The October 2022 Consumer Reports, On Health, gives us a brief report on the effectiveness and limitation of the antiviral Covid-19 drug treatment of Paxlovid.
The Healthcare Savvy article tells explains, “For people at high risk of severe COVID-19, including seniors and those with chronic health issues, Pfizer’s Paxlovid – a prescription antiviral authorized for emergency use in December 2021 – has been a game changer.” In fact, the drug company’s study showed that Paxlovid “cut the risk for hospitalization or death in high-risk unvaccinated people by 88 percent when given within five days of the first symptoms.” However, for those individuals who are not at high-risk, who are vaccinated, or both, the drug therapy may be less effective but still may help. A study concluded in Israel showed that both vaccinated and unvaccinated high-risk patients showed an overall 46 percent lowering of the risk of severe COVID-19 or death.
Paxlovid is actually a two-drug treatment: nirmatrelvir and ritonavir to be taken both in the AM and PM for five consecutive days. Nirmatrelvir functions as an antiviral, stopping the Sars-COV-2 virus from replicating (copying) itself. The ritonavir drug helps boost the first drug’s effectiveness. But ritonavir can also, unfortunately, limit the effectiveness of other drugs in the person’s system which might include some common prescriptions such as statins. For this reason, it is first suggested that patients share their complete drug and supplement list with their medical provider. People, using this therapeutic treatment, might be able to simply pause or lower the dose of other drugs with the help of their consulted physician or pharmacist.
The broad use of Paxlovid then is extended to people older than 12 years old, at risk of severe COVID-19, including most importantly those over the age of 50, pregnant individuals, or those with chronic health issues such as obesity, hypertension, or diabetes. Early results from a Pfizer trial of 1,153 people did not demonstrate a strong benefit for unvaccinated not at high-risk individuals or for fully vaccinated people with only one risk factor for severe disease. Nevertheless, with limited data on the subject, experts still state that older patients may be helped by the med combo. Dr. Kelly Gebo, a professor at The John Hopkins School of Medicine and co-author of a set of guidelines on treatment of COVID-19, states “Ultimately, everyone should discuss the benefits and risks of the treatment with their provider.”
Common side effects of Paxlovid are nausea, diarrhea, and a changed sense of taste. In addition, rarely found are liver problems with the yellowing of skin and the whites of eyes, and allergic reactions. Even though some people report the return of symptoms or a positive test, it is advised to simply isolate yourself during this period. A “rebound effect” is not presently clearly understood, but is noted to not be returning patients to hospitalizations. Therefore, Jason Gallagher, PharmD, clinical pharmacy specialist in infectious diseases at Temple University School of Pharmacy states, “The drug is designed to keep you from being hospitalized. Paxlovid did its job if you are not admitted.”
