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COVID-19 Outpatient Treatment

Outpatient Treatment and therapies for COVID-19 can greatly reduce the risk of developing severe COVID-19.

Treatment for COVID-19 when symptoms are still quite mild can greatly reduce risk of developing severe COVID-19 and help you get better faster. These treatments are available at Mass General Brigham and at Massachusetts Department of Public Health treatment sites.

Patients at increased risk of severe COVID-19 are eligible for treatment. Patients with multiple medical conditions or who are not fully vaccinated are strongly encouraged to ask about treatment.

Please see below for additional details regarding outpatient treatment options for COVID-19.

Oral antiviral treatments for COVID-19 - Paxlovid and Lagevrio

Oral antiviral treatments are taken by mouth to treat mild-to-moderate symptoms of COVID-19. The Food and Drug Administration (FDA) has issued emergency use authorizations (EUAs) for Paxlovid (nirmatrelvir tablets and ritonavir tablets) and Lagevrio (molnupiravir). Both of these medications slow down COVID-19’s ability to replicate.  

Oral antiviral treatments are taken by mouth to treat mild to moderate symptoms of COVID-19. The Food and Drug Administration (FDA) has issued an emergency use authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets). This medication slows down COVID-19’s ability to replicate.

They are used for patients who have symptoms like runny nose, cough, or sore throat from COVID-19. They are not used for patients who have been exposed to COVID-19 but have not contracted the virus.

Note: Lagevrio is an alternative treatment option that is used when patients cannot take Paxlovid.

Both Paxlovid and Lagevrio are pills that are taken by mouth twice a day for 5 days. They are available by prescription only.

Paxlovid and Lagevrio should be taken when you have symptoms. They can only be started during the first 5 days of symptoms. If your symptoms are already improving, treatment is probably not necessary.

Yes. These treatments are available for vaccinated and not-yet-vaccinated patients.

Yes. The antiviral treatments are especially helpful if you have not been vaccinated.

Researchers at Mass General Brigham and other hospitals have found that Paxlovid reduces chances of being hospitalized or dying from COVID-19 by 45 to 80%. Lagevrio reduces chances of being hospitalized or dying from COVID-19 by about 30% and shortens illness by 3 to 5 days.

Paxlovid therapy is available for patients ages 12 years and older who:

  • Weigh at least 40 kilograms (a little over 88 pounds) AND
  • Have symptoms of COVID-19 AND
  • Are within 5 days of the start of symptoms AND
  • Have a health condition that makes them more likely to experience severe COVID-19 infection.

Paxlovid can interact with other medications. Please let your care team know all the medications and supplements you are taking.

Paxlovid should not be used without specific discussion with your care team if you:

  • Have had a transplant and must take tacrolimus, cyclosporine, everolimus, or sirolimus
  • Have severe kidney or liver disease
  • Require certain anticoagulant medications (clopidogrel, rivaroxaban, or others)
  • Take many chemotherapy medications
  • Take St. John’s wort

There are other equally effective options for patients who have COVID-19 who cannot take Paxlovid. Contact your care team to understand what your best option might be.

Lagevrio therapy is available for patients ages 18 years and older who:

  • Have symptoms from COVID-19 AND
  • Are within 5 days of the start of symptoms AND
  • Are not pregnant AND
  • Have a health condition that makes them more likely to have severe COVID-19 infection.

Please note: There are some additional considerations for patients and their partners who are able to become pregnant. Please check with your doctor about the need for birth control (contraception).

No. Paxlovid and Lagevrio are available for free in the United States.

If you think you might be eligible for treatment, please contact your primary care or specialty care team. They can prescribe treatment.

For Massachusetts residents, there is also a free telehealth program to get oral COVID-19 treatment. This is offered through the Department of Public Health. You can get started on their website. Hours are 8 a.m. to 10 p.m. daily. Their services are available in English, Spanish, Haitian Creole, and Portuguese. Find out more information about program eligibility and Paxlovid on the mass.gov website.

Remdesivir

Remdesivir is an FDA-approved medicine that interferes how the COVID-19 virus replicates. It can help people with COVID-19 recover faster and reduce the chances of developing severe COVID-19. It can also be used to treat patients in the hospital, but here we are focusing its use to prevent being hospitalized. The NIH COVID-19 Treatment Guidelines provide information about this drug.

Remdesivir is given by 3 daily intravenous (IV) infusions. It’s not a pill.

Remdesivir works best when given early at least within the first seven days of symptoms. If you are already improving, treatment is probably not necessary.

You can get Remdesivir if you have been vaccinated for COVID-19. You must meet eligibility criteria.

You can get Remdesivir if you have not been vaccinated. You must meet eligibility criteria.

Remdesivir has been shown to reduce the chance of hospitalization by 82% and help people improve faster.

Remdesivir is available for patients ages 12 years and older who:

  • Weigh at least 40 kg AND
  • Have symptoms of COVID-19 AND
  • Are within 7 days of the start of symptoms AND
  • Have a health condition that makes them more likely to have severe COVID-19 infection.

Not usually. It is available for free (no copay, deductible) for insured patients in Massachusetts. If you do not have insurance or your insurance is from outside of Massachusetts you may need to pay for co-payments or deductibles depending on your insurance. Remdesivir can be obtained for free regardless of insurance status at Massachusetts Department of Public Health treatment sites.

If you think you might be eligible, please contact your primary care provider or specialist. They can refer you for treatment. Please note that due to the limited supply of places to provide IV therapy, not all patients referred will be able to receive the treatment.

Do not go to urgent care or the emergency room or for any of these therapies. They are not available at those locations. There are specific clinics designed to give this therapy.

We have limited quantities of Remdesivir available. If you are able to get the therapy, we will contact you with information and instructions. For patients who are on Patient Gateway, we will send a Patient Gateway message if we determine that we cannot offer treatment.

Monoclonal antibodies (mAb)

The Federal Drug Administration (FDA) issued emergency use authorization (EUA) for several investigational monoclonal antibodies. Monoclonal antibodies were previously used to help fight the virus. However, the Omicron subvariants in our region are not effectively treated by any of the available monoclonal antibodies. The NIH COVID-19 Treatment Guidelines provide information about these drugs.

Evusheld 

Tixagevimab/Cilgavimab (Evusheld) was a preventive antibody cocktail used in people who cannot be adequately protected by vaccination. The COVID-19 viruses that began circulating in late 2022 are resistant to Evusheld. For this reason, Evusheld is no longer authorized by the FDA as of January 26, 2023.

Who is eligible for these treatments?

To receive outpatient treatments for COVID-19, you must have COVID-19 confirmed by either antigen or PCR testing. You must also have a health condition that makes you more likely to experience severe COVID-19 infection. Patients are prioritized for the available treatments based on their risk of severe COVID-19.

High-risk conditions for severe COVID-19 include undergoing treatment for cancer, currently taking medications for transplant, or immunosuppressant medications for other conditions. Other high-risk conditions, including having chronic lung, kidney, or liver disease; diabetes; HIV; obesity; and age 65 years or older, may predispose you to worse symptoms from COVID-19 or influenza.

Learn more about predisposing health conditions from the CDC

 
Updated 2/16/2022

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