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Two new oral antiviral medications are available for treatment of COVID-19.
Two new antiviral medications, ritonavir-boosted nirmatrelvir (Paxlovid, ie, nirmatrelvir-ritonavir) and molnupiravir (Lagevrio), are currently available in the US under emergency use authorization. These 2 drugs are authorized for treatment of patients with mild to moderate COVID-19 who are not currently hospitalized but are at high risk of developing severe disease. Nirmatrelvir-ritonavir and molnupiravir are approved for use only within 5 days of onset of COVID-19 symptoms.
Nirmatrelvir-ritonavir and molnupiravir should be considered for patients with symptoms of COVID-19 who test positive for SARS-CoV-2 and either are an older adult (aged 65 years or older) or are aged 12 years or older with an underlying condition that increases risk of severe outcomes of COVID-19 (such as cancer, heart disease, diabetes, and obesity).
How Do These Medications Work and How Effective Are They?
Nirmatrelvir-ritonavir and molnupiravir reduce the ability of SARS-CoV-2 to multiply and spread through the body. While these drugs may not shorten the duration of symptoms, they decrease the need for hospitalization and work best when taken early in the course of COVID-19.
Nirmatrelvir-ritonavir has been found to be substantially more effective against hospitalization and death than molnupiravir, so it is the preferred drug unless it is unavailable or cannot be given due to kidney or liver disease or certain drug interactions.
Nirmatrelvir-ritonavir cannot be given to people with severe kidney or liver disease and should not be taken with certain other drugs (such as amiodarone, colchicine, and statins). Doctors may stop or replace such medications temporarily while a patient is taking nirmatrelvir-ritonavir, or they may decrease the dose of a medication that interacts with nirmatrelvir-ritonavir. Patients should provide a complete list of medications, including over-the-counter and herbal products, to their doctor or pharmacist before starting this medication.
Molnupiravir should not be prescribed to patients who are pregnant or attempting to become pregnant. Men who have sexual contact with individuals of childbearing age should use a reliable method of contraception consistently while taking molnupiravir and for 3 months afterward. Use of molnupiravir is not authorized for patients younger than 18 years due to potential effects on bone and cartilage.
What to Expect While Taking the Medication
Both nirmatrelvir-ritonavir and molnupiravir are taken twice daily for 5 days. Altered taste, nausea, diarrhea, and dizziness are the most common side effects. Most patients feel better over several days to 2 weeks, but those who develop shortness of breath or other worrisome symptoms should notify their doctor without delay.
How Can Patients Get Oral Antiviral Medications for COVID-19?
People who develop symptoms of COVID-19 should get tested as early as possible. Those who test positive for SARS-CoV-2 and are at high risk of severe illness should contact their doctor to find out if they are eligible for treatment.
Nirmatrelvir-ritonavir and molnupiravir are provided to patients for free, although pharmacies may request insurance information for dispensing charges. To avoid spreading SARS-CoV-2, patients should use drive-through windows to pick up oral antiviral medications for COVID-19. Home delivery options may be available for patients who do not have transportation.
Créditos: Comité científico Covid