What Do We Know About Paxlovid, a New COVID-19 Drug Prescribed to Biden?

President Joe Biden, who tested positive for COVID-19 last week, is taking an antiviral drug Paxlovid. The new medicine prevents developing severe symptoms that might lead to hospitalization or death.

On Sunday, the White House published a letter by Biden's physician. It said that the president's symptoms continue to improve significantly and that he will continue Paxlovid as planned.

The drug has been making headlines since the FDA authorized its emergency use last December and authorized state-licensed pharmacists to prescribe Paxlovid in July 2022.

What is Paxlovid?

Paxlovid, developed by the German company Pfizer, is an oral antiviral pill that can be taken at home and comes in a three-pill dose.

Two of the pills are nirmatrelvir, a drug that makes the COVID-19 virus released from the cells no longer able to enter uninfected cells in the body.

The third pill is ritonavir, which makes nirmatrelvir to work longer by shutting down its metabolism in the liver.

Paxlovid must be taken within five days after symptoms begin, twice daily for five days.

Who is eligible for Paxlovid?

The FDA concluded that Paxlovid is effective for treating mild-to-moderate COVID-19 in adults and pediatric patients, who are 12 years and older, weighing at least 88 pounds, and at high risk for progression to severe COVID-19, including hospitalization or death.

At higher risk are people 65 years and older or those who have underlying conditions, such as diabetes, cancers, chronic lung diseases, etc. You can find the list of the conditions issued by the CDC here.

The drug is not recommended for people with severe kidney or liver diseases.

To get a Paxlovid prescription, an individual has to present a positive COVID-19 home test result from a rapid antigen diagnostic test, or a positive PCR test.

What are the side effects?

Among the side effects of Paxlovid are metallic taste on the tongue, diarrhea, increased blood pressure, muscle pains, abdominal pain, and nausea.

A health provider should be contacted immediately in case of more severe side effects, such as hives, trouble swallowing or breathing, swelling of the mouth, lips, or face, people, and liver problems.

In May, the CDC issued a Health Advisory on the COVID-19 rebound. There have been cases when symptoms returned four or five days after completing the full course of Paxlovid, or a person, who previously tested negative for COVID-19, had a positive test result again.

The CDC said that "a brief return of symptoms may be part of the natural history of SARS-CoV-2 infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status."

How effective is Paxlovid?

The clinical trial of Paxlovid involved over 2000 non-hospitalized patients with mild-to-moderate COVID-19. The results showed that the treatment with Paxlovid reduced the risk of hospitalization or death by 89%. Pfizer claims the drug is also effective against the now predominant Omicron variant.


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