COVID-19 Resources

COVID-19 Oral Antiviral Medications Are Here: What You Should Know

Feb. 25, 2022

COVID-19 continues to challenge daily life, and it may do so for the foreseeable future, but there’s good news too. We’re continuously learning more and have more options than ever for preventing and treating COVID-19.

You’ve likely heard of some COVID-19 treatments, like antibody infusions (ex. Regeneron)—the goal of these treatments are to reduce the risk of serious illness, hospitalization or death.

The newest treatments in the arsenal are antiviral pills, which are used to treat infections caused by viruses like COVID-19. Two new antiviral medications recently received emergency use authorization from the US Food and Drug Administration (FDA) for the treatment of COVID-19.

“The new antiviral medications for COVID-19 are an exciting addition to our treatment toolbox. Anytime we have access to more options for treating an illness, it’s good news—and these antivirals are shown to help prevent patients from getting very sick or needing hospitalization,” says Jennifer Forrester, MD, associate chief medical officer and infectious disease specialist at UC Health.

Antiviral drugs are not new—they have been used for decades to help treat everything from HIV to the flu. The COVID-19 antiviral drugs available now are Paxlovid from Pfizer and Molnupiravir from Merck.

About COVID-19 antiviral medications

Antiviral medications,or antivirals, are developed to fight a specific type of virus. For example, Tamiflu is an antiviral medication that treats the influenza virus. Many antivirals are pills, including the new medicines for treating COVID-19.

 “The new COVID-19 antivirals are good at their job. Patients who are eligible to take an antiviral are likely to feel less sick over time, and likely to have less symptoms than if they didn’t take anything at all. Plus, these are pills the patient can take at home, making it easier than some of the more complex COVID-19 treatments that must be done in a clinical setting,” says Dr. Forrester.

How COVID-19 antivirals work

Antivirals help your immune system fight off infection by stopping the virus from making copies of itself. When a virus makes copies of itself, it’s like it’s creating more soldiers to attack your immune system. Less soldiers and copies of the virus mean an easier fight for your immune system.

Because antiviral drugs are typically made to target a specific virus, researchers have been working hard to make antivirals that can slow or stop the COVID-19 virus from growing in your body. Wondering if you can take any antiviral to treat COVID-19? The answer to that is no.

“Viruses are complex. No two are alike, so the antivirals used to treat them have to be specifically made to fight each virus. Taking the wrong antiviral to treat COVID-19 would be like wearing sandals in the pouring rain and hoping your feet don’t get wet. It just won’t work,” says Dr. Forrester. Talk with your healthcare provider to see determine if you meet the criteria for taking antiviral pills.

The benefits of COVID-19 antivirals

The omicron variant caused a significant spike in COVID-19 cases, and there are already signs the next mutation has arrived. It’s not cause for alarm—this is the nature of viruses. They change and mutate just like influenza and common cold viruses. For now, the COVID-19 antiviral medications have demonstrated they are a good defense against the omicron variant, reducing hospitalization and death.

Antivirals: they’re not for everyone

If you test positive for COVID-19, you can’t just call your provider and ask for a prescription for an antiviral. Your doctor will need to determine if you meet the criteria for taking antiviral pills. That criteria includes:

  • You’re at higher risk of complications from COVID-19.
  • You don’t need to be hospitalized.
  • You haven’t had COVID-19 symptoms for more than five (5) days.
  • You meet age and weight requirements.

There are some reasons you may not be able to take COVID-19 antivirals, such as being pregnant, breastfeeding, or having liver or kidney problems.

“Antivirals can be used by both vaccinated and unvaccinated people. Once your provider has determined you’re eligible to take a COVID-19 antiviral, they’ll decide which one is best for you,” says Dr. Forrester.

What are the ingredients?

The active ingredients inside Pfizer’s Paxlovid are nirmatrelvir and ritonavir. The active ingredient in Merck’s molnupiravir is molnupiravir.

Both medications have a small list of inactive ingredients, which are used to keep the active ingredients inside the drug safe. People are rarely allergic to inactive ingredients in medicines, but it is always important to talk with your healthcare provider to see which antiviral treatment option is right for you.

Side effects

As with any medication, there could be side effects with these antivirals.

“Your doctor will carefully weigh the risks and benefits when prescribing any medication, including antivirals. Make sure you’re aware of what the side effects are, and you talk to your care team about what to do if any side effects occur,” says Marisa Brizzi, PharmD, clinical pharmacist at UC Health.

Side effects from COVID-19 antivirals can include altered sense of taste, diarrhea, high blood pressure, dizziness, nausea and muscle aches. A rare but serious side effect includes liver problems.

Though both new antiviral medications received emergency use authorization from the FDA for the treatment of COVID-19, they are still going through clinical trials, which may discover additional side effects. 

COVID-19 vaccine vs. antiviral

It’s important to note that antiviral medications are not an alternative to being vaccinated against COVID-19. Antiviral medications treat COVID-19 after you’ve been infected. They don’t prevent infection, so you may still feel sick or experience complications from COVID-19 even after taking an antiviral.

It is still recommended that you get vaccinated to protect yourself and your loved ones. Learn more about vaccines and how to make an appointment here. If you think you may have COVID-19, learn more about testing here.

“COVID-19 vaccines are proven to prevent serious illness, death and hospitalization. Your best bet in the fight against COVID-19 is to get fully vaccinated and boosted, if you’re eligible. The antivirals are a great treatment option, but the best option of all is prevention,” says Dr. Forrester.

COVID-19 antiviral prescriptions

“COVID-19 antiviral medications can interact with many other drugs. Our team looks carefully at every medication a patient is taking and we consider other factors too, like age and weight. It’s our job to make sure the medications you’re taking help you, not harm you,” explains Dr. Brizzi.

Patients who are prescribed a COVID-19 antiviral can expect to take pills for five (5) days.

You have a prescription. Now what?

If you receive a prescription from UC Health in Greater Cincinnati for a COVID-19 antiviral, wait until you receive a phone call before heading to a UC Health pharmacy location. Filling the prescription is not instant. Antiviral medications are a scarce resource, so treatment will be based on availability from the government. Because quantities are limited and COVID-19 can still make you sick, please know that vaccination is your best defense.

Talk to your doctor about availability if your prescription for a COVID-19 antiviral drug is to be filled by a non-UC Health pharmacy.

What comes next in the pandemic?

The pandemic isn’t over, and we don’t yet know what its end will look like, but scientists and researchers are still working hard to help us better understand, treat and prevent COVID-19.

“There is a lot of interesting and exciting work happening right now,” says Dr. Forrester. “Researchers are evaluating everything from a vaccine that’s specific to the omicron variant, to what the genetic risk factors are for developing long COVID.”

In fact, there are nearly 3,000 clinical trials underway for COVID-19 around the world. Science has delivered answers and hope during the pandemic and will continue to deliver even more. As we all know, in science lives hope.