Should I Take Paxlovid?

Jun 8, 2022

Like almost every question about Covid, the answer is that we don’t completely know the answer. This is what we do know.

  • Paxlovid received emergency authorization from the FDA to use as an UNAPPROVED PRODUCT for the treatment of Covid in
  • mild to moderate cases of confirmed Covid in adults and children over 12
  • who are at “high risk” for progression to severe Covid disease

It should be started as soon as possible after diagnosis, within 5 days of onset of symptoms. It consists of two medications that are taken as 3 pills twice daily for 5 days. The most common side effect is a bad taste in the mouth.

The emergency authorization was based on a study that showed it decreased hospitalization by 89% in unvaccinated, high-risk individuals when started within 3 days from onset of symptoms.

While that seems very impressive, most of the people taking Paxlovid now are fully vaccinated and many have relatively minor risk factors compared to those in the clinical trial. Being vaccinated already largely protects us from severe illness. We don’t really know to what extent Paxlovid benefits fully vaccinated, healthy, younger individuals,l with less significant risk factors, such as being overweight or suffering from anxiety/depression, or former smokers, all of which have been associated with a higher risk of severe Covid. Many people with Covid do report feeling better 1-2 days after starting Paxlovid.

There is also the unanswered question of Rebound. There are reports of people taking Paxlovid, feeling better, and then having a recurrence of symptoms 3-5 days after completing Paxlovid. Some of these patients had negative Covid tests after completing the Paxlovid and then reverted to positive tests when their symptoms returned. Is it possible that Paxlovid may increase the period needed for isolation for active cases? We also don’t yet know what effect Paxlovid has on developing immunity. Is it possible that with the help of our vaccine-induced immunity we might be better off letting our immune system fight the disease? Perhaps that will provide us with better protection against future infection? These studies have not yet been done.

Finally, there is the question of Paxlovid having interactions with many prescription medications that must be considered individually. Certain anticoagulants, antiarrhythmics, anticonvulsants, psychiatric, immunosuppressive, lipid-lowering and other medications cannot be taken with Paxlovid. For those at high risk for severe disease who cannot take Paxlovid, monoclonal antibodies should be considered.

In summary, it is best practice to make the decision to take Paxlovid, when diagnosed with Covid, in consultation with your doctors, after considering your individual risks, circumstances, and the medications you are taking.

You might even want to discuss this with your doctor prior to being infected.

I took Paxlovid when I tested positive.