COVID-19 is making a comeback these days. So if you or someone you know has COVID-19, one of the main medications your doctor is likely to prescribe is Paxlovid . It contains two drugs called Nirmatrelvir and Ritonavir . So since it is being used by many people in Sri Lanka, let's see how to use this medication exactly and what are the things to be careful about.
What happens with this medicine?
Simply put, this medicine is used to treat mild to moderate COVID-19 infections . It is especially helpful for people who are at higher risk of developing severe illness from COVID-19 (for example, the elderly or those with other serious medical conditions ).
This medicine works by limiting the spread of the COVID-19 virus inside your body. That is, it stops the virus from multiplying. This can help reduce symptoms quickly and prevent the disease from getting worse. The most common brand name for this medicine is PAXLOVID .
Things to tell your doctor before taking this medicine
Okay, now before you start this medication, there are a few things you should definitely discuss with your doctor, because these are very important for your safety.
- Do you have any allergies ? That is, if you are allergic to Nirmatrelvir, Ritonavir, any other medicine, food, or dye contained in this medicine, be sure to tell us.
- Do you have any other serious medical conditions? It is especially important to inform your doctor if you have kidney disease or liver disease, as your medication dosage may need to be adjusted.
- Are you pregnant? Or are you trying to get pregnant? In such a situation, it is very important to seek medical advice before using this medicine.
- Are you a breastfeeding mother? If so, tell your doctor about that too.
Don't hide this information from your doctor. All of this will help him decide on the best treatment for your safety.
How should I use the medicine?
There are two types of medication in this package. The standard dose is:
- Two (2) pink Nirmatrelvir tablets
- White Ritonavir tablet (1)
You should take all three of these pills together at once . You should drink this twice a day (morning and night) with water.
Swallow the tablets whole . Do not break, crush, or chew them. You can take this medicine with or without food. However, if you experience stomach upset, it is best to take it with food.
The most important thing is to take this medicine for the full number of days prescribed by the doctor. Don't stop taking it just because you feel a little better. If you stop, the virus may not go away completely and the illness may get worse again.
Can this medicine be given to children?
For children over the age of 12, the doctor may prescribe this medicine in selected cases. However, special care is required, so discuss it carefully with the doctor.
What if you take too much medicine? (Overdosage)
Imagine that you have accidentally taken too much of this medicine. If this happens , you should immediately call the National Poisons Information Centre at the Colombo National Hospital. Or go to the Emergency Treatment Unit (ETU) of the nearest hospital. Do not take this lightly.
Remember: This medicine has been prescribed for you only. Never share your medicine with anyone else.
What to do if you miss a dose of medication?
If you miss a dose, take it as soon as you remember. But if it has been more than 8 hours since you missed a dose, skip it. Take the next dose as usual. Never take a double dose (6 tablets) to make up for a missed dose.
Other medications that may interact with this medicine
This is very important. Paxlovid can interact with other medications you are taking. This can cause serious side effects. Therefore, it is important to tell your doctor about all the medications you are taking, including prescription medications, over-the-counter medications, herbal remedies, and vitamins.
If you are using the medications listed below, it is strictly forbidden to take them with Paxlovid.
| Drug Category | Examples |
|---|---|
| Some medications for anxiety or sleep | Midazolam, Triazolam |
| Some cholesterol-lowering medications | Lovastatin, Simvastatin |
| Medications for heart rhythm disorders | Amiodarone, Dronedarone, Flecainide, Propafenone, Quinidine |
| Some medications for seizures | Carbamazepine, Phenobarbital, Phenytoin, Primidone |
| Some medications for mental illness | Lurasidone, Pimozide |
| Ergot class drugs for migraine | Dihydroergotamine, Ergotamine, Methylergonovine |
| Some medicines for tuberculosis | Rifampin, Rifapentine |
| Herbal medicine | St. John's wort |
| Various other medications | Alfuzosin, Colchicine, Eplerenone, Sildenafil (Revatio®), Silodosin, Tolvaptan |
This list is not complete. Many other medications can interact with this one. Therefore, it is your responsibility to tell your doctor about all medications you are taking.
Things to be careful about when taking medicine
- Pay close attention to whether your symptoms are getting better or worse. If your symptoms do not improve or worsen, call your doctor right away.
- If you have untreated HIV infection , this medicine may make some future HIV medications less effective. So tell your doctor about your HIV status.
- If you are a girl and you are using birth control pills, there is something you need to know. Taking this medicine may reduce the effectiveness of the birth control pills (estrogen and progestin hormones). So talk to your doctor about using another form of birth control during this time.
What are the possible side effects?
Like any medicine, this one can cause some side effects. Some of them are serious, some of them are common.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Symptoms of liver injury | Pain in the upper right side of the abdomen, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, yellowing of the eyes or skin, and feeling unusually tired. |
| Severe skin reactions | Skin redness, blistering, peeling (even inside the mouth). |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Change in taste | Feeling a metallic or bitter taste in the mouth. |
| Digestive system problems | Diarrhea, nausea, stomach pain. |
| Other | Feeling lethargic, muscle pain, increased blood pressure. |
This list does not include all possible side effects. If you experience any unusual symptoms in addition to these, please consult your doctor.
How should you store your medicine?
- Keep out of reach of children and pets.
- Store at room temperature (between 20-25 degrees Celsius).
- Do not use this medicine after the expiration date.
- If you are throwing expired medication in the trash, take the pills out of their packaging, mix them with something like used tea leaves or coffee grounds, put them in a bag, seal it well, and dispose of them.
Take-Home Message
- Paxlovid (Nirmatrelvir; Ritonavir) is a treatment for people at risk of severe COVID-19 disease.
- Before you start taking this medicine, tell your doctor about all other medications you are taking.
- Use the medicine for the full number of days prescribed by the doctor. Do not stop taking it even if you feel better.
- Seek immediate medical attention if you experience a serious side effect, such as an allergic reaction, severe skin reaction, or signs of liver damage.
- This medicine is for you only. Never give it to anyone else.
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