One of the best tools to prevent serious complications from COVID-19 is the prescription antiviral drug paxlobid. But they say not as many people are prescribed it as there are people who could benefit from it. Dr. Amesh Adalja, FIDSASenior Scholar Johns Hopkins Health Safety Center A person who specializes in infectious diseases and pandemic preparedness. Adalja says both patients and healthcare providers need to be better informed about the benefits of paxlobid and other similar antiviral drugs.
Paxrobid is most effective when taken within 5 days of the onset of symptoms. In clinical trials, the risk of hospitalization and death was reduced by almost 90% in unvaccinated people. “It’s a great tool, but it’s completely underutilized,” she says.
How does Paxrovid work?
“Paxlobid is a type of antiviral drug called a protease inhibitor,” Adalja explains. It prevents the SARS-CoV-2 virus that causes coronavirus disease from replicating in the body. At the molecular level, “Paxlovid works by interfering with the protein cleavage process of his SARS-CoV-2,” he explains. “It blocks a critical step in the virus’s life cycle.”
Who is Paxlovid recommended for?
Paxrovid is designed to benefit people age 12 and older and weighing 88 pounds or more who are at increased risk for serious illness. Its purpose is to prevent hospitalization or death, not to reduce symptoms or help you recover faster, although patients who take it may experience one or both of these benefits.
Who is considered to be at “high risk” of severe illness, hospitalization, or death from COVID-19?
According to the CDC, people who are over the age of 50, are unvaccinated or do not have up-to-date COVID-19 vaccinations, are immunocompromised, or have an infectious disease are at risk of severe illness. You are more likely to experience COVID-19. specific medical condition.
“Conditions such as diabetes, high blood pressure, heart disease, and lung diseases such as asthma and COPD are considered high-risk,” Adalja says. Other common risk factors include being overweight, obesity, and pregnancy. “The vast majority of Americans probably have some kind of high risk factor,” he says. “Many people will benefit from Paxlobid based on their weight status.”
Is paxlobid prescribed as often as necessary?
“Antiviral prescriptions are underutilized in the United States,” Adalja said. “There are many people with high-risk conditions who are not prescribed paxlobid. [or] Alternative antiviral drugs like molnupiravir. ”
This may be due to misconceptions about who should take paxlobid, including doctors. “Some people might say, ‘Wait, you don’t seem so bad,’ but that’s a complete misunderstanding of how this drug works,” says Adalja. Paxlobid is designed to be administered early. prevent Symptoms may become more serious. The decision to prescribe paxlobid for COVID-19 infection should be based on the patient’s risk factors for severe disease, regardless of the severity of symptoms.
Antiviral drugs for influenza have the same problem. “Many high-risk people are not prescribed anti-influenza virus drugs, despite evidence that they are effective,” Adalja says. Doctors may be comfortable prescribing Tamiflu because they are familiar with it, but Tamiflu is underused.
How can patient education about paxlobid be improved?
One reason not many people know about paxlobid is because the drug has been under emergency use authorization for quite some time, which prohibited Pfizer from promoting it. Instead, they resorted to raising it with their doctor. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “Some people complain about direct-to-patient advertising, but this is effective,” Adalja says. “If patients know the name of a drug, they’re more likely to ask their doctor about it.”
It’s important that patients feel empowered to ask their health care providers questions about all treatment options, he says. “Patients should ask their doctors, ‘Will I benefit from paxlobid?'” “Will Tamiflu work?” “Do I really need this antibiotic?”
Are there any alternatives to Paxrovid?
There are currently two other treatments available to prevent hospitalization due to coronavirus. Molnupiravirwhich is an oral antiviral drug also taken at home. remdesivirwhich is an intravenous drip administered daily for three days in a medical facility.
Molnupiravir is a good alternative for people taking medications that may interact with paxlobid, Adalja says.
Are there any downsides to taking paxlobid if I don’t have risk factors for serious illness?
“It’s always about the risk-reward ratio,” says Adalja. If you take paxlobid without having risk factors for serious illness, you may not get the benefits the drug is supposed to provide and may experience side effects such as altered taste, possible gastrointestinal upset, and rebound symptoms. there is.
Can Paxrovid help prevent long-term coronavirus infection?
Some early studies suggested that paxlobid may reduce the chance of developing a long-term coronavirus infection, but more recent studies have shown that this is not the case. Masu. This includes: study A paper published in January 2024 found no association between paxlobid treatment and long-term COVID-19 symptoms in vaccinated individuals who were not hospitalized.
Adalja said there are new antiviral drugs not yet available in the United States that may be effective in preventing long-term COVID-19 infections.
Do concerns about COVID-19 rebound* outweigh the benefits of taking Paxlobid?
no. “[Rebound] It doesn’t happen to everyone. “Research shows that perhaps one in five people who take Paxrobid experience rebound symptoms,” says Adalja. “But people who experience rebound, with or without paxlobid, are not doing worse.” For people who take paxlobid and experience rebound, the symptoms are generally mild to moderate. degree and does not require hospitalization.
“News articles about people like President Biden experiencing a COVID-19 rebound actually made the COVID-19 rebound seem like a bigger, more common problem than it actually is. ” he explains. The risk of rebound, whether definitively related to paxlobid or not, does not prevent high-risk individuals from taking paxlobid, nor does it prevent physicians from prescribing paxlobid.
*COVID-19 rebound is the return of symptoms after initial recovery from COVID-19 infection. Generally, the order of events is as follows: A person feels infected with the new coronavirus and has symptoms. Symptoms subside as the infection progresses. Home antigen tests can even test negative for the new coronavirus. Symptoms may return after a few days and the home antigen test may come back positive.
How much does Paxrobid cost?
Paxlovid will be free to Americans until the end of 2023, with the cost covered by the federal government.Ann Agreement between Pfizer and the U.S. Department of Health and Human Services Guaranteed free access to Paxrovid through the end of 2024 to patients with Medicare and Medicaid insurance or who are uninsured. It will remain free for uninsured and underinsured individuals through 2028. Paxlovid is covered by many private insurance plans (costs vary by plan).
How do I get a prescription for Paxlobid?
If you test positive for coronavirus, talk to your doctor as soon as possible about factors that increase your risk of severe disease and whether you might benefit from taking paxlobid.
If you don’t have a health care provider, you can Program from inspection to treatment Give people ready access to low-cost or free treatments. Anyone who tests positive for the coronavirus (or influenza) Treatment program from home examination.
Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health.
