The Food & Drug Administration has authorized for emergency use two pills — Molnupiravir and Paxlovid — for the treatment of COVID-19. What do the COVID pills do? Are they a cure? COVID-19 expert Dr. Gonzalo Bearman explains what we can expect from the COVID-19 pills.
What do the COVID-19 pills do?
The COVID-19 pills are antiviral medications. They don’t protect you from getting the virus, but they do attack the virus if you’re infected. The pills keep the virus from multiplying and spreading throughout your body. If taken soon enough, the pills prevent mild to moderate symptoms from turning severe or deadly.
A major advantage of the COVID pills is that you can take the pills at home rather than undergoing more complex IV therapy at a hospital or clinic. IV therapy, in the form of monoclonal antibody therapy or the drug remdesivir, has been the primary treatment available for COVID-19 until now. Taking a pill is much easier than IV infusion, is more convenient and costs a lot less.
What is the significance of the pills?
With approval of these pills, the world has its first treatment for mild to moderate COVID-19. This means you won’t have to wait until you’re severely ill before starting treatment.
By taking the pills within five days of your first symptoms, when symptoms are still mild to moderate, you will likely avoid severe COVID-19. COVID-19 could become a treatable disease, like the flu, rather than a potentially fatal illness.
The COVID-19 pills are effective against all of the currently known COVID-19 variants, including omicron. This is not the case with most monoclonal antibody therapies.
Has the CDC signed off on the COVID-19 pills?
Although the CDC has not yet signed off on the pills, both have been authorized for emergency use by the Food and Drug Administration. That means they can be prescribed for COVID-19.
Molnupiravir and Paxlovid are authorized for people with mild-to-moderate COVID-19 who are not hospitalized but are at high risk of severe COVID-19. Molnupiravir is authorized for adults 18 and older. Paxlovid is authorized for anyone age 12 and older.
What’s the difference between the Merk pill (Molnupiravir) and the Pfizer pill (Paxlovid)?
The major difference is in efficacy:
Molnupiravir — made by the drug companies Merck and Ridgeback Biotherapeutics, lowers the risk of hospitalization or death by about 30% in COVID-19 patients at risk for severe illness if given within five days of the first symptoms. Pfizer’s pill, Paxlovid, reduces this risk by 88%.
Because the efficacy of Paxlovid is so much greater than that of Molnupiravir, Paxlovid is expected to be the pill of choice except in times of shortage.
There are two other important differences between the two:
One is that the means by which Molnupiravir attacks the SARS-CoV-2 virus might cause the virus to mutate. The resultant variant(s) could reduce the efficacy of our current vaccines and treatments.
The other is that Molnupiravir may prove hazardous to fetal development if taken during pregnancy. If you think you might possibly be pregnant, tell your doctor. You should not take Molnupiravir if you might be pregnant.
Tell me more about Molnupiravir and pregnancy.
There is concern that the Merck pill may not be safe if you are pregnant. In that case, you will not be offered Molnupiravir unless your life is in danger — and then you will be given the choice as to whether to take it. If you are thinking about getting pregnant, you will not be prescribed Molnupiravir. You will be prescribed Paxlovid, instead. In addition, you should not take Molnupiravir if you are breastfeeding.
Are there other possible side effects with either pill?
For Paxlovid, possible side effects include:
- Liver problems
- Resistance to HIV medicines
- Altered sense of taste
- Diarrhea
- High blood pressure
- Muscle aches
Possible side effects of Molnupiravir include diarrhea, nausea and dizziness. As mentioned above, Molnupiravir might harm a developing fetus. Do not take Molnupiravir if you are pregnant or breastfeeding.
How many pills do you have to take?
For Paxlovid, you take three pills twice a day for five days. For Molnupiravir, you take four pills every 12 hours over five days.
Are the pills available now? How do I get them?
It takes several months for the pills to be manufactured, so they've been hard to come by. Supplies are increasing, though. You will be able to pick up the pills at a pharmacy after receiving a positive COVID-19 test result from either your doctor or a home test kit. You would take the pills as directed at home while you isolate.
Are the pills free?
The pills are covered by insurance.
Now that we have pills to treat COVID-19, do we still need to get vaccinated or boosted?
Despite the pills’ effectiveness at keeping symptoms from progressing, the pills are not 100% effective. You could be one of the few who does not recover. It’s better to get vaccinated and boosted to avoid getting COVID-19 in the first place.
Keep in mind that although the pills reduce your risk of getting severely ill, you’re still infected and can pass the disease onto others. It’s best to avoid the disease in the first place through vaccination.
Is there anything else we ought to know?
The COVID pills are only good if taken within five days of your first symptoms — so the sooner you are diagnosed with COVID-19, the greater the likelihood you will get the pills in time. If you have any of the above symptoms, get tested as soon as possible. Please visit the Virginia Department of Health for a list of COVID-19 testing sites near you or pick up a test kit from your local pharmacy.
Original source can be found here.
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