More guidance on using the COVID-19 drug Paxlovid – Harvard Health

The National Institutes of Health recommends that people unvaccinated against COVID who are at high risk for getting a severe case take the drug Paxlovid (a combination of nirmatrelvir and ritonavir) within five days of the appearance of mild to moderate symptoms. The drug is taken twice daily for five days. But is Paxlovid helpful if you are fully vaccinated and also at high risk for severe COVID symptoms? What if you are healthy but unvaccinated? A study published April 3, 2024, in The New England Journal of Medicine explored these questions. Researchers enrolled 1,300 people who had mild to moderate COVID-19 symptoms. To be eligible for the study, participants needed either to be vaccinated (fully or partially) and have at least one risk factor for more severe COVID symptoms, or else have never been vaccinated but have no risk factors. Unvaccinated people at high risk were excluded.

About half of the people were randomly chosen to receive Paxlovid every 12 hours for five days. The others received a placebo. The researchers found no significant difference in symptom relief or progression of disease between the Paxlovid and placebo groups. These results, combined with the findings of other studies, suggest many people with mild or moderate COVID symptoms don’t immediately need to start taking Paxlovid. However, people ages 65 and older, anyone with a chronic condition (especially heart or lung disease), those who have an impaired immune system, and those whose COVID symptoms get worse over 24 hours should call their doctor for advice.

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