From the Guidelines
Paxlovid can be taken within 5 days of symptom onset for COVID-19, and taking it on day 5 is still within the recommended timeframe. According to the American College of Physicians' living, rapid practice points for the outpatient treatment of confirmed COVID-19 1, the use of nirmatrelvir–ritonavir combination therapy, which is the active ingredient in Paxlovid, is supported for 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 standard regimen for Paxlovid is nirmatrelvir (300 mg) with ritonavir (100 mg) taken together twice daily for 5 days. It's essential to consult with a healthcare provider before starting Paxlovid, as it has significant drug interactions with many common medications 1. Patients should inform their doctor about all medications they're taking, including over-the-counter drugs and supplements.
Paxlovid works by inhibiting a key enzyme that the coronavirus needs to replicate, which is why early treatment is crucial - to stop viral replication before the infection becomes severe. If a patient is beyond day 5 of symptoms, they should contact their healthcare provider immediately to discuss alternative treatment options, as Paxlovid would no longer be recommended 1.
Some key points to consider when taking Paxlovid include:
- Starting treatment within 5 days of symptom onset
- Consulting with a healthcare provider before starting treatment
- Informing the doctor about all medications being taken
- Taking the standard regimen of nirmatrelvir (300 mg) with ritonavir (100 mg) twice daily for 5 days
- Being aware of potential drug interactions and side effects.
From the FDA Drug Label
Initiate PAXLOVID treatment as soon as possible after diagnosis of COVID-19 and within 5 days of symptom onset. The FDA drug label does not explicitly state that PAXLOVID can be taken after 5 days of symptoms, but rather that treatment should be initiated within 5 days of symptom onset. Therefore, the answer to whether you can take PAXLOVID after 5 days of symptoms is no, as the treatment window is within 5 days of symptom onset 2.
From the Research
Paxlovid Treatment Timing
- The timing of Paxlovid treatment is crucial in determining its effectiveness in treating COVID-19 symptoms 3, 4.
- According to the study by 3, Paxlovid should be started within 5 days of symptom onset and given for 5 days' duration.
- However, a retrospective study by 4 compared the outcomes of patients who received Paxlovid within or after five days of COVID-19 symptom onset and found that starting Paxlovid within five days reduced the length of stay and SARS-CoV-2 duration.
Efficacy of Paxlovid After 5 Days of Symptoms
- While the recommended treatment window for Paxlovid is within 5 days of symptom onset, some studies suggest that it may still be effective when started after 5 days 4, 5.
- A study by 4 found that severe case conversion among mild COVID-19 patients might be comparable whether starting Paxlovid within or after five days.
- Another study by 5 compared the effectiveness of Paxlovid with other antiviral treatments and found that Paxlovid was associated with a higher proportion of virological clearance at day 7 post-treatment.
Safety and Efficacy Considerations
- The safety and efficacy of Paxlovid have been evaluated in several studies, including those by 6, 7.
- These studies suggest that Paxlovid is generally safe and effective in treating COVID-19 symptoms, but may have different outcomes compared to other antiviral treatments.
- Factors such as age, comorbidities, and time from symptom onset to treatment initiation may influence the effectiveness of Paxlovid 6, 5.