Questions about Paxlovid? COVID-19 medication tips from your local infectious diseases pharmacist
I am Tasha Ramsey, an infectious diseases pharmacist and co-chair of the COVID-19 Therapeutics and Prophylactics Advisory Group.
This advisory group reviews the evidence for COVID-19 medications and makes recommendations for their use in Nova Scotia.
While people are still testing positive for COVID-19, I hear Nova Scotians have questions about nirmatrelvir/ritonavir, also known as Paxlovid – a medication that may be used to treat people with COVID-19.
Let’s start at the beginning of a patient journey, from symptoms to testing to referral and discuss who may benefit from nirmatrelvir/ritonavir (Paxlovid).
Got symptoms? Get tested. Early detection is key when it comes to being considered for COVID-19 medication. Nirmatrelvir/ritonavir (Paxlovid) is recommended to be taken within 5 days of developing symptoms.
In Nova Scotia, we encourage testing within 48 hours of noticing mild symptoms of COVID-19, such as sore throat, runny nose/nasal congestion, shortness of breath, cough, headache, fever (chills/sweats), nausea, vomiting or diarrhea.
To get support, you must fill out the report and support online screening form.
Nova Scotians are asked to fill out the report and support online screening form when they:
- Book a PCR COVID-19 test (they do not need to wait for the results of their PCR test)
OR
- Test positive for COVID-19 with a rapid test
Completing the report and support online screening form will help patients to be assessed for COVID-19 medication, including nirmatrelvir/ritonavir (Paxlovid), and other supports quickly if needed. The form is also how individuals with mild COVID-19 can self-refer for nirmatrelvir/ritonavir (Paxlovid) assessment.
For those who do not have internet access, they can call 1-833-797-7772 to have the report and support online screening form completed.
What is nirmatrelvir/ritonavir (Paxlovid)?
Paxlovid is a combination of two medications, nirmatrelvir and ritonavir, taken together to treat individuals with mild symptoms of COVID-19. Nirmatrelvir is an antiviral that prevents the virus that causes COVID-19 from multiplying and ritonavir helps nirmatrelvir work in the body. These tablets are taken by mouth twice a day for 5 days.
Not everyone will benefit from nirmatrelvir/ritonavir (Paxlovid):
Research shows that nirmatrelvir/ritonavir (Paxlovid) will NOT benefit patients unless they are at high risk of developing severe disease. It has been shown to reduce progression to severe disease ONLY in adults at high risk for progression to severe disease.
Examples of being at high risk for getting very sick are the elderly, those without sufficient vaccination, or those with certain underlying medical conditions or immunosuppression. Using antivirals when they are not needed can encourage the development of resistance and make nirmatrelvir/ritonavir (Paxlovid) no longer useful for those at high risk for progression to severe disease.
Inappropriate use may also lead to side effects and interactions with the MANY medications that interact with nirmatrelvir/ritonavir (Paxlovid).
Who can prescribe nirmatrelvir/ritonavir (Paxlovid)?
Prescribing of nirmatrelvir/ritonavir (Paxlovid) in Nova Scotia is through designated prescribers only. At this time, prescriptions completed by primary care providers, specialists, and other prescribers will not be filled.
Completing the report and support online screening form allows you to provide information to be assessed by a designated prescriber for COVID-19 medications, including nirmatrelvir/ritonavir (Paxlovid).
Where do Nova Scotians obtain nirmatrelvir/ritonavir (Paxlovid) from?
Dispensing of nirmatrelvir/ritonavir (Paxlovid) is through designated pharmacies.
If a patient is assessed by a designated prescriber and determined to benefit from nirmatrelvir/ritonavir (Paxlovid), they are provided with instructions to obtain nirmatrelvir/ritonavir (Paxlovid) from their nearest designated pharmacy.
To ensure supply is near all Nova Scotians, nirmatrelvir/ritonavir (Paxlovid) is located in a minimum of two community pharmacies in each of the 53 health clusters in Nova Scotia.
Nova Scotia has a process to identify and distribute nirmatrelvir/ritonavir (Paxlovid) to Nova Scotians across the province who may benefit from it. In order to do so, we are asking people to test for COVID-19 within 48 hours of noticing symptoms and to complete the report and support online screening form. This is how Nova Scotians can ensure they are considered for medications, including nirmatrelvir/ritonavir (Paxlovid), within the timeframe they are recommended.
