A number of new medications have received emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) for the treatment of mild-to-moderate COVID-19. These therapies are for use in individuals who are at high risk of getting severe disease if infected with COVID-19. Most individuals with COVID-19 have mild illness and can recover at home without medical care. Read more about common symptoms and recovering at home.
2 of the new oral antiviral therapies, Paxlovid and molnupiravir, are now being supplied to certain retail pharmacies in New Hampshire, and are available through a prescription from your primary care provider if you are COVID-19 positive, symptomatic and considered at high risk for complications from the disease.
Note: Paxlovid and Remdesivir are endorsed for use for pregnant women by the Society for Maternal Medicine and by the American College of Obstetrics and Gynecology.
These treatments are not alternatives to getting vaccinated and boosted, or wearing a mask.
Paxlovid (nirmatrelivir/ritonavir) is an antiviral pill used to treat mild-to-moderate COVID-19 in patients ages 12 and older who have tested positive for COVID-19 and who are at an increased risk of severe illness or hospitalization. This medication requires a prescription and should be taken within 5 days after the start of symptoms. Results of a clinical study showed an 88% decrease in the risk of hospitalization or death at 28 days as compared with a placebo. Laboratory studies also showed that Paxlovid was effective against the Omicron variant. Paxlovid is not meant to be used to prevent infection or to prevent illness after being exposed to COVID-19.
Please note that Paxlovid has many interactions with other medications. Consultation with a pharmacist is strongly advised for anyone prescribed Paxlovid.
Remdesivir is an antiviral given by IV infusion over 3 consecutive days. While the drug was previously used in the inpatient setting during the early COVID-19 pandemic, subsequently studies done in non-hospitalized patients showed an 88% decrease in in the risk of hospitalization or death at 28 days, if given to high-risk patients within 7 days of the start of symptoms.
Starting in late December 2022, Dartmouth Hitchcock Medical Center (DHMC) will be piloting an outpatient IV Remdesivir clinic at DHMC for high-risk patients. Availability for this clinic will be very limited and at first, only DHMC providers will be able to refer patients to this clinic. Expansion to other providers outside of DHMC will be discussed as we review the recourses and logistics needed to run this clinic.
Molnupiravir is an antiviral pill used to treat mild-to-moderate COVID-19 in patients ages 18 and older who have tested positive for COVID-19 and who are at an increased risk of severe illness or hospitalization. Molnupiravir can only be prescribed in patients who are not able to receive Paxlovid due to drug interactions, certain chronic health conditions, or lack of availability. This medication requires a prescription and should be taken within 5 days from the start of symptoms.
Results of a clinical study showed a 31% decrease in the risk of hospitalization or death at 29 days as compared to placebo. Laboratory studies also showed that molnupiravir was effective against the Omicron variant. Molnupiravir is not meant to be used to prevent infection or to prevent illness after being exposed to COVID-19.
Molnupiravir is not authorized for use in patients under the age of 18. While pregnancy is not an absolute contraindication for use, fetal toxicity has been observed in animal models at significantly higher exposures than with human dosing, and risk of use in pregnancy may outweigh the benefit. Discussion with your health care provider on the risks and benefits of molnupiravir and the available alternatives in pregnancy is required before prescribing. If taking molnupiravir, women of child-bearing age should use a reliable method of contraception during treatment and for at least 4 days afterwards, while men of child-bearing age should use a barrier form of contraception during treatment and for at least 3 months after.
Please contact your primary care provider to determine your best treatment option for COVID-19.
If you have any questions after your treatment about side effects or your COVID-19 symptoms, please follow up with your primary care provider.
Please note that your insurance company will be billed for your Remdesivir treatment. If you have questions about your coverage, please contact your insurance company. Dartmouth Health provides financial assistance for those who are unable to pay for their medical care based on their individual financial situation.