Paxlovid: The COVID Drug Leaving a Bad Taste in Our Mouths

The FDA recently authorized the use of Paxlovid under an Emergency Use Authorization (EUA). Paxlovid is an investigational antiviral medication for treating mild-to-moderate COVID-19 in adults and children who have tested positive for the virus and are at high risk for progression to severe COVID-19, including hospitalization or death.

Key takeaways:

This includes people with cancer, diabetes, obesity, or 65 or older (more than 81% of COVID-19 deaths occur in this group). It is an effective medication with unpleasant side effects.

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What is Paxlovid?

Paxlovid (the brand name for the drug, which is made up of two antiviral medications, ritonavir which is not effective against SARS-CoV-2 however is utilized to suppress the clearance of nirmatrelvir to ensure it stays in the body longer and) Nirmatrelvir, the antiviral effective against SARS-CoV-2 blocking the SARS-CoV-2-3CL protease (the main protease, Mpro) thus preventing processing of the polyprotein precursors, rendering the virus incapable of producing proteins necessary for viral replication.Paxlovid has been studied in two Phase III randomized, controlled trials involving over 3700 participants.

What are the benefits of taking this medication?

Although Paxlovid is not the only medication with an EUA used to treat COVID-19, it has been more effective than the other drugs and has a lot of upsides. According to Yale Medicine, it has had an 89% reduction in hospitalization and death in clinical trials, in those that were unvaccinated and had at least one risk factor for severe disease. In fact, the National Institute of Health prioritized its use over other COVID-19 treatments. While we remain in a public health emergency, the drug is provided by the Federal Government, free of charge, to those who qualify. It is also considered an improvement over older treatments like remdesivir, which must be administered intravenously.

How do I take this medication?

If you qualify, your provider will prescribe Paxlovid. It is imperative to take Paxlovid within five days of developing symptoms, and it is unlikely that your provider will prescribe this medication if you have experienced symptoms for longer than five days, as this is also not authorized by the EUA. The medication comes in a "dose card" that allows you to punch out the pills as needed. You will take three Paxlovid pills twice a day for five days, which ends up being 30 pills.

What are the side effects of this medication?

The most common side effects reported with Paxlovid were diarrhea,high blood pressure, muscle pain, and dysgeusia (a taste disorder). However, some people have reported a bad taste in their mouth after taking Paxlovid. This side effect is called "Paxlovid mouth," or dysgeusia. People who have experienced this phenomenon report that the bad taste comes shortly after taking the first set of pills. Some have compared it to mixing soap and grapefruit or chewing a whole bunch of vitamins.

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Dysgeusia

Dysgeusia is a condition that results in a change in taste. People with this condition may experience a metallic, bitter, or sour taste. This can make eating and drinking difficult. Dysgeusia can be caused by certain medications, medical conditions, and pregnancy. It can also be a side effect of chemotherapy. Treatment for dysgeusia often focuses on the underlying cause.

In some cases, switching to a different medication may help. There are also home remedies that can help improve the symptoms of dysgeusia. These include sucking on lemons or ginger root, drinking lots of fluids, and avoiding strong-tasting foods. Dysgeusia can have a big impact on quality of life. People with this condition often find that they can no longer enjoy their favorite foods and drinks. This can lead to weight loss and malnutrition. Dysgeusia can also cause social isolation as people may avoid going out to eat or drink with friends.

How to counteract Paxlovid mouth

If you are taking Paxlovid and experience a bad and persistent taste in your mouth, there are some things you can do to try to get rid of the bad taste.

  • Drink lots of fluids, especially water. This may help to get rid of the bad taste.
  • Eat acidic foods, such as citrus fruits or tomatoes. The acidity may help to mask the bad taste.
  • Chew gum or suck on hard candy. This can help to stimulate saliva production and may help to get rid of the bad taste.
  • Rinse your mouth with a solution of equal parts water and baking soda. This can help neutralize the pH in your mouth and may help eliminate the bad taste.
  • Try over-the-counter products designed to eliminate bad breath, such as mouthwashes or toothpaste. These products may also help to get rid of Paxlovid mouth.

Talk to your healthcare provider if you are still experiencing Paxlovid mouth after trying these tips. They may be able to prescribe a different medication for you that does not cause this side effect or helps reduce the bad taste in your mouth.


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