COVID-19 Outpatient Treatment

Paxlovid and Lagevrio are used for patients who have symptoms like runny nose, cough, or sore throat from COVID-19. They are not used for prevention, in other words for patients who have been exposed to COVID-19 but have not contracted the virus. Paxlovid is considered somewhat more effective, although sometimes due to drug interactions, or other issues, Lagevrio must be used.

Paxlovid and Lagevrio can be obtained only when you have COVID-19. Your clinical team is not allowed to prescribe these medications "just in case" you test positive during a trip or another time when it could be helpful.

Both Paxlovid and Lagevrio are pills that are taken by mouth twice a day for 5 days. They are available by prescription only.

Paxlovid and Lagevrio should be taken as soon as you have symptoms. They can only be started during the first 5 days of symptoms. If your symptoms are already improving, treatment might not be necessary.

Yes. These treatments are available for everyone with COVID-19 infection who is at risk for severe disease.

Yes. The antiviral treatments are especially helpful if you have not been vaccinated.

Researchers at Mass General Brigham and other hospitals have found that Paxlovid reduces chances of being hospitalized or dying from COVID-19 by 45 to 80%. Lagevrio reduces chances of being hospitalized or dying from COVID-19 by about 30% and shortens illness by 3 to 5 days. We have less information now that people are widely vaccinated, but both treatments are effective.

Paxlovid therapy is available for patients ages 12 years and older who:

• Weigh at least 40 kilograms (a little over 88 pounds) AND
  
• Have symptoms of COVID-19 AND
  
• Are within 5 days of the start of symptoms AND
  
• Have a health condition that makes them more likely to experience severe COVID-19 infection.

Paxlovid can interact with other medications. Please let your care team know all the medications and supplements you are taking.

Paxlovid should not be used without specific discussion with your care team if you:

• Have had a transplant and must take tacrolimus, cyclosporine, everolimus, or sirolimus
• Have severe kidney or liver disease
• Require certain anticoagulant medications (clopidogrel, rivaroxaban, or others)
• Take many chemotherapy medications
• Take St. John’s wort

There are other effective options for patients who have COVID-19 who cannot take Paxlovid. Contact your care team to understand what your best option might be.

Lagevrio therapy is available for patients ages 18 years and older who:

• Have symptoms from COVID-19 AND
• Are within 5 days of the start of symptoms AND
• Are not pregnant AND
• Have a health condition that makes them more likely to have severe COVID-19 infection.

Please note: There are some additional considerations for patients and their partners who are able to become pregnant. Please check with your doctor about the need for birth control (contraception).

Initially, these medications were covered by the US government, but they are now commercially distributed so you could have a significant copayment. There are some programs that may help you pay for Paxlovid and if you have a high copay.

If you think you might be eligible for treatment, please contact your primary care or specialty care team. They can prescribe treatment.

For Massachusetts residents, there is also a free telehealth program to get oral COVID-19 treatment. This is offered through the Department of Public Health. You can get started on their website. Hours are 8 am to 10 pm daily. Their services are available in English, Spanish, Haitian Creole, and Portuguese. Find out more information about program eligibility and Paxlovid on the mass.gov website.

Remdesivir is given by 3 daily intravenous (IV) infusions. It’s not a pill.

Remdesivir works best when given early at least within the first seven days of symptoms. If you are already improving, treatment is probably not necessary.

You can get Remdesivir if you have or have not been vaccinated for COVID-19. You must meet eligibility criteria.

Remdesivir has been shown to reduce the chance of hospitalization by 82% and help people improve faster.

Remdesivir is available for patients ages 12 years and older who:

• Weigh at least 40 kg AND
• Have symptoms of COVID-19 AND
• Are within 7 days of the start of symptoms AND
• Have a health condition that makes them more likely to have severe COVID-19 infection.

Initially, this medication was covered by the US government, but this is now commercially distributed, so you could have a significant copayment.

If you think you might be eligible, please contact your primary care provider or specialist. They can refer you for treatment. Please note that due to the limited supply of places to provide IV therapy, not all patients referred will be able to receive the treatment.

Do not go to urgent care or the emergency room or for any of these therapies. They are not available at those locations. There are specific clinics designed to give this therapy.

We have limited quantities of Remdesivir available. If you are able to get the therapy, we will contact you with information and instructions. For patients who are on Patient Gateway, we will send a Patient Gateway message if we determine that we cannot offer treatment. If you don't have access to remdesivir, you may wish to take one of the treatments in pill form discussed above.