Thông tin nhà cung cấp liên quan đến COVID-19
Cập nhật phương pháp điều trị COVID:
Tháng 12 năm ngoái, FDA đã cấp phép sử dụng khẩn cấp cho Paxlovid (nirmatrelvir/ritonavir; Pfizer) và Lageviro (molnupiravir; Merck) để điều trị các trường hợp nhiễm COVID-19 từ nhẹ đến trung bình.
Cả hai liệu pháp hiện nay đều có bán rộng rãi tại các nhà thuốc cộng đồng. Và trong khi tỷ lệ nhiễm và nhập viện đã giảm, những bệnh nhân có nguy cơ cao hơn vẫn bị ốm và phải nhập viện. Điều trị sớm bằng Paxlovid và các phương pháp điều trị khác có thể tạo ra sự khác biệt.
Liệu pháp COVID-19: Công cụ và phương pháp điều trị
Infusion Centers Offering COVID Therapeutic Treatment
When to Prescribe?
Lagevrio and Paxlovid should be started within 5 days of symptoms onset.
For patients who:
- Test positive for COVID-19 (not currently approved for pre- or post-exposure prophylaxis).
- Are high risk for progression to severe COVID-19, including hospitalization or death, including1:
- Older Adults
- Chronic Kidney, liver or lung disease
- Dementia or Alzheimer’s
- Diabetes
- A disability
- Heart Condition
- HIV Infection
- Tuberculosis
- Mental Health Conditions
- Overweight or Obese
- Physically inactive
- Pregnancy
- Sickle cell disease or thalassemia
- Current or former smoker
- Transplant recipient
- Stroke or cerebrovascular disease
- Substance use disorder
- Immunocompromised condition or weakened immune system
- Are adults (Paxlovid can be prescribed to children ages 12 and older weighing at least 40 kg).
- Lagevrio should be used only when treatment with another therapy is not appropriate or accessible.
When NOT to Prescribe?
- Lagevrio and Paxlovid should not be used as pre- or post-exposure prophylaxis or prevention of COVID-19.
- Certain medications may interact with Paxlovid. Check interactions here.
- Patients with severe liver and/or kidney impairment should not take Paxlovid.
- Lagevrio should not be prescribed to children. Children ages 12 and older (weighing at least 40 kg) are approved to take Paxlovid.
- Patients requiring COVID-19 related hospitalization should not start therapy with one of these medications.
- Contraindications for Paxlovid and Lagevrio are listed below.
|
Paxlovid |
Lagevrio |
|
Less than 12 years old or less than 40 kg |
Less than 18 years old (may affect bone and cartilage growth) |
|
Requires hospitalization due to COVID-19 |
Requires hospitalization due to COVID-19 |
|
Severe renal impairment (eGFR < 30 mL/min)* |
Pregnancy (not recommended, could be considered in certain individuals) |
|
Severe hepatic impairment (Child-Pugh Class C) |
Breastfeeding |
|
History of hypersensitivity reaction to nirmatrelvir or ritonavir or any other components |
|
|
Co-administration with CYP3A metabolized drugs or inducers of CYP3A (see notes below for list of Drug-Drug Interactions) |
* Dose reduction for moderate renal impairment (eGFR ≥30 to <60 mL/min): 150mg nirmatrelvir (one 150 mg tablet) with 100 mg ritonavir (one 100 mg tablet), with both tablets taken together twice daily for 5 days
How effective is therapy?
Clinical trials showed:
- Paxlovid .reduced hospitalization or death risk by 88%
- Lagevrio reduced hospitalization or death risk by 30%
Because Lagevrio is less effective, Paxlovid is preferred. Lagevrio is reserved for patients who are not good candidates for other treatment options.
What are common adverse reactions?
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Paxlovid |
Lagevrio |
|
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Which treatment should I choose?
What is the treatment schedule?
Both drugs should be started within 5 days of symptom onset.
Paxlovid (ritonavir – nirmatrelvir): nirmatrelvir 300 mg with ritonavir 100 mg orally twice daily for 5 days. For those with moderate renal impairment (eGFR ≥30 to <60 mL/min): 150 mg nirmatrelvir (one 150 mg tablet) with 100 mg ritonavir (one 100 mg tablet), with both tablets taken together twice daily for 5 days.
Lagevrio: molnupiravir 800 mg orally twice daily for 5 days
Which pharmacies have treatments?
Both Paxlovid and Lagevrio are now available at over 50,000 pharmacies across the country.
