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Paxlovid (nirmatrelvir with ritonavir) has already saved countless people from hospitalization and death by reducing the length and severity of COVID-19. Formally approved by the FDA in late May of 2023, the drug has not received its share of publicity as the media and the public, weary of COVID, have moved on, even if the disease remains a major problem post-pandemic. As medical providers dedicated to the health of our patients, Dr. Michael Farzam and House Call Doctor Los Angeles are providing Paxlovid to patients with Covid who are benefiting from milder, less dangerous cases of the illness.
As of this writing, Paxlovid is primarily prescribed to patients who have tested positive for Covid and who are considered to be at an increased risk of suffering from serious symptoms. This includes those over 50 years of age or who are unvaccinated, immunocompromised, or otherwise more vulnerable. While it is primarily given to adults, it can be prescribed to patients as young as 12. Some in the media are currently arguing that the drug should be prescribed more widely to non-high-risk patients under 50.
Paxlovid is not the only drug in its category, but it is the most widely prescribed and the best. The procedures and impacts of Paxlovid and its sister medications are similar to Tamiflu, which can reduce the severity of the flu if taken within a few days of contracting the illness. Similarly, Paxlovid and related drugs are only effective for about five days after someone becomes ill with Covid. After that, it is too late for treatment.
There are at least 30 prescription drugs where interactions with Paxlovid may be a concern, so it’s important to check in with your doctor, make sure they know about every drug you are presently taking, and discuss whether you should temporarily discontinue some or all while you are on Paxlovid. It has not been tested for safety during pregnancy and breastfeeding, so it’s important to discuss the matter with your doctor if you are having a baby. To be safe, anyone who may become pregnant should either use a barrier type of birth control or avoid sexual intercourse until they have finished taking Paxlovid.
Paxlovid is not associated with serious side effects, though some mostly mild symptoms are possible. The most common side effects resemble those associated with many other drugs including diarrhea and nausea, as well as muscle aches and increased blood pressure. More dramatic possible symptoms are typical for allergic reactions including rashes, hives, swelling, trouble swallowing, and throat tightening. Especially in the latter cases, you should contact medical personnel immediately if these types of symptoms arise. If you believe the issue may be a life-or-death emergency, call 911 or head to the nearest emergency room.
Two additional drugs may be better for certain individuals: Veklury (remdesivir) and Lagevrio (molnupiravir). If you have concerns about Paxlovid, feel free to ask your doctor if they may be better in your specific case.
The answer for now is yes. Studies at the National Institute of Health and elsewhere have indicated that it remains highly effective against Omicron.* It has also proven effective for Omicron variants so far and is expected to work against likely mutations as of this writing. (October 2023).
One concern expressed by some experts is that resistant strains – not unlike the ones that can develop due to overuse of antibiotics – may be a possibility. Fortunately, they do not appear to have become a problem so far.
* “Nirmatrelvir Plus Ritonavir for Early COVID-19 in a Large U.S. Health System: A Population-Based Cohort Study.” Annals of Internal Medicine. Scott Dryden-Peterson, Andy Kim, Arthur Y. Kim, Ellen C. Caniglia, Inga T. Lennes, Rajesh Patel, Lindsay Gainer, Lisa Dutton, Elizabeth Donahue, Rajesh T. Gandhi, Lindsey R. Baden, Ann E. Woolley. January 2023.
You may have heard about discussions of Paxlovid rebound and been confused or concerned but it may be more accurate to call it Covid rebound. When medical professionals talk about rebounds, they simply mean a second bout of symptoms which are nearly always milder and shorter-lived than the first case. Rebounds after Covid can happen whether or not a patient takes Paxlovid.
It may be that rebounds are reported more after Paxlovid use because users may tend to be hypervigilant about new drugs. Regardless, your illness should be shorter and milder overall than if you have taken nothing.
As we said above, Paxlovid and similar medications must be obtained and taken promptly to be effective. This may mean contacting your regular doctor but an appointment may not be available; you may be referred to an urgent care facility or need to look for doctors on call. Especially if you live in a large urban area like Greater Los Angeles, this means time spent in often stressful traffic and risking contact with others – wearing a mask is essential in medical offices, even now.
One option that may be preferable for many people is looking into house-call medicine in your area. House calls all but disappeared in the second half of the 20th century because the rapidly advancing medical technology of the time required large machines. Thanks to the ongoing revolution in miniaturization and mobile technology, modern medicine no longer requires bulky devices and communication is more efficient than ever. Testing and diagnosis are often just as easy to accomplish at a patient’s home or hotel room as at most doctors’ offices and clinics.
Whether it’s for a Paxlovid prescription or any other reason, house calls have a host of benefits in terms of convenience and health. Most importantly, they save ill patients a great deal of stress and avoid contact with others at a time when their bodies may be more susceptible to contracting illnesses. For most house call doctors, the offerings run the full gamut of healthcare – from vaccines and immunizations when and where patients need them, to the latest and most advanced treatments for all types of conditions.
If you are in the Greater Los Angeles area, consider reaching out to House Call Doctor Los Angeles. Led by noted board-certified internist Dr. Michael Farzam, we offer 24-7-365 care for residents and visitors in Los Angeles and its environs, including the Westside, the San Fernando Valley, Burbank, downtown/mid-city, Culver City, Santa Monica, Hollywood/West Hollywood, and Beverly Hills. To reach out to a 24-hour doctor, call us at the number on your screen or use one of the links on our contact page and fill out the online form.