Paxlovid: what you need to know

At the beginning of the COVID-19 pandemic it was hard to imagine the speed at which there would be vaccines to help people combat the virus. At that point, you could only dream of accessible medication that you’d be able to take to stop COVID-19 in its tracks.

In late November of 2021, Pfizer, the maker of one of the many COVID-19 vaccines, released an oral antiviral medication called Paxlovid. By January of 2022, it was approved by Health Canada. But what exactly is Paxlovid, and who’s eligible to take it? Read more to find out everything you need to know about the first Health Canada-approved oral COVID-19 treatment.

What is Paxlovid and how effective is it?

Paxlovid is a COVID-19 antiviral pill that combines two medications which are packaged together — nirmatrelvir and ritonavir. Nirmatrelvir stops the virus from replicating in your body, while ritonavir delays the breakdown of nirmatrelvir so that it remains in the body for longer and at higher concentrations.

If you’re prescribed the medication, you’ll take three pills twice daily for five consecutive days. This also makes it more convenient for patients to take at home to use, unlike previous drugs that have required an IV and hospitalization.

The antiviral medication is given to high-risk adults within five days of experiencing mild to moderate symptoms of COVID-19. High-risk adults include those who are:

• Over the age of 18 and are immunocompromised due to a health condition or medication
• Over the age of 18 with fewer than three vaccines and have a risk condition including obesity, diabetes, heart disease, kidney disease, liver disease, and more.
• Over the age of 60 with fewer than three vaccines
• Over the age of 70

It should be noted that Paxlovid isn’t used for those who are hospitalized because of COVID-19, to prevent the virus, to be used for more than five days in a row, or for children under the age of 18.

While it’s still early days for Paxlovid, studies have shown that it’s effective in reducing mortality and hospitalization rates in patients with COVID-19, and that it’s a safe medication to take. And, even though the drug was originally known for being effective at stopping severe illness from the Omicron variant when it first came out, it appears to be just as effective at protecting people against all other COVID-19 variants so far.

Can Canadian doctors prescribe Paxlovid to patients?

Yes, doctors in Canada can prescribe Paxlovid to patients. To receive a prescription, you’ll need to test positive on either a rapid antigen or PCR test and then speak to a doctor about getting a prescription.

Prescriptions can be taken to a COVID-19 clinical assessment centre or to a participating pharmacy, depending on where you live. If you plan on going to a pharmacy, your best bet is to call ahead to make sure your local pharmacy is distributing the antiviral medication.

Before considering using this medication, however, you should speak with your family doctor about it before possibly contracting COVID-19. The reason is that they know your medical history best and will be able to tell you if the drug could be harmful based on any medications you take.

This way, if you do contract the virus, you’ll be prepared to take action within the first five days if you’re experiencing mild to moderate symptoms. If you don’t have a family doctor, make a list of the medications you take and talk to a doctor about them to make sure Paxlovid is safe for you.

Will Paxlovid be effective against future COVID-19 variants?

While there’s no COVID-19 variant crystal ball, the current research looks promising. Paxlovid was originally undergoing trials when the Delta variant was dominant, and was released when Omicron took over. Since then, it has been effective in preventing serious disease and death. However, the drug is considered to be in its early stages and continues to be studied.

What are the side effects and risks of Paxlovid?

Like most drugs, Paxlovid isn’t side-effect-free. Typical side effects include:

• Altered sense of taste
• Diarrhea
• Muscle pain
• Vomiting
• High blood pressure
• Headache

There are also many medications Paxlovid can’t be taken with due to properties of the ritonavir. The list is pretty long and includes but isn’t limited to certain prescriptions for kidney problems, liver problems (or both), blood pressure, prostate cancer, epilepsy, allergies, and more.

This is because as your body metabolizes nirmatrelvir, the other half of the medication, ritonavir, suppresses certain liver enzymes to make sure the nirmatrelvir stays in your body. By suppressing certain liver enzymes, your liver isn’t able to properly metabolize other medications.

Is Paxlovid safe for children?

Paxlovid has only recently been tested in children as young as six-years-old, however, there’s no conclusive research that it’s safe just yet. Currently, the antiviral medication is only approved for those in Canada who are 18 years of age or older and meet the higher risk criteria.

Is Paxlovid safe during pregnancy?

You shouldn’t take the medication if you’re pregnant, think you may be pregnant, or are planning to become pregnant unless recommended otherwise by a healthcare provider. The reason for this is that there isn’t enough information just yet for those in similar situations who have taken the drug.

Is Paxlovid the same as Ivermectin?

While Ivermectin was used in an attempt to treat people with severe COVID-19 infection in the beginning stages of the pandemic, it’s not the same as Paxlovid.

Ivermectin is an antiparasitic drug, meaning it’s used to treat parasites in humans and animals. If you’ve heard of a dog having worms before, for example, it’s likely they were treated with Ivermectin. In humans, the treatment has been used in some cases related to worms and parasites.

However, COVID-19 is caused by a virus, not a parasite, and Ivermectin isn’t recommended as a treatment method. In fact, taking large doses of Ivermectin could be dangerous. Paxlovid, on the other hand, is an antiviral medication that’s specifically meant to treat — you guessed it — viruses.

What’s the cost of Paxlovid in Canada?

There’s no cost for Paxlovid in Canada. Regardless of what province or territory you live in, the government has covered the costs of the medication. If you’re experiencing mild to moderate symptoms within five days of contracting COVID-19, you’ll need a prescription from a doctor and can pick up the medication at a clinical assessment centre or at a participating pharmacy.

Could Paxlovid help treat long COVID?

There’s no concrete evidence yet that Paxlovid helps treat post-COVID, also known as long COVID — lingering symptoms in those who have recovered from an initial infection. The condition may affect as many as three in ten who have had COVID-19. The most common symptoms of long COVID in adults include:

• Fatigue
• Memory problems
• Trouble sleeping
• Shortness of breath
• Anxiety and depression
• General body pain and discomfort
• Difficulty thinking or concentrating
• Post-traumatic stress disorder (PTSD)

Children can also experience long COVID, with symptoms such as:

• Fatigue
• Headaches
• Weight loss
• Muscle pain
• Trouble sleeping
• Stuffy or runny nose
• Difficulty thinking or concentrating

So far, some studies have shown a significantly reduced risk of developing the condition if you’re vaccinated as opposed to not being vaccinated. One study found a 50% lower risk of persistent COVID-19 symptoms in patients who were vaccinated, while another study — which is still new and requires more research — found a 41% lower risk.

While there’s no conclusive answer just yet, being vaccinated appears to reduce but not eliminate your risk of long COVID. However, it’s best to be safe than sorry and continue to take precautions if someone around you may have symptoms of the virus, as well as get fully vaccinated — including a fourth booster dose, if eligible — if you haven’t yet.

Is Paxlovid a replacement for the COVID-19 vaccine?

Paxlovid should absolutely not be considered a substitute for vaccinations, since you might not be eligible to receive a prescription. And, Paxlovid can only be used once you’ve been exposed to the virus and have mild to moderate symptoms, not as a prevention method.

Vaccines are your first line of defence against hospitalization and death caused by COVID-19, and prevention is key when it comes to staying safe from the virus.

It has been a long two years, but science has also come a long way. Moving at lightning speed, we now have vaccinations and antiviral medication to help stop the virus from making people sicker.

With that being said, it’s still important to take precautions and avoid seeing others if you feel you may have COVID-19, and test yourself or get tested if you feel you may have the virus. Jumping on this early enough — specifically in that five-day window— could mean that you may take Paxlovid and avoid potential complications. Remember, the sooner the better when it comes to taking this antiviral pill.

This pandemic may feel like it has gone on forever, but it’s still too early to let your guard down with the virus spreading. It remains crucial to continue to stay away from others if they’re sick or if you’re feeling sick, and to monitor your own symptoms as we continue to get through this together.