From the Guidelines
Several antiviral medications can be used to treat COVID-19 symptoms, with Paxlovid (nirmatrelvir/ritonavir) being the first-line option, and alternative antivirals include remdesivir (Veklury) and molnupiravir (Lagevrio), as recommended by the American College of Physicians in 2024 1. When considering treatment options for COVID-19, it's essential to prioritize medications that have shown efficacy in reducing morbidity, mortality, and improving quality of life.
- The American College of Physicians recommends considering molnupiravir to treat 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 1.
- Nirmatrelvir–ritonavir combination therapy is also recommended for 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 1.
- Remdesivir is suggested for treatment in patients with severe COVID-19, according to the World Health Organization in 2020 1, and the American College of Physicians recommends considering remdesivir for 5 days to treat hospitalized patients with COVID-19 who do not require mechanical ventilation or ECMO in 2021 1. It's crucial to consult a healthcare provider before taking any of these medications, as they may interact with other drugs and have specific contraindications.
- These antivirals don't replace vaccination, which remains the most effective prevention strategy against severe COVID-19.
- The American College of Physicians also recommends against using ivermectin and sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting, as stated in their 2024 guidelines 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Antiviral Medications for COVID-19
Other antiviral medications that can be used to treat Coronavirus disease (COVID-19) symptoms include:
- Molnupiravir: an oral antiviral treatment that has been shown to be effective in reducing the risk of hospitalization and death in nonhospitalized patients with COVID-19 2, 3
- Nirmatrelvir/ritonavir: an antiviral combination that has been studied extensively and has shown promising results in treating COVID-19, with a mechanism of quick clearance of SARS-CoV-2 and reduction in viral load 4, 5
- Remdesivir: an antiviral medication that can be used to treat COVID-19 in nonhospitalized patients with at least one risk factor for severe disease course 4, 6
- Sotrovimab: a monoclonal antibody that can be used to treat COVID-19 in unvaccinated patients with at least one risk factor for severe disease course 4
- Bebtelovimab: a monoclonal antibody that can be used to treat COVID-19 in nonhospitalized patients 6
Treatment Guidelines
The treatment guidelines for COVID-19 recommend the use of these antiviral medications in specific patient populations, such as:
- Unvaccinated patients with at least one risk factor for severe disease course
- Immunocompromised patients who are at high risk of severe disease
- Patients with mild-to-moderate COVID-19 who are at risk of disease progression and hospitalization
Medication Availability and Prescribing Practices
The availability and prescribing practices of these antiviral medications may vary depending on the location and healthcare setting. Studies have shown that nirmatrelvir-ritonavir is the most prescribed medication for the treatment of mild-to-moderate COVID-19, consistent with its position as first-line therapy and widespread accessibility 6