Antiviral Medication for COVID-19

What Is Paxlovid?

Paxlovid is the first oral pill approved in Malaysia that is specifically developed to treat COVID-19.¹

Paxlovid dosage

Paxlovid is given as three tablets per dose:

Two Nirmatrelvir tablets and one Ritonavir tablet.

The three tablets are taken every 12 hourly for 5 days.

Paxlovid is administered after COVID-19 diagnosis and within five days of symptoms onset.²

What Does Paxlovid Do?

Paxlovid consists of Nirmatrelvir and Ritonavir.

Nirmatrelvir inhibits a SARS-CoV-2 protein to stop the virus from replicating.

Ritonavir slows down the breakdown of Nirmatrelvir to help maintain high concentrations of Nirmatrelvir in the body.³

What Paxlovid Is Not?

Paxlovid is not approved for COVID-19 prevention. Paxlovid is not a replacement for COVID-19 vaccines.

Paxlovid is also not a substitute for treatment in those requiring hospitalization due to severe or critical COVID-19 infection.³

Of course, Paxlovid is not an over-the-counter medication. You cannot buy Paxlovid like paracetamol or aspirin in a pharmacy.

Indication

Paxlovid would be indicated for the treatment of Covid-19 in adults aged 18 and above who do not require supplemental oxygen and who are at increased risk for progressing to severe Covid-19.¹

Possible Side Effects

Paxlovid side effects include impaired sense of taste, diarrhea, high blood pressure and muscle aches. Paxlovid may have significant drug interactions with some medications. Ritonavir may cause liver damage. Paxlovid must be used with caution in patients with liver diseases.³

Other Potential COVID-19 Medications in Malaysia

“There are two more (drugs) that we will buy (namely) Molnupiravir, and another from AstraZeneca, but this has not been finalised,” said Health Minister, Khairy Jamaluddin⁴

Molnupiravir is another potential COVID-19 treatment. Molnupiravir functions similarly to Paxlovid in the sense of interrupting the replicating process of the virus. Molnupiravir reduces hospitalization rate in high risk patients by about 30% while Paxlovid reduces the same risk by 90%.⁵

AstraZeneca’s Evusheld has obtained FDA (United States Food and Drug Administration) emergency use authorization for the prevention of COVID-19 in certain high risk individuals. Evusheld is a combination of two antibodies, tixagevimab and cilgavimab. Do note that Evusheld is not a pill but is in injection form. In Singapore, Evusheld is used only for the treatment of Covid-19, and not prevention.⁶