Paxlovid® is a combination of two antiviral medicines. There are two different tablets to take for each dose; two pink tablets and one white tablet.
It is given to adults aged over 18 years when they have tested positive for COVID-19 and have at least one risk factor for developing severe illness.
Treatment should be started as soon as possible after diagnosis of COVID-19 disease and within the first five days of symptoms.
About Paxlovid® tablets
|Type of medicine
|Treatment of mild to moderate COVID-19 disease in adults over 18 years of age
|Ritonavir and nirmatrelvir
Paxlovid® is a combination product containing two different tablets of antiviral medicines: ritonavir and nirmatrelvir. This medicine has been authorised in the UK under a conditional approval scheme and will be monitored closely.
Nirmatrelvir is active against the SARS-CoV-2 virus and prevents the virus from replicating. Ritonavir, although an antiviral medicine, is not active against SARS-CoV-2. Ritonavir is included in the treatment pack because it slows the breakdown of nirmatrelvir in the body and so leads to higher blood levels for longer. Taking ritonavir tablets at the same same time is essential for the treatment to work.
Paxlovid® is used for adults aged over 18 who have tested positive for COVID-19 and have at least one risk factor for severe disease. Taking Paxlovid® as soon as possible once COVID-19 symptoms have started can lower your risk of being severely ill or needing hospital admission.
Clinical trials have shown that Paxlovid® may reduce the risk of needing hospital admission or dying from COVID-19 disease by up to 89%.
People at high risk of severe COVID-19 disease include those with medical conditions such as long-term heart, lung, liver, kidney or nerve problems, people with diabetes and people with weakened immune systems.
Before taking Paxlovid® tablets
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking Paxlovid® tablets it is important that your doctor knows:
- If you are pregnant, trying for a baby, or breastfeeding.
- If you have any problems with the way your liver works or the way your kidneys work.
- If you are being treated for HIV infection.
- If you are taking any other medicines. This is important as Paxlovid® affects the blood levels of many commonly used medicines. This includes medicines which are available to buy without a prescription, as well as some herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take Paxlovid® tablets
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about Paxlovid® tablets and a full list of side-effects which you may experience from taking them.
- Take Paxlovid® tablets exactly as your doctor tells you to. There are two differently coloured tablets. The pink tablets each contain 150 mg of nirmatrelvir. The white tablets each contain 100 mg of ritonavir.
- One dose of Paxlovid® consists of two pink tablets and one white tablet taken together at the same time.
- The tablets are presented in five 'daily dose cards' with enough tablets for each day of treatment.
- Take one dose twice each day for five days. Space your doses evenly apart, every 12 hours.
- Make sure you complete the full course of treatment even if you are feeling better.
- Swallow the tablets whole with a drink of water. Do not break, chew or crush the tablets.
- It is not important whether you take your doses before or after food.
- If you forget to take a dose, take it as soon as you remember unless it has been more than eight hours since it was due. If it has been more than eight hours, leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed one.
Getting the most from your treatment
- Treatment with Paxlovid® should be started as soon as possible after diagnosis of COVID-19 disease and within the first five days of symptoms.
- Help your body fight the infection by drinking plenty of water, eating sensibly and getting lots of rest.
- The best way to protect yourself against COVID-19 is through vaccination. Ensure your vaccinations are up to date in line with national guidance.
- Paxlovid® can affect the metabolism of many commonly used medicines and could lead to you experiencing additional side-effects. Ask a pharmacist to check each of your prescribed medicines and advise you on any specific action to take. If you buy any medicines, check with a pharmacist that they are suitable for you to take with Paxlovid® tablets.
- People taking certain medicines may need extra checks by their doctor to make sure their treatment hasn't been affected by taking Paxlovid®. Try to attend any blood tests or follow-up appointments that your doctor arranges.
- There are no data on the use of Paxlovid® during pregnancy. For this reason pregnant women should not be treated with Paxlovid®. If there is any chance you could get pregnant, you must use effective contraception during treatment with Paxlovid®. Discuss with your doctor which types may be suitable for you.
- Paxlovid® can reduce the effectiveness of combined hormonal contraceptives. Women using this type of contraception should use an additional barrier method of contraception during treatment with Paxlovid® and for one complete menstrual cycle afterwards.
- There are no data on the use of Paxlovid® when breastfeeding. Mothers who are breastfeeding should stop doing so during treatment with Paxlovid® and for seven days afterwards.
Can Paxlovid® tablets cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with Paxlovid® tablets. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common Paxlovid® side-effects (affecting fewer than 1 in 10 people)
|What can I do if I experience this?
|Diarrhoea, being sick (vomiting)
|Drink plenty of water to replace the fluids lost
Stick to simple meals - avoid rich or spicy foods
|An altered sense of taste or a metallic taste
|This should pass after stopping treatment with Paxlovid®
Take frequent sips of water, try sucking sugar-free sweets
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store Paxlovid® tablets
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking Paxlovid® tablets.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Paxlovid® 150 mg/100 mg film-coated tablets; Pfizer Ltd, The electronic Medicines Compendium. Dated January 2022.
Medicines Complete BNF 86th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.