Paxlovid

Sounds like 'pax-low-vid'

Paxlovid is used to treat people who have moderate COVID-19 infection. Paxlovid consists of 2 antiviral medicines – nirmatrelvir and ritonavir.

On this page, you can find the following information:

What is Paxlovid?

Paxlovid is given to some people to help fight a COVID-19 virus infection. It may help you get better faster and stay out of hospital. 

Paxlovid consists of 2 antiviral medicines – nirmatrelvir (150mg) and ritonavir (100 mg). When taken together, they reduce the amount of virus in your body. 

Paxlovid is only useful when given within 5 days of the start of your COVID-19 illness.

Who should have Paxlovid for COVID-19 infection?

From September 2022, more people can get antiviral medicines to treat COVID infection. If you have symptoms that started within the last 5 days, AND 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 should have antivirals for COVID-19 infection.

If you're not sure if you qualify for antivirals, talk to your GP or pharmacist about COVID-19 antiviral medicines as soon as possible. They will advise on whether or not Paxlovid is suitable for you.

Can I get Paxlovid from my pharmacy without a prescription?

From 28 July 2022, you might be eligible to get Paxlovid from some pharmacies. The pharmacist will need to ask you questions to work out if you are eligible for antiviral medications. It will depend on several factors, including your age, ethnicity, other health conditions and vaccination status.

Click on the links below to find a pharmacy near you:

Important notes

  • Paxlovid is not available from all pharmacies. Only pharmacists who have completed additional training can supply Paxlovid. 
  • When you have COVID-19, you must self-isolate for at least 7 days and cannot leave your home. So, if you have symptoms and test positive and think you are eligible for antivirals, phone your pharmacy.
  • It's important that you do not go to the pharmacy yourself because you could infect others. Similarly, arrange to have your antivirals picked up and delivered by friends or whānau, or order online from a pharmacy.

How to take Paxlovid

Paxlovid consists of 2 medicines – nirmatrelvir (pink tablet) and ritonavir (white tablet). It's important to take these tablets as directed below.

  • Timing:  Try to space the doses evenly throughout the day such as the first thing in the morning and at bedtime. Ideally these times should be 12 hours apart. 
  • Food: You can take your tablets with or without food. If Paxlovid gives you nausea (feeling sick), try taking it with food.
  • Swallow the tablets whole with a glass of water (200–250 mLs). Do not chew, break, or crush them.
  • Missed dose: If you miss a dose of Paxlovid but remember within 8 hours of the time it is usually taken, take it as soon as you remember.
    If you miss a dose by more than 8 hours, skip the missed dose and take the next dose at your regular time. Do not take extra doses of Paxlovid to make up for a forgotten dose. If you are not sure what to do, ask your healthcare provider.
  • Complete the course. Do not stop taking Paxlovid without talking to your healthcare provider, even if you feel better. A course of treatment lasts 5 days.

What to consider before taking Paxlovid

Tell your healthcare provider about all the medicines you take.

There are some medicines that may not mix with Paxlovid and when taken together may 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 without telling your healthcare provider. Your healthcare provider can tell you if it is safe to take Paxlovid with other medicines.

Are you pregnant or trying for a baby?

If you are pregnant, think you may be pregnant, or are planning to have a baby, do not 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 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, or 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 will be passed to the baby. Tell your healthcare provider you are breastfeeding BEFORE taking this medicine.

Possible side effects 

As Paxlovid is a new medicine, it is possible that we do not know all of the side effects yet. However, many people in clinical trials have been treated with Paxlovid for COVID-19.

Common side effects

These are usually mild and go away with time or when the medicine is stopped. Tell your doctor if these side effects cause you problems or don’t go away:

  • runny poo (diarrhoea)
  • being sick (vomiting)
  • changes in your sense of taste. 

Rare, serious side effects

Contact your healthcare team or Healthline on 0800 611 116 immediately if you notice these side effects and tell them you are taking Paxlovid.

  • 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.
  • Signs of liver problems such as yellow eyes or skin, dark urine (pee), or pain or discomfort in the upper stomach area.

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 completing a course of Paxlovid. This is known as ‘Paxlovid rebound’.

  • In these situations, people get symptoms after completing a course of Paxlovid, or have negative test results immediately after Paxlovid treatment but subsequently test positive.
  • The rebound symptoms are usually mild and short-lived, getting better within 3 to 5 days. 

If you get Paxlovid rebound and it's 28 days or less since you first got 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 during this time. If you develop COVID symptoms after completing 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: Health Navigator Editorial Team Last reviewed: 13 Aug 2022