Health

Paxlovid as a treatment for COVID-19: What you should know


POrders for Pfizer’s COVID-19 antiviral drug — the first such pill approved by the U.S. Food and Drug Administration (FDA) — have increased tenfold in the past two months. From late February to April 22, the number of patients using Paxlovid increased from 8,000 to 80,000, according to to Pfizer CEO Albert Bourla; The drug is available at about 33,000 locations, such as pharmacies and outpatient clinics, nationwide.

On April 26, the White House announced it would step up efforts to encourage more doctors to prescribe antiviral drugs. As part of this, the Biden Administration announced the drug would be delivered directly to pharmacies (in addition to already being available at federal agencies). test for treatment webpage). In doing so, it hopes the number of sites nationwide offering Paxlovid will eventually grow to 40,000. “The bottom line is we want to make this therapy available to all Americans,” said Dr. Ashish Jha, White House COVID-19 response coordinator, speak CNN.

With COVID-19 cases on the rise again in the United States and Paxlovid becoming more widely available, it would be helpful to understand a little more about the drug, how it works, and who might get it.

What is Paxlovid and how does it work?

Paxlovid is made up of two drugs: nirmatrelvir, an inhibitor of the SARS-CoV-2 protein that replicates, and ritonavir, best known as an HIV/AIDS treatment currently used to prevent antiretroviral drugs like nirmatrelvir from breaking down too quickly so that your body can continue to fight the infection. The patient was prescribed Paxlovid to take a total of 30 tablets: three tablets twice a day for five days.

How effective is Paxlovid in treating COVID-19?

Based on the studies done to date, Paxlovid should be prescribed within five days of symptoms appearing for the best chance of success. Taking pills in this window has been shown to be reduce risk 89% of those most vulnerable to the worst impacts of COVID-19 are hospitalized. This data is based on a Clinical Trial Pfizer conducted in the second half of 2021 in unvaccinated adults. The company is currently in clinical trials study the safety and success of Paxlovid in children and adolescents 6 to 17 years of age.

And while clinical trials were done before Omicron took off, Pfizer said Paxlovid is not active against variations. Lab results are detailed in March learn published in New England Journal of Medicine also found that the key ingredients in Paxlovid are effective against Omicron sub-variable BA.2.

Dr Zenobia Brown, chief medical officer and vice president of population health care management at Northwell Health, told TIME that Paxlovid “remains highly effective and well-tolerated”. “However, we may be faced with a situation where a longer course is warranted for some patients, particularly those who receive the drug very early in their disease process and/or are impaired. reduced immunity.”

Dr Paul Sax, professor of medicine at Brigham and Women’s Hospital and Harvard Medical School, added that “the most important new information is that some people will experience a relapse of COVID symptoms days after stopping treatment.” . People with a relapse of the disease should consider themselves infectious, especially if they test positive again on an antigen test.”

How can you get Paxlovid?

Paxlovid is currently approved for use by people 12 years of age or older, weighing at least 88 pounds, who have tested positive for COVID-19 and are at high risk of developing severe illness. This includes people with underlying medical conditions such as cancer or diabetes, or those 65 years of age or older.

However, some experts are urging doctors to start prescribing the drug even before people who test positive for COVID-19 start to have symptoms. “Because we initially had a short supply of the drug, people were getting the message that we should be very cautious and only give the drug to people with a higher supply when they are sick,” FDA Commissioner Robert M. Califf speak SiriusXM Doctors Radio Report hosts Dr. Marc Siegel on May 6. “But in reality, what we want to do is use it before they get sick — and who are at risk. significantly older, or with multiple comorbidities, we certainly want to treat those people early.”

“One problem we’re seeing is that people go in or get diagnosed, they feel fine, but they’re at high risk,” he continued. “And if you wait until they get sick, it’s too late. You want to prevent them from getting sick.”

Meanwhile, preliminary data suggests Paxlovid may also protect people who are not considered high risk, potentially strengthening the argument for the drug being made available to more people. Analysis based on a Pfizer testing in progress found that participants with COVID-19 who received Paxlovid were 70% less likely hospitalized than those who were not given medication.

What are the side effects of Paxlovid?

There are a few side effects to watch out for. One is digestive disorders, which negatively affects your taste buds; it’s a side effect that’s also listed for other medications like antibiotics, chemotherapy, and antihistamines. More than 5% of Pfizer clinical trial participants experienced this side effect.

While everyone’s experience can vary, many people with this condition describe it as having a bitter or metallic taste in the mouth. “It tastes horrible – but not terrible enough to make most people stop treatment,” says Sax.

Other General side Effects including diarrhea, muscle aches and high blood pressure. “These side effects are relatively minor and are well tolerated by most people,” says Brown. “The bigger problem with Paxlovid, and why many vendors don’t want to use it, is that the drug is metabolized by the same enzyme that metabolizes many common drugs. In some cases, those interactions can dangerously increase or decrease drug levels or decrease the amount of medication and effectiveness of Paxlovid. For example, she points out that “patients who are using hormonal contraceptives are asked to use a backup method.”

Ritonavir can also cause life problemsso the patient has a history of liver problems or pre-existing liver disease, liver enzyme abnormalities, or Hepatitis, should talk to their doctor before taking the medication. Paxlovid is also not recommended for patients with severe kidney problems, while those with moderate kidney problems may need a different dosage level.

Both active ingredients in Paxlovid can also interact with other medications—such as immunosuppressants for organ transplant recipients and blood thinners — so FDA advises everyone talk to their doctor first about any medications they’re taking.

Can Paxlovid help with long COVID?

There is not much data on this yet. Hitherto, two patients with Long COVID – one of them a researcher who tested it himself – saw their symptoms lessen or go away after taking Paxlovid. In one case, a person reported that their acute symptoms disappeared after 48 hours, but their intense fatigue continued.

Anecdotally, “it appears that some of the factors that influence Long COVID and Paxlovid are the time of birth as well as the likelihood of developing Long COVID based on prior immunization and booster,” Brown explained. “In some cases, taking Paxlovid too soon after the onset of symptoms may not be protective. We are seeing a small number of cases where recovery could theoretically become long-term COVID, as end-organ inflammation occurs in these recoveries despite early drug administration. On the other hand, some studies would suggest long-term COVID benefits. “More research is needed.

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