Paxlovid

Sounds like 'pax-low-vid'

Paxlovid is used to treat COVID-19 infection. It may help you become less sick and stay out of hospital.


Paxlovid for people with kidney problems: Factsheet update



English version
An error in the number of tablets to take has been identified in an older version of the Samoan, Cook Islands Māori and Niuean translations of our Paxlovid for people with kidney problems factsheet. These have been removed from the website. The updated Samoan and Cook Islands Māori factsheets are now available (see the sidebar) and are dated 22 November 2022. An updated Niuean factsheet will be added soon. Read more here.


Samoan version
IA MATAALA: O se sesē i le numera o fuāla‘au e inu na maua i se fa‘aliliuga tuai i le Gagana Samoa, le Atu Kuki Māori ma le gagana Niue o la matou pepa o faamatalaga o le Paxlovid mo tagata e fa‘alētonu fatuga‘o. Ua ave‘esea nei mai la matou upegatafa‘ilagi. O fa‘asa‘oga o fa‘aliliuga i le Gagana Samoa ma le Atu Kuki Māori ua maua nei ‘iinei ma o loo tusia ai Novema 2022. O se fa‘asa‘oga o le fa‘aliliuga i le Gagana Niue o le ‘a maua atu i se taimi o i luma. Faitau atili inei.

Cook Islands Māori version
Akamatakiteʻanga: Kua kitena ia mai tetai tarevake no runga i te numero o te uero ka kai i roto i tetai nga uriʻanga taʻito o teia kapi akamaramaramaʻanga no runga i te uero no te au tangata maki mape, koia te Paxlovid. Ko teia tarevake koia oki tei roto i te reo Samoa, Kuki Airani e te Niue. Kua akaatea ia atu te reira mei runga mai i te kupe roro uira. Ko te kapi akamaramaramaʻanga Kuki Airani e te reo Samoa tei akatanoʻia, tei runga te reira i te kupe roro uira i teia nei, ma te tuatau i akatanoʻia ei te reira, koia i roto ia Noema 2022. Ka tukuna katoa ia atu te kapi no te reo Niue ki runga i te kupe, me oti mai te reira i te akatanoʻia atu.
Tatau ua atu rai ki konei.

What is Paxlovid?

Paxlovid is given to people who are at most risk of becoming very unwell from a COVID-19 virus infection. It may help you become less sick and stay out of hospital. To be effective, Paxlovid must be started within 5 days of your symptoms starting.

Paxlovid contains 2 medicines:

  • ritonavir (white tablet)
  • nirmatrelvir (pink tablet).

When taken together, they can reduce the amount of virus in your body.

Image credit: James Heilman on Wikimedia Commons

Who can get Paxlovid for COVID-19 infection?

If your symptoms started within the last 5 days, AND you have tested positive for COVID-19 OR are a household contact of a person with COVID -19 AND at are at high risk of severe infection, you may be eligible for treatment. Read more about who can get COVID-19 antiviral medicines?

If you're not sure if you are eligible for antivirals, talk to your GP, nurse, hauora provider or pharmacist about COVID-19 antiviral medicines as soon as possible. They will advise you. 

How can I get Paxlovid?

There are 2 ways to get Paxlovid.

  • Ask your doctor or nurse practitioner for a prescription.
  • Ask your pharmacist. Many pharmacies can give you antiviral medicines without a prescription, after a health check by phone. Check healthpoint.co.nz for the nearest pharmacy offering COVID-19 antiviral medicines.

How to take Paxlovid

You healthcare provider will decide how much Paxlovid you will need to take. It will depend on whether you have kidney problems.

 Click on the link below to find out how to take Paxlovid safely and possible side effects.
If you have normal kidney function:
If you have kidney problems:
If you have advanced kidney disease or you're on dialysis:

What to consider before taking Paxlovid

Tell your healthcare provider about ALL the medicines you take.

Paxlovid may affect some of your other medicines and cause serious side effects.

  • Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including prescription and over the counter medicines, vitamins and herbal supplements (for example, St. John’s Wort).
  • Do not start taking a new medicine while you are taking Paxlovid without talking to your healthcare provider. Your healthcare provider can tell you if it is safe to take Paxlovid with other medicines.
My Paxlovid Plan
This plan is to help you record all your medicine doses when taking Paxlovid. It is especially useful if you need to stop or adjust your other medicines. Learn more: My Paxlovid Plan 

Are you pregnant or trying for a baby?

If you are pregnant, think you may be pregnant, or are planning to have a baby, don't take Paxlovid. Ask your doctor for advice as Paxlovid is not recommended during pregnancy. Women should avoid becoming pregnant (eg, use contraception or abstain from sexual activity) while taking Paxlovid and for 7 days after the treatment ends.

Contraception is very important

If you are taking birth control pills, extra care is needed as Paxlovid may affect how they work. It is recommended that you don’t have sexual activity while taking Paxlovid and for 7 days after the treatment ends. Otherwise use condoms as well as your usual contraception, while taking Paxlovid and for 7 days after treatment ends. Ask your doctor or pharmacist for advice.  

Are you breastfeeding?

Breastfeeding is not recommended during treatment and for 7 days after the last dose of Paxlovid. This is because it is not known if Paxlovid gets into breast milk and could be passed to the baby. Tell your healthcare provider you are breastfeeding BEFORE taking this medicine.

Possible side effects 

Like all medicines, Paxlovid can cause side effects, although not everyone gets them. The side effects should pass after completing the course of treatment.

Side effects What should I do?
  • Nausea (feeling sick)
  • Vomiting (being sick)
  • Headache
  • Diarrhoea (runny poos)
  • This is quite common when you take Paxlovid.
  • If you have nausea, try taking your dose with food.
  • Drink plenty of water to replace the fluids lost.
  • Tell your doctor if these side effects bother you.
  • Changes to your sense of taste
  • Metallic or unpleasant taste
  • This is quite common. 
  • Take frequent sips of water.
  • Try sucking flavoured (mint, lemon) sugar-free lollies or chewing sugar-free gum.
  • Aching muscle, muscle tenderness or weakness
  • Tummy (abdominal pain)
  • Tell your doctor if these side effects bother you.
  • Signs of an allergic reaction such as skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, chest tightness and trouble breathing.
  • This is rare.
  • Contact your healthcare team or Healthline on 0800 611 116 immediately if you notice these side effects and tell them you are taking Paxlovid.
For more information on side effects, see the Medsafe consumer information leaflet below.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

Can COVID symptoms return after treatment with Paxlovid?

Yes, for some people symptoms may return after finishing a course of Paxlovid. This is known as ‘Paxlovid rebound’.

  • This is when, people get symptoms after finishing a course of Paxlovid, or have negative test results immediately after Paxlovid treatment but later test positive.
  • The rebound symptoms are usually mild and get better within 3 to 5 days. 

If you get Paxlovid rebound within 28 days of your symptoms or tested positive, you should stay home until you've had no symptoms for at least 24 hours.   

There is no need to take another course of Paxlovid if your symptoms return within 28 days. If you develop COVID symptoms after finishing a course of Paxlovid and you're not sure what to do, call your doctor or pharmacist for advice. Read more about return of symptoms after Paxlovid treatment. 

Learn more

Paxlovid Consumer Medicine Information Medsafe, NZ

References

  1. Paxlovid Medsafe datasheet
  2. Nirmatrelvir and ritonavir NZ Formulary
  3. Nirmatrelvir and ritonavir (Paxlovid) for mild-to-moderate COVID-19 NPS MedicineWise, Australia 
  4. COVID-19 rebound after Paxlovid treatment CDC, US 
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 11 Nov 2022