Thank you to GeriatRx Pharmacy for providing this information.
In the fight against COVID-19, earlier this year, Paxlovid became available in Ontario. Paxlovid is a combination of two medications that are used to treat mild symptoms of COVID-19. One of the medications prevents the virus from replicating and the other medication helps keep the first medication from being broken down in the body so that it can work longer. These tablets are taken by mouth twice a day for 5 days. It is only prescribed once the resident has tested COVID-19 positive and has been symptomatic for 5 days or less.
In a clinical trial, Paxlovid reduced the risk of hospitalization or death by 89% in people at higher risk of serious illness from COVID-19. It has been shown to reduce progression to severe disease ONLY in adults at high risk. Using antivirals when they are not needed can encourage the development of resistance and make the drug no longer useful.
Currently, those considered to be at higher risk include:
Immunocompromised (have an immune system that is weakened)
70 years of age or older
60 year of age and older with less that three vaccine doses
18 years of age or older with les than three vaccine doses and at least once risk condition.
Risk conditions include diabetes, obesity, heart disease, hypertension, congestive heart failure, chronic lung disease and moderate to severe kidney or liver disease, to name just a few. As we learn more about Paxlovid treatment and the drug becomes more readily available, these inclusion criteria may be expanded.
There are some issues that need to be looked into before treatment with Paxlovid is started. The drug is contraindicated in those with very poor kidney function. Many drug interactions have been identified with Paxlovid. Therefore, if it is necessary for someone to take the drug, it may be necessary to stop some other prescribed medications or lower the doses for a period of time. Our GeriatRx pharmacists will do a full renal and interaction analysis in conjunction with the attending physician to determine which residents qualify for Paxlovid® and what modifications must be made.
If a resident is unable to take Paxlovid, there are a limited number of other medications that may be available. The health care providers can determine which medication is the best option for an individual resident.
