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Tuesday, January 18, 2022

Two new COVID treatment pills: who can take them and when?

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As the European Union’s drug regulator advised the member states that they can use two COVID-19 antiviral pills — Pfizer’s Paxlovid and Merck’s molnupiravir – ahead of their formal approval, patients will soon have new treatment options that can be taken at home.

Both Paxlovid and molnupiravir — to be branded Lagevrio in Europe — are potentially groundbreaking and were shown to reduce the chances of hospitalization or death from COVID-19 in high-risk patients.

With cases spiking in a number of countries on the continent, driven by the highly infectious Omicron strain, governments are expected to introduce the pills in the fight against the virus as soon as they become available to ease the burden on the strained healthcare systems.

However, the pills will have to be taken as soon as possible once symptoms appear, and getting tested, getting a prescription, and starting the pills in a short window might prove to be a challenge.

Who should take these pills?

The antiviral pills aren’t for everyone who gets a positive test. The pills are intended for those with mild or moderate COVID-19 who are more likely to become seriously ill.

That includes older people and those with other health conditions like heart disease, cancer or diabetes that make them more vulnerable.

Who shouldn’t take these pills?

In the US, Merck’s molnupiravir is not authorized for children because it might interfere with bone growth. It also isn’t recommended for pregnant women because of the potential for birth defects.

Pfizer’s pill isn’t recommended for patients with severe kidney or liver problems. It also may not be the best option for some because it may interact with other prescriptions a patient is taking.

The antiviral pills aren’t authorized for people hospitalized with COVID-19.

What’s the treatment window?

The pills have to be started as soon as possible, within five days of the start of symptoms.

Cough, headache, fever, the loss of taste or smell and muscle and body aches are among the more common signs.

Dr. Cameron Wolfe, an infectious disease specialist at Duke University Hospital, advises getting a test as soon as you have symptoms of COVID-19.

“If you wait until you have started to get breathless, you have already to a large extent missed the window where these drugs will be helpful,” Wolfe said.

Will the pills work for the Omicron variant?

The pills are expected to be effective against Omicron because they don’t target the spike protein where most of the variant’s worrisome mutations reside. The two pills work in different ways to prevent the virus from reproducing.

Are there other options?

Yes, but they aren’t as easy to use as a pill. They are given by IV or injection, typically at a hospital or clinic. Three drugs provide virus-fighting antibodies, although laboratory testing suggests the two aren’t effective against Omicron.

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