The development of newer therapeutic alternatives provides additional tools for the prompt and appropriate management of COVID-19 infections. Two oral antivirals have received an Emergency Use Authorization (EUA) by the Food and Drugs Administration (FDA) for the treatment of mild-to-moderate COVID-19 infections. The purpose of the EUA for these treatments is to quickly manage the disease to limit the risk of progression to severe infection, which could result in complications that include hospitalization and death.

Information on these drugs is presented below:

Indication

Both are for the treatment of mild-to-moderate COVID-19 in patients with positive results to COVID-19 viral testing, and who are at high risk of progression to severe disease, including hospitalization and death:

PAXLOVID

(nirmatrelvir & ritonavir)

Population: Age 12 years or older, weight 40 kg (88 pounds) or more

Dosage: 300 mg of nirmatrelvir (two tablets) and 100 mg of ritonavir (one tablet)

Administration Frequency: Twice daily

Dosage Form: Tablets

Treatment Duration: 5 days

Possible Adverse Effects: Altered taste, diarrhea, hypertension, and muscle pain

Special Considerations: Dosage should be adjusted in renally compromised patients. This therapy interacts with some medications taken for other conditions.



LAGEVRIO

(molnupiravir)

Population: Age: 18 years or older

Dosage: 800 mg of molnupiravir (four capsules)

Administration Frequency: Twice daily

Dosage Form: Capsules

Treatment Duration: 5 days

Possible Adverse Effects: Diarrhea, nausea, dizziness, rash and itchy skin.

Special Considerations: Not recommended for patients that are pregnant or that could become pregnant.

Lactation should be stopped while on treatment and 4 days after the last dose was taken.

Limitations for both medications:

Not authorized for use:

In patients already hospitalized for severe COVID-19 infection

As a preventive measure, either before or after exposure

For more than 5 days of treatment

To facilitate the selection of the most appropriate treatment, it is important to provide the physician a complete list of medications currently taken. Additionally, these treatments should be started in the first 5 days after symptoms onset to maximize their effectiveness. These treatments are already available and require a medical prescription.