Thursday, June 13, 2024

Prescription-only antiviral agents can reduce the length, severity of symptoms of your viral infection


Q: Should I contact my doctor for an antiviral medication?

That can depend on which virus you are trying to protect against and how long you have had the viral illness. Several prescription-only antiviral agents can reduce the length and severity of symptoms of your viral infection. However, these antiviral agents only work against one particular virus, like influenza or COVID-19. Currently, no prescription antiviral drugs work on both influenza AND COVID-19.

This is the middle of the influenza season. The flu season that hit the Southern Hemisphere six months ago was one of the most severe in years. Experts are concerned that our flu season here in the Northern Hemisphere will also be worse than usual.

On top of that, the relaxation in wearing masks has caused a jump in upper respiratory viral infections, including strains of COVID-19, influenza, RSV (Respiratory Syncytial Virus), and the common cold.

Many influenza, COVID-19, and RSV symptoms overlap. Before treatment with an antiviral can start, testing is essential to correctly identify whether your illness is caused by a virus that has a specific antiviral available, like influenza or COVID-19.

Antiviral agents are most likely to reduce symptom severity or length of symptoms when given very early in the illness, as soon as possible from the appearance of symptoms. For influenza, it’s best to start antiviral medication no later than 48 hours from the onset of flu-like symptoms. For COVID-19, the time frame of treatment with a prescription antiviral agent is more forgiving. Antivirals active against COVID-19 must be started within 5 days of symptom onset.

In July 2022, the U.S. Food and Drug Administration (FDA) revised the emergency use authorization for Paxlovid® (nirmatrelvir and ritonavir). This decision allows pharmacists to prescribe oral antiviral medication to eligible patients if particular criteria are met. These criteria include evaluating the list of drugs you are taking and assessing your liver and kidney health to ensure the appropriate use of Paxlovid®. 

The FDA took this action to help prevent severe illness from COVID-19. Paxlovid® must be taken within five days after symptoms begin to be effective. Authorizing licensed pharmacists to prescribe Paxlovid® could help provide more timely treatment for COVID-19 to those eligible to receive it.

Suppose you have evidence of a positive home test result from a rapid antigen diagnostic test or a positive PCR test. In that case, you may be eligible for treatment with Paxlovid®. Confirmation of a home rapid antigen diagnostic test with additional direct SARS-CoV-2 viral testing, such as a PCR test, is not required.

Suppose you have tested positive for COVID-19 and want to receive Paxlovid® at a location where prescribing by licensed pharmacists is available. In that case, you will need to bring to the pharmacy certain information to help determine if you are eligible.

The pharmacist needs your electronic or printed health record with recent reports of appropriate laboratory blood work to screen for kidney or liver problems. Another way the pharmacist could also get this information is by consulting with your doctor.

You will also need to provide a current list of all the medicines you currently take, including any over-the-counter medications, to the pharmacist. This is important because several drugs can react with Paxlovid®, with potentially serious consequences.

If the pharmacist does not have the laboratory test information to assess your kidney and liver function, plus a complete list of your medications, they cannot give you Paxlovid® from their pharmacy. You will need to contact your doctor for treatment options.

Paxlovid® is authorized by the FDA to treat mild-to-moderate COVID-19 illness in adults and children 12 years of age and older who weigh at least 88 pounds. They must have a positive test for SARS-CoV-2 and be at high risk for COVID-19 infection to progress to severe symptoms, hospitalization, or death.

Here Are 3 Tips About Prescription Antiviral Drugs:

1.  Start antiviral medications as soon as possible. 

Antiviral agents for influenza should be started within 2 days of flu-like symptoms and within 5-7 days of signs of COVID-19.

2.  Know what virus you are dealing with.

To select the appropriate antiviral, your medical provider needs to know which virus you have. Documentation of a positive COVID test is required to be eligible for a COVID-19 antiviral.

3 .An oral antiviral agent for COVID-19 may be available from your local pharmacy.

Several criteria are needed to be eligible for the antiviral Paxlovid® to help fight COVID-19, including a positive COVID-19 test and no more than 5 days since your symptoms started.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog, Ó2023 Louise Achey



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