in adults at high risk for severe illness.
- Initiation of treatment: As soon as possible after diagnosis and within 5 days of symptom onset.
- Dosage: 300 mg nirmatrelvir with 100 mg ritonavir, twice daily for 5 days 2.
From the Research
Paxlovid Covid Treatment
- Paxlovid, a combination protease inhibitor, has been shown to reduce the risk for hospitalization and death among patients with mild to moderate COVID-19 who are at risk for progression to severe disease 3.
- The treatment consists of nirmatrelvir and ritonavir, with nirmatrelvir blocking replication of SARS-CoV-2 and ritonavir inhibiting the metabolism of nirmatrelvir 4.
Efficacy of Paxlovid
- Studies have demonstrated the effectiveness of Paxlovid in reducing severe COVID-19 and mortality in high-risk patients, with a significant decrease in the rate of severe COVID-19 or mortality 5, 6.
- Paxlovid has been shown to be more effective in older patients, immunosuppressed patients, and patients with underlying neurological or cardiovascular disease 6.
Comparison with Other Treatments
- Paxlovid has been compared to other COVID-19 antivirals, such as molnupiravir, and has demonstrated a greater risk reduction in hospitalization and death 4.
- COVID-19 vaccination has also been shown to be effective in preventing hospital admission and mortality, and may be a more cost-effective approach than antivirals 5.
Real-World Effectiveness
- Real-world data has been used to evaluate the effectiveness of Paxlovid, with results suggesting that it is highly effective in reducing the risk of severe COVID-19 or mortality in high-risk patients 6.
- The treatment has been shown to be effective in reducing viral load and improving clinical symptoms, and may be associated with reduced disease spread in the community 7.