Covid Update: Paxlovid Works

My wife Ann Feeney and I contracted COVID at the end of a cruise to Alaska in August, and we spent the next 5 days taking Paxlovid pills to reduce the risk of any serious outcome. We recovered within 7 days and we were antigen-test negative prior to our return flight from Anchorage. We were able to isolate in remote cabin/lodge settings with occasional views of Mount Denali during our treatment period.

What is it? 

Paxlovid is a two-drug combination used to treat early-stage COVID infection. It is made by Pfizer, and the clinical trial in unvaccinated individuals resulted in an 89% reduction in the risk of hospitalization and death. One of the components, nirmatrelvir, inhibits a critical viral enzyme, while the other, ritonavir, slows the liver destruction of nirmatrelvir and thus boosts its efficacy. Paxlovid is packaged in blisters with two pills of nirmatrelvir and one pill of ritonavir, and you are instructed to take the 3 pills twice each day for 5 days.

Who should take it?

Anyone over the age of 65 or with serious underlying health issues should start taking Paxlovid within 5 days of the onset of COVID symptoms. You should have a doctor prescribe it after reviewing your current medications because of possible drug interactions. In my case, a test for kidney function was required before treatment and I was instructed to stop taking Lipitor (a cholesterol-lowering statin) while being treated. Paxlovid is recommended even if you have been fully vaccinated, as we were when we became ill.

What are the side effects?

A common side effect that we experienced was a metallic taste in our mouths that was unpleasant but not that bad. Other side effects were difficult to distinguish from the symptoms of COVID infection (muscle aches, lethargy, nausea), but the clinical studies indicate that the benefits of Paxlovid outweigh the minor side effects for those with normal liver and kidney function.

Did Paxlovid keep us out of the hospital? There really is no way to tell for certain, but I would rather be safe than sorry. Paxlovid is under-prescribed in the U.S., and a recent report in the New York Times (Oct. 7th, “The Power of Paxlovid”) concluded that the current COVID death rate of 400 per day could be reduced to 50 per day if the drug was given to everyone who is eligible. If you are over 65 and you get it, take it!