Paxlovid – Advanced antiviral combination for high-risk COVID-19 treatment.
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What is Paxlovid?
Paxlovid is a breakthrough antiviral combination specifically developed for COVID-19 treatment in high-risk patients. The combination of nirmatrelvir and ritonavir provides powerful antiviral activity that can significantly reduce the risk of hospitalization and severe outcomes when used appropriately.
Book an online consultation if you’ve tested positive for COVID-19 and are at high risk of severe disease, or if you need assessment for antiviral treatment eligibility. Our GPs can evaluate your risk factors and determine if Paxlovid is appropriate while managing the complex drug interaction considerations.
What is Paxlovid used for?
- COVID-19 treatment in high-risk adults
- Prevention of severe COVID-19 outcomes
- Treatment within 5 days of symptom onset
- High-risk patients with comorbidities
- Immunocompromised patients with COVID-19
- Elderly patients with COVID-19
How does Paxlovid work?
Nirmatrelvir inhibits the SARS-CoV-2 main protease (3CLpro), preventing viral replication, while ritonavir boosts nirmatrelvir levels by inhibiting its breakdown, maintaining effective antiviral concentrations.
Dosage and Administration
Adults
300mg nirmatrelvir + 100mg ritonavir twice daily for 5 days. Must start within 5 days of symptom onset.
Children
Not currently approved for use in children under 12 years or weighing less than 40kg.
Important Notes
- Take with or without food, but preferably with food to improve tolerability.
- Complete the full 5-day course even if symptoms improve.
- Start as soon as possible within 5 days of symptom onset.
- Each dose contains 2 nirmatrelvir tablets + 1 ritonavir tablet.
Side Effects
Common Side Effects
- Metallic taste (dysgeusia)
- Diarrhoea
- High blood pressure
- Muscle aches
- Abdominal pain
- Nausea and vomiting
- Headache
Serious Side Effects
Seek immediate medical attention if you experience:
- Severe allergic reactions
- Liver problems
- Drug interactions causing toxicity
- Heart rhythm changes
- Severe diarrhoea
- Kidney problems
Important Warnings
- CRITICAL: Extensive drug interactions—tell your GP about ALL medications you take.
- Not suitable for patients with severe kidney or liver disease.
- Must start within 5 days of COVID-19 symptom onset to be effective.
- May need to temporarily stop other medications during treatment.
- Complete isolation requirements still apply during treatment.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- Blood thinners (warfarin)—may significantly increase bleeding risk.
- Immunosuppressants—may increase levels and toxicity.
- Heart medications—may affect levels of cardiac drugs.
- Seizure medications—complex interactions requiring dose adjustments.
- Oral contraceptives—may reduce effectiveness.
- Many other medications—comprehensive review essential before prescribing.
Frequently Asked Questions
Who is eligible for Paxlovid treatment?
High-risk adults with COVID-19 who can start treatment within 5 days of symptom onset, including elderly patients, immunocompromised individuals, and those with serious comorbidities.
How effective is Paxlovid at preventing severe COVID-19?
Clinical trials showed approximately 89% reduction in hospitalization and death when started within 3 days of symptom onset in high-risk patients.
What should I do about the metallic taste?
Metallic taste is very common and usually resolves after completing treatment. Chewing gum, sucking on citrus fruits, or using mouth rinses may help.
Can I take Paxlovid if I'm vaccinated?
Yes, Paxlovid can be prescribed to vaccinated individuals who are at high risk of severe COVID-19, especially if they have breakthrough infections.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14