As the omicron variant began to rapidly spread across the country in late 2021, two new treatments for those at greatest risk of serious illness from COVID-19 were given emergency use authorization (EUA) by the Food and Drug Administration (FDA). Drugmakers Pfizer and Merck’s prescription oral antiviral medications were added to the toolbox of treatments for mild to moderate COVID-19.
“The two new treatments give physicians another tool to fight COVID,” says Suzanne Shea, RPh, vice president of Sharp HealthCare’s system pharmacy services. “Pfizer’s Paxlovid and Merck’s molnupiravir are both authorized for COVID-positive patients who are at high risk for severe illness.”
However, Shea is quick to point out that the medications are not prophylactic treatments, meaning they are not intended to prevent disease. But because both are oral medications in tablet form, a trip to an infusion center is not needed. “This saves time for our clinicians, and patients can be treated at home,” Shea says.
How COVID-19 antiviral medications work
The two new COVID-19 antiviral medications prevent the coronavirus from replicating, allowing people with COVID-19 who may be at risk for developing severe illness to avoid hospitalization. And with hospitals throughout the U.S. overwhelmed by increasing numbers of patients needing care for COVID-19, the medications are arriving at the perfect time.
While Shea reports that there are differences in the drugs’ effectiveness — studies have found Paxlovid 89% effective and molnupiravir 30% effective in treating COVID-19 — both are showing the ability to be effective against the delta and omicron variants when taken as directed. The prescription oral antivirals are to be started as soon as possible after a diagnosis of COVID-19 and within 5 days of symptom onset.
Eligibility for treatment with the new antiviral drugs
According to the drugs’ EUAs, Pfizer’s Paxlovid can be used in patients age 12 and older with confirmed COVID-19. Due to its possible effect on bone and cartilage growth, the Merck drug molnupiravir is limited to COVID-positive patients age 18 and older.
Additionally, the Merck drug is not for use with pregnant women, and the Pfizer drug should not be taken by people with kidney or liver disease. Pfizer’s Paxlovid may also cause interactions with commonly prescribed drugs, such as blood thinners, statins, HIV treatments and antidepressants. Talk with your doctor about whether Paxlovid is right for you.
Vaccination remains vital
While the addition of the two new antiviral medications to treat COVID-19 is to be celebrated, experts agree that vaccination is the best way to lower the risk of getting and spreading COVID-19. Vaccines are also safe and highly effective at preventing serious illness and death.
What’s more, doctors are reporting difficulty in accessing supplies of the new antiviral medications for their patients. So, availability of the drugs cannot be counted on as a substitute for vaccination.
On the other hand, access to COVID-19 vaccines is abundant in most areas of the country. Children age 5 and older can receive the Pfizer COVID-19 vaccine, and adults age 18 and older can receive either the Pfizer or Moderna COVID-19 vaccines. Additionally, the Centers for Disease Control and Prevention (CDC) now recommends that all fully vaccinated adults and kids ages 5 and older receive a booster shot.
“Our first line of prevention of COVID-19 is still the vaccine and now, getting a booster,” Shea says. “These are shown to prevent COVID-19 and if infected, patients are far less likely to be hospitalized and suffer a severe form of the disease. Most hospitalized patients are not vaccinated, and so we can’t emphasize enough the importance of receiving a COVID-19 vaccine and booster when eligible.”