COVID prescription drugs are medications designed to treat an active COVID-19 infection. Prescribed by healthcare professionals, these treatments aim to reduce symptom severity, shorten illness duration, and prevent progression to severe disease, including hospitalization or death. They are distinct from vaccines, which prevent infection or severe illness.
Types of COVID Prescription Drugs
Antiviral medications form a primary class of COVID-19 prescription drugs, working by targeting the virus’s ability to multiply within the body. Paxlovid, a combination of nirmatrelvir and ritonavir, is an oral antiviral that inhibits the SARS-CoV-2 main protease (Mpro), an enzyme the virus needs for replication. By blocking this protease, nirmatrelvir prevents the virus from producing functional proteins, thereby halting its spread. Ritonavir is included to boost the levels of nirmatrelvir in the bloodstream by inhibiting its breakdown, allowing the active drug to remain effective for longer.
Another antiviral, Remdesivir (Veklury), is administered intravenously and works as a nucleoside analog. Once inside infected cells, remdesivir is converted into an active form that mimics a building block of the viral genetic material. This active form is then incorporated into the viral RNA by the RNA-dependent RNA polymerase (RdRp) enzyme, leading to premature termination of the RNA chain and stopping viral replication. While antivirals directly combat the virus, other prescription treatments, such as corticosteroids like dexamethasone, may be used for managing severe cases. These anti-inflammatory drugs are reserved for hospitalized patients with severe COVID-19 to reduce an overstimulated immune response.
Eligibility and Administration
Eligibility for COVID-19 prescription drugs requires a recent positive COVID-19 test, symptom onset within a specific timeframe, and risk factors for severe disease. For example, Paxlovid is recommended for individuals with symptoms for five days or fewer who are at high risk for progression to severe COVID-19, such as those 50 years or older or with certain health conditions. Remdesivir treatment should begin within seven days of symptom onset for non-hospitalized patients. Risk factors for severe illness include older age (e.g., 50 or 65 years and older), a weakened immune system, or underlying conditions like diabetes or chronic lung disease.
To obtain these medications, individuals need a prescription from a healthcare provider. This can involve consulting a primary care provider, visiting an urgent care center, or utilizing telehealth services. Some “Test-to-Treat” locations may also offer both testing and immediate prescription. In some cases, pharmacists may be authorized to prescribe Paxlovid directly, provided they can access recent medical records and a list of current medications to check for interactions.
Paxlovid is an oral medication, taken as two nirmatrelvir 150 mg tablets and one ritonavir 100 mg tablet together, twice daily for five days. Remdesivir is administered as an intravenous (IV) infusion, with a loading dose on day one followed by daily maintenance doses for three to ten days, depending on the patient’s condition and whether they are hospitalized.
Important Considerations
Patients considering or taking COVID prescription drugs should be aware of potential side effects. For Paxlovid, common side effects include an altered sense of taste and diarrhea. Other possible side effects include headache, nausea, vomiting, and abdominal pain. Remdesivir can cause side effects such as nausea and elevations in liver enzyme levels, which healthcare providers monitor with blood tests. Infusion-related reactions, though less common, can also occur with Remdesivir.
Disclosing all current medications to a healthcare provider is important due to the potential for significant drug interactions. Paxlovid, containing ritonavir, can interact with many drugs by affecting their metabolism, potentially leading to increased concentrations of other medications and severe adverse reactions. Examples of interacting medications include certain statins, blood thinners, anti-seizure medications, and some mental health drugs. Patients should not self-medicate or stop other prescribed medications without medical advice.
It is also important to understand that these prescription drugs are treatments for an active infection and do not replace the protection offered by COVID-19 vaccination. Vaccination remains the most effective strategy to prevent serious illness. Patients should seek immediate medical attention by calling emergency services if they experience trouble breathing, persistent chest pain or pressure, new confusion, inability to wake or stay awake, or bluish lips or face.