[Q&A] COVID-19 Treatment Pills Should Be Swallowed, Not Chewed... Painkillers Should Not Be Taken Together

Pfizer Oral Treatment 'Paxlovid'
Regardless of Meals... Must Follow Dosage Timing
If Over 8 Hours Passed, Take Next Dose
Home Care Patients Should Receive Medical Consultation and Delivery

[Image source=Yonhap News]

[Asia Economy reporters Sojeong Seo and Daehyun Kim] Pfizer’s oral antiviral treatment, Paxlovid, which is gaining attention as a new game changer for COVID-19, will be administered to patients starting from the 14th. The initial batch introduced consists of about 21,000 doses, which is part of the 762,000 doses contracted by the government. It will be prioritized for immunocompromised patients undergoing home treatment or admitted to residential treatment centers. Home treatment patients must first receive a medical consultation and can then obtain the medication through local governments or designated pharmacies.

Q. Who is prioritized for prescription?

A. Priority is given to mild to moderate (between mild and severe) patients at high risk of progressing to severe illness who are 65 years or older or immunocompromised, and who are receiving home treatment or admitted to residential treatment centers. Immunocompromised individuals include those with autoimmune diseases, people infected with human immunodeficiency virus (HIV), and patients on immunosuppressive drugs such as steroids. The medication must be administered within 5 days of symptom onset and is not given to asymptomatic patients. The initial supply introduced domestically is 21,000 doses, with an additional 10,000 doses expected by the end of this month. Since the initial supply is insufficient, authorities plan to expand the eligible patient group based on future supply and patient trends. There are also plans to administer the drug to hospitalized patients if necessary.

Q. How is the medication taken?

A. The medication is taken twice daily, morning and evening, for 5 days, totaling 30 pills: 2 pink pills (nirmatrelvir) and 1 white pill (ritonavir) each time. The pills must be swallowed whole and should not be chewed or crushed. The timing of doses is not affected by meals. If a dose is missed, check if 8 hours have passed; if not, take it immediately. If more than 8 hours have passed, skip the missed dose and take the next dose at the scheduled time. Do not double the dose to make up for a missed one. Do not stop taking the medication even if symptoms improve, as a shorter treatment period reduces effectiveness. Interrupting treatment may lead to drug resistance. However, if adverse reactions occur, consult medical staff and discontinue if advised. It is illegal to give leftover medication to others. Remaining medication must be returned to health centers or pharmacies.

Q. What adverse reactions may occur from taking the medication?

A. Clinical trials observed mild side effects such as altered taste, diarrhea, increased blood pressure, and muscle pain. If suspected side effects appear, consult the prescribing medical institution. Reports can also be made to the Korea Institute of Drug Safety & Risk Management or Pfizer Korea.

Q. Which medications should not be taken together with Paxlovid?

A. There are 28 active ingredients that should not be taken with Paxlovid, 23 of which are approved in Korea. Representative examples include the painkiller pethidine, dronedarone (for atrial fibrillation), ranolazine (for angina), lovastatin (for hyperlipidemia), rifampicin (for tuberculosis), sildenafil (for erectile dysfunction and pulmonary arterial hypertension), amiodarone (for arrhythmia), St. John’s Wort (for anxiety and depression), colchicine (for gout), phenobarbital and phenytoin (for epilepsy), and clozapine (for schizophrenia). Taking these together may increase drug toxicity or reduce effectiveness. Some drugs, like St. John’s Wort, require caution as Paxlovid should not be taken even immediately after stopping them.

Q. How is the medication delivered?

A. Home treatment patients receive non-face-to-face consultations (outpatient treatment centers provide face-to-face consultations) and obtain the medication through local governments and designated pharmacies. Patients admitted to residential treatment centers receive medication through dedicated medical staff. Home treatment patients confirm eligibility for treatment through non-face-to-face consultations with managing medical institutions. If eligible, the managing medical institution sends the prescription to the designated pharmacy via email or fax. Caregivers or others can pick up the medication at the designated pharmacy, and if unavoidable, delivery is arranged through local governments (health centers, etc.) or pharmacies.

Q. What if testing or delivery is delayed and more than 5 days have passed since symptom onset?

A. In principle, patients are not eligible for treatment if more than 5 days have passed since symptom onset. If medication is received after 5 days, consult with medical staff.

This content was produced with the assistance of AI translation services.