Breaking down COVID-19 and PAXLOVID® (nirmatrelvir 150mg tablets; ritonavir 100mg tablets) with a family medicine doctor. Link to PI in full post. Sponsored by Pfizer.
Please see full Prescribing Information, including BOXED WARNING. PAXLOVID is a prescription medicine used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. PAXLOVID is not approved for use as pre-exposure or post-exposure treatment for prevention of COVID‑19. PAXLOVID can interact with other medicines, causing severe or life-threatening side effects or death. It is important to know the medicines that should not be taken with PAXLOVID. See a list of these medicines and learn about the risks and potential side effects of PAXLOVID in the Important Safety Information below to learn more. This is directed to a US audience and may not be suitable outside of the US. It is intended to be viewed as it was originally produced. The author, Dr. Jen Caudle, is a board-certified family medicine physician who received compensation from Pfizer for her participation.
TL;DR – Think COVID-19 is “old news”? Think again! The virus circulates year-round and an infection can quickly turn from mild to severe in certain people.^(1,2) If you are age 50+ or living with underlying medical conditions like diabetes or heart disease, this might mean you. Prescription medicines like PAXLOVID® ^((nirmatrelvir 150mg tablets; ritonavir 100mg tablets)******) are available for those eligible and may help keep COVID-19 from becoming severe. I use my experience as a family doctor to break down common questions people still have about the virus and why it continues to be important to consider prescription treatment as part of a care plan. For more information, visit PAXLOVID.com.
Dr. Jen Caudle, board-certified family medicine physician
As a board-certified family medicine physician, I’ve seen many patients at my practice who have “moved on” from even thinking about COVID-19 and the potential threat it may pose to their health. If they experience COVID-19-like symptoms, they might even wait and see whether these escalate before booking an appointment or otherwise seeking care from a medical professional. And few seem to be testing at home despite experiencing symptoms – especially when symptoms start out very mild. People often make decisions about whether or not to seek care based on their past COVID-19 experiences.
However, for some people, COVID-19 remains a serious health consideration because they are at risk of getting very sick from the virus and long-term health implications are also possible for them! For adults 50 years of age or older and those with certain underlying medical conditions such as diabetes, heart disease, obesity, or asthma, COVID-19 infections can quickly become severe.^(3)
That’s why I continue to stress how important it is for people at high risk for severe COVID-19 to speak with a doctor ASAP after symptoms first appear or they test positive. They may be eligible for prescription treatments, such as PAXLOVID^(®) (nirmatrelvir 150mg tablets; ritonavir 100mg tablets) that are designed specifically to treat COVID-19.^(4,5)
- PAXLOVID is an oral prescription treatment for mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.^(4) It works to help stop the virus from multiplying because viruses spread in the body by making copies of themselves. If there are enough copies of the virus in the body, it may be hard for immune systems to fight off the infection.^(6) When taken within the first five days of symptoms, PAXLOVID can help keep COVID-19 from becoming severe.^(4) Visit PAXLOVID.com for more information.
- PAXLOVID is not for everyone, so be sure to discuss all your health conditions, lifestyle factors, and all the medicines you take, including herbal supplements and over-the-counter (OTC) medicines, with your doctor. Taking PAXLOVID with certain medicines can lead to serious or life-threatening side effects, or affect how it or other medicines work, including hormonal birth control. Serious side effects can include liver problems and allergic reactions, some severe like anaphylaxis. Stop taking PAXLOVID and call your doctor right away if you have an allergic reaction. These are not all the possible side effects, so talk to your doctor.^(4)
- Still need more reasons to take action when it comes to COVID-19? Watch a video below, where I address five of the biggest misconceptions I continue to hear in my practice about the virus.
https://reddit.com/link/1ujcx41/video/ytleslzizm9h1/player
While my video covers some of the broader COVID-19 misconceptions that are out there, I’ll now dig further into the area of prescription treatments, like PAXLOVID – a topic that often warrants more in-depth discussion with my patients.
Question: How do I know if PAXLOVID is necessary or right for me, especially if my COVID-19 symptoms are mild? Will PAXLOVID help me get better faster?
Answer:
- This topic comes up a lot in my practice – specifically, whether prescription treatments like PAXLOVID are suitable for the patient and what they should consider.
- PAXLOVID is an oral prescription treatment for mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. It does not prevent COVID-19.^(4)
- There are many different health and lifestyle factors that should be considered when determining if you’re at high risk for COVID-19 – factors such as being aged 50+ or living with one or more underlying health conditions, such as diabetes or obesity.^(3) The CDC conveniently has a full list of high-risk factors, which can be found at www.cdc.gov/covid/risk-factors/.
- As some people don't experience any symptoms (and mild symptoms can sometimes get worse quickly),^(2,7) I recommend that my patients who suspect they might be sick – and certainly those who test positive – speak with me ASAP instead of waiting to see whether their COVID-19 symptoms continue to get worse. Quick action is especially important given that some prescription treatments, like PAXLOVID, must be taken within the first five days from when you first begin experiencing symptoms.^(5) This means the window for starting potential treatment isn’t all that long!
- PAXLOVID is not for everyone. Some medicines can interact with PAXLOVID and cause severe or life-threatening side effects or death. Tell your healthcare professional about all the medications you take, including OTC medicines and herbal supplements, and about all your medical conditions, including if you have any allergies, have liver or kidney problems, have human immunodeficiency virus 1 (HIV-1) infection, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Don’t take PAXLOVID if allergic to its ingredients. Serious side effects can include liver problems and allergic reactions, some severe like anaphylaxis. Stop taking PAXLOVID and call your doctor right away if you have an allergic reaction.^(4)
- If you don’t have a doctor you see regularly, or if your current doctor is unavailable, urgent care is another option. There are also many great telehealth resources available. Remember, when choosing a telehealth provider, always make sure you’re speaking with a reputable, licensed clinician.
Question: I have had COVID-19 before and recovered without taking prescription treatment – why should I consider it in the future?
Answer:
- It's completely understandable to think that potential future COVID-19 infections will be similar to your past experiences. But it’s important to remember that not all COVID-19 experiences are the same.^(8) In my practice, I continue to see patients getting very sick from COVID-19 – even when a prior infection was mild. And we also know that COVID-19 has the potential to impact long-term health in people who are already at high risk for severe symptoms.^(9) Because COVID-19 can be so unpredictable, I encourage you to have a conversation with your doctor as soon as COVID-19 strikes and discuss the topic of treatment. Together, you and your doctor can decide on a care plan and whether prescription treatment may be right for you.
Question: If my other health conditions are well managed, am I still at high risk for developing severe COVID-19? And how could PAXLOVID help?
Answer:
- I see so many patients with health conditions like diabetes, heart disease, obesity, or asthma who are actively managing their health day in and day out. These are the patients who track their vitals, communicate regularly with their doctor, or take their medications as prescribed.
- However, even when existing conditions are properly managed, COVID-19 can still lead to severe outcomes. The key is to be aware of how COVID-19 may impact your health and know what to do if the virus strikes.
- So, how could PAXLOVID help if you have COVID-19? Viruses spread in the body by making copies of themselves. If there are enough copies of the virus in your body, it may be hard for your immune system to fight the infection off.^(6) PAXLOVID works to help stop COVID-19 from multiplying. COVID-19 symptoms may be mild at first, but don't wait to reach out to your doctor and ask about treatment – PAXLOVID must be started within five days of symptoms.^(4)
- A COVID-19 infection can exacerbate existing conditions or even lead to the onset of new health concerns.^(10,11) So, if you test positive or start feeling sick, talk to your doctor about what you should do. You are already working proactively to maintain your health, so make sure you’re aware of your options if COVID-19 strikes.
Question: How effective is PAXLOVID at reducing the risk of severe COVID-19?
Answer:
- Before starting any prescription, my patients are often curious to hear more about what data are available to support their treatment decision-making.
- Clinical trial data support the safety and effectiveness of PAXLOVID in patients at high risk for progression to severe COVID-19, and real-world evidence studies have also evaluated its use.^(12) With the plethora of data available and with several years of people having been prescribed PAXLOVID, I never hesitate to start a discussion with my eligible patients around appropriate treatment options. So, if you are an adult at high risk of getting very sick from COVID-19, reach out to your doctor any time you test positive or start feeling sick. Because even if you have no or mild symptoms, COVID-19 can quickly turn very severe.^(2)
- Of course, it’s important to understand the possible risks and side effects before taking PAXLOVID. PAXLOVID isn't right for everyone. Before you start treatment, take time to learn about potential safety issues and side effects to discuss with your healthcare professional.
Question: How can I get a PAXLOVID prescription?
Answer:
- PAXLOVID is a medication that needs to be prescribed by a healthcare professional. This is because it is critical for them to determine whether the specific treatment is right for you based on a multitude of factors. In order to discuss potential treatment options, you may choose to visit your regular doctor, nurse, or physician’s assistant, visit a local urgent care center, or connect with a healthcare professional via telehealth. If you receive a prescription for PAXLOVID, make sure to pick up your treatment at the pharmacy and begin taking it as soon as possible (as directed) because the medicine should be started within five days from when COVID-19 symptoms started.
Question: Are any cost-saving options available?
Answer:
- Eligible commercially insured patients may access PAXLOVID for as little as $0,* and eligible Medicare, Medicaid, and uninsured patients may access PAXLOVID for free^(†) with the PAXCESS^(®) Patient Support Program.
- Learn more about the PAXCESS^(®) Patient Support Program and explore other cost-saving options at paxlovid.com/paxcess.
^(* Eligible commercially insured patients can save up to a maximum of $1,000 annually.) ^(Terms and conditions apply)^(.)
^(† Eligible government insured and uninsured patients can access PAXLOVID for free through December 31, 2026. The USG PAP operated by Pfizer is an independent program with separate eligibility requirements offered by the United States Department of Health and Human Services and is not owned by Pfizer.) ^(Terms and conditions apply)^(.)
To discover more about COVID-19 and PAXLOVID, check out this Ask Me Anything (AMA) where I dig into additional topics my own patients – and those on Reddit! – are asking about.
INDICATION
PAXLOVID is a prescription medicine used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in adults who are at high risk for progression to severe COVID-19, including hospitalization or death.
PAXLOVID is not approved for use in the prevention of COVID-19.
IMPORTANT SAFETY INFORMATION AND INDICATION
Significant Drug Interactions. PAXLOVID can interact with other medicines, causing severe or life-threatening side effects or death. Do not take PAXLOVID if you are taking any of the following medicines:
- alfuzosin
- amiodarone
- apalutamide
- carbamazepine
- colchicine
- dihydroergotamine
- dronedarone
- eletriptan
- enzalutamide
- eplerenone
- ergotamine
- finerenone
- flecainide
- flibanserin
- ivabradine
- lomitapide
- lovastatin
- lumacaftor/ivacaftor
- lurasidone
- methylergonovine
- midazolam (oral)
- naloxegol
- phenobarbital
- phenytoin
- pimozide
- primidone
- propafenone
- quinidine
- ranolazine
- rifampin
- rifapentine
- St. John’s Wort (hypericum perforatum)
- sildenafil (Revatio®) for pulmonary arterial hypertension
- silodosin simvastatin
- suzetrigine
- tolvaptan
- triazolam
- ubrogepant
- voclosporin
These are not the only medicines that may cause serious or life-threatening side effects if taken with PAXLOVID. PAXLOVID may increase or decrease the levels of other medicines. It is very important to tell your healthcare professional about all the medicines you are taking, including prescription and over-the-counter medicines, vitamins, and herbal supplements, because additional laboratory tests or changes in the dose of your other medicines may be necessary during treatment with PAXLOVID. Your healthcare professional may also tell you about specific symptoms to watch out for that may indicate that you need to stop or decrease the dose of some of your other medicines. Do not start taking a new medicine without telling your healthcare professional.
Before taking PAXLOVID, tell your healthcare professional about all your medical conditions, including if you:
- have kidney or liver problems, including hepatitis.
- have Human Immunodeficiency Virus 1 (HIV-1) infection. PAXLOVID may lead to some HIV-1 medicines not working as well in the future.
- are pregnant, plan to become pregnant, breastfeeding, or plan to breastfeed. PAXLOVID can pass into your breast milk.
Tell your healthcare professional if you are taking hormonal contraceptive (birth control). PAXLOVID may affect how your birth control works. People who can become pregnant should use another or an alternative effective form of birth control.
PAXLOVID may cause serious side effects, including:
- Allergic reactions, including severe allergic reactions (anaphylaxis). Do not take PAXLOVID if you are allergic to nirmatrelvir, ritonavir, or any of the ingredients in PAXLOVID. See Important Facts for a complete list of ingredients in PAXLOVID. Stop taking PAXLOVID and get medical help right away if you get any of the following symptoms of an allergic reaction:
- skin rash, hives, blisters or peeling skin
- painful sores or ulcers in the mouth, nose, throat or genital area
- swelling of the mouth, lips, tongue or face
- trouble swallowing or breathing
- throat tightness
- hoarseness
- Liver problems. Tell your healthcare professional right away if you get any of the following signs and symptoms of liver problems during treatment with PAXLOVID:
- loss of appetite
- yellowing of your skin and the whites of your eyes
- dark-colored urine
- pale-colored stools
- itchy skin
- stomach-area (abdominal) pain
The most common side effects of PAXLOVID include: altered sense of taste (such as metallic, bitter taste) and diarrhea.
Other possible side effects include:
- headache
- vomiting
- abdominal pain
- nausea
- high blood pressure
- feeling generally unwell
These are not all of the possible side effects of PAXLOVID. For more information, ask your healthcare professional or pharmacist.
Take PAXLOVID exactly as your healthcare professional tells you.
If you take too much PAXLOVID, call your healthcare professional or go to the nearest hospital emergency room right away. If you are taking a ritonavir- or cobicistat-containing medicine to treat hepatitis C or HIV-1 infection, you should continue to take your medicine as prescribed.
Talk to your healthcare professional if you do not feel better or if you feel worse after 5 days.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
© 2026 Pfizer Inc. All rights reserved. July 2026. PP-C1D-USA-2492
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- Rose EB, Paden CR, Cook PW, et al. Estimated COVID-19 periodicity and correlation with SARS-CoV-2 spike protein S1 antigenic diversity, United States. Emerg Infect Dis. 2025 Aug;31(8):1573-1579. doi:10.3201/eid3108.250451
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- Bull-Otterson L, Baca S, Saydah S, et al. Post–COVID conditions among adult COVID-19 survivors aged 18–64 and ≥65 years — United States, March 2020–November 2021. MMWR Morb Mortal Wkly Rep. 2022 May 27;71(21):713–7. doi:10.15585/mmwr.mm7121e1
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- About PAXLOVID. PAXLOVID. Accessed June 26, 2026. https://www.paxlovid.com/about.
Posted Jun 30, 2026, 2:44 AM UTC · locked