How To Get Paxlovid—and Tips for Taking It

The Food and Drug Administration (FDA) updated its emergency use authorization (EUA) for Paxlovid (nirmatrelvir/ritonavir) in 2022. This change has allowed people who test positive for COVID-19 and are at high risk for severe disease to get Paxlovid from state-licensed pharmacists. You can also visit a healthcare provider for a diagnosis and treatment for COVID.

This adjustment recognizes the important role pharmacists play and has allowed greater access to timely treatment. It's also especially beneficial for people who live in rural communities and those who may be traveling.

What Is Paxlovid?

Paxlovid is an oral antiviral regimen that helps prevent severe illness, hospitalization, and death from COVID. You'll take Paxlovid two times per day for five days. It's meant to be taken as soon as possible after a diagnosis, usually within five days of symptom onset.

Paxlovid includes two pills called nirmatrelvir and ritonavir. Nirmatrelvir is an antiviral. This class of drugs stops SARS-COV-2, or the virus that causes COVID, from replicating in the body. Ritonavir is a pharmacokinetic booster, which boosts the effects of nirmatrelvir.

The FDA first approved for emergency use Paxlovid to treat mild-to-moderate illness in adults and children aged 12 and older who are at high risk for severe COVID. Paxlovid earned full approval for adults in May 2023.

How To Get Paxlovid

You must meet eligibility requirements for a state-licensed pharmacist to prescribe Paxlovid. You must also be able to provide:

• A list of all medications you're currently taking, including over-the-counter (OTC) medications
• Electronic or printed health records that are less than 12 months old
• The most recent reports of laboratory blood work, including liver and kidney function tests

This extra information helps pharmacists determine whether you can receive a prescription for Paxlovid. They may also use this information to adjust a prescription. A pharmacist may refer you to a healthcare provider to prescribe Paxlovid if you can't provide this information.

Who Should Take It?

Paxlovid is authorized for adults and children older than 12 who weigh at least 88 pounds. This antiviral drug is recommended for people who have a high risk of severe illness, such as:

• Asthma
• Cancer
• Chronic obstructive pulmonary disease (COPD)
• Diabetes, heart disease, or stroke
• Kidney, lung, or liver disease
• Overweight or obesity
• Physical inactivity
  Older age (i.e., 65 and older)
• Pregnancy
• Smoking 
• Weak immune system

You must also have mild-to-moderate COVID symptoms that have lasted for five days or fewer. The sooner you start taking Paxlovid, the more effective it is.

How To Take It

You must take both nirmtrelvir and ritonavir together as directed for Paxlovid to be effective. A healthcare provider or pharmacist will instruct you to take both pills two times per day for five days.

You can take Paxlovid with or without food. Just make sure you take it at the same time each day. It's also important not to chew, crush, or split the tablets. Swallow them whole with a glass of water.

Don't end treatment before you finish all of the pills, even if you feel better. Stopping Paxlovid early or skipping doses can negatively affect treatment outcomes.

Potential Drug Interactions

Paxlovid may interact with a number of drugs. It's important to give a healthcare provider or pharmacist a list of all the medications and supplements you're currently taking.

Paxlovid may interact with the following:

• Antipsychotics
• Blood thinners, such as warfarin
• Drugs that regulate heart rhythm
• Drugs that treat erectile dysfunction, such as Viagra (sildenafil)
• Seizure medications
• St. John's wort
• Statins, which lower cholesterol

What Is Paxlovid Rebound?

Some evidence suggests that people who take Paxlovid may experience a "rebound" of COVID symptoms. This is called Paxlovid rebound, and it may occur two to eight days after finishing treatment. You may have a new positive test after previously testing negative.

The FDA estimates that 1% to 2% of people experience Paxlovid rebound. The Centers for Disease Control and Prevention (CDC) still recommends Paxlovid for those at risk for severe illness. Paxlovid significantly reduces the risk of hospitalization or death from COVID.

A Quick Review

You can get Paxlovid from a healthcare provider or state-licensed pharmacists. This antiviral drug is available for people who test positive for COVID and are at risk for severe illness. Paxlovid significantly reduces the risk of hospitalization and death from COVID.

It's important to follow a healthcare provider or pharmacist's instructions for taking Paxlovid. Take both pills at the same time twice per day for five days.