Anyone seeking Paxlovid, which must be prescribed within five days of the first symptoms, should be sure to let their prescribers and pharmacists know the complete lists of other medications and over-the-counter supplements they are taking.
Some medications, such as particular statins, are most likely safe to stop taking during treatment with the Covid pills. For example, it might be better to stay on certain blood thinners but to lower the doses. Some heart rhythm drugs cannot be taken with Paxlovid.
Conversely, some anti-seizure medications can boost liver enzymes’ metabolic action and thus lower the body’s Paxlovid levels, as can the herbal supplement St. John’s Wort. The FDA warned that they should not be combined with Paxlovid.
Because the Paxlovid treatment is brief — 30 pills, taken asthree pills twice a day for five days — experts are hopeful that the risk of adverse interactions with other medications is low.
“Five days of interactions is not a big deal for the majority of drugs,” said Jason Gallagher, a clinical pharmacy specialist in infectious diseases at Temple University Hospital in Philadelphia.
If a drug’s potential interaction with Paxlovid poses too much of a risk, a safe and effective alternative Covid-19 therapy would be GlaxoSmithKline’s sotrovimab — the sole authorized monoclonal antibody treatment that research indicates reliably neutralizes the omicron variant of the virus. Otherwise, the antiviral molnupiravir is an option, albeit one with a much lower efficacy than either Paxlovid or sotrovimab.
Even with the concerns about taking Paxlovid with other prescription medications, experts are excited about the drug’s potential.