Paxlovid is a medicine used to treat early COVID-19 infection. It can help to prevent more severe symptoms.
Paxlovid comes as tablets.
Start taking Paxlovid:
- as soon as possible after testing positive for COVID-19
- within 5 days of your symptoms starting
Paxlovid is only available on prescription. You can only get the medicine if you have a weak immune system and are in the highest risk group for COVID-19.
How Paxlovid works
Paxlovid is an antiviral medicine. It works by stopping the virus that causes COVID-19 from growing and spreading in the body.
It reduces the risk of serious illness or death in some groups of people who are at the highest risk from COVID-19.
Who can have Paxlovid
Your GP or hospital consultant can prescribe Paxlovid.
You may be recommended Paxlovid if all of these apply to you:
- you are in the highest risk group for COVID-19
- you've had COVID-19 symptoms within the last 5 days
- you've had a positive PCR or antigen COVID-19 test within the last 5 days
- you're age 18 or older
Who may not be able to have Paxlovid
Paxlovid is not suitable for some people.
To make sure it's safe for you, tell your GP, hospital consultant or pharmacist if you:
- ever had an allergic reaction to Paxlovid or any of its ingredients
- are pregnant, trying to get pregnant or breastfeeding
- have severe kidney or liver disease
- take other medicines - your GP will discuss this with you
Paxlovid and other medicines
Tell your GP or hospital consultant if you are taking any other medicines. These may affect how Paxlovid works.
Have a list of your medicines and dosage ready.
This should include:
- prescribed medicines
- medicines you buy without a prescription
- herbal remedies, vitamins and supplements
How to make a list of your medicines
To make a list, have all your medicines in front of you.
Include all the medicines you take regularly and occasionally, such as:
- prescription medicines - include inhalers, patches, injections, creams and eye drops
- medicines you buy without a prescription
- vitamins and other supplements
- herbal, homeopathic or alternative medicines
Write down:
- the strength of each medicine - for example, 50mg
- how much you take each day - for example, 2 tablets
- the time you take the medicine - for example, at night
Also include:
- any allergies you have
- the contact numbers of your GP and pharmacist
Template of a medicines list
If you need a template, you can download a copy of the 'My medicines list'.
You may be able to get a physical copy of this list from your pharmacist.
You can also ask your pharmacist or GP to print out a copy of your medicines for you.
Pregnancy and Paxlovid
Talk to your GP or hospital consultant before taking Paxlovid if you:
- are pregnant
- think you may be pregnant
- are trying to get pregnant
There is no evidence to show that Paxlovid is safe for use in pregnancy.
Your GP or hospital consultant will advise you if the benefits of treatment are greater than the possible risks for you and your baby.
Taking contraceptives with Paxlovid
Do not have sex or use contraception while taking Paxlovid and for 7 days after stopping.
Contact your GP if you become pregnant while taking Paxlovid, or shortly afterwards.
Paxlovid can stop combined oral contraceptive pills from working properly. If you have sex while taking Palovid, use barrier contraception such as a condom, diaphragm or cap. Do this for the full 5 days of treatment and during 1 full menstrual cycle.
Breastfeeding and Paxlovid
Talk to your GP or hospital consultant before taking Paxlovid if you are breastfeeding.
Stop breastfeeding while you are taking Paxlovid and for up to 7 days after finishing the medicine course.
How and when to take Paxlovid
If Paxlovid is recommended for you, you’ll get it as soon as possible after you've had a positive COVID-19 test.
Only take Paxlovid within 5 days of your symptoms starting. Otherwise it is not as effective.
Paxlovid comes in a pack of pink (nirmatrelvir 150mg) and white (ritonavir 100mg) tablets.
You usually take 2 pink tablets and 1 white tablet:
- at the same time
- twice a day (about 12 hours apart)
- for 5 days
But your doctor, pharmacist or consultant may recommend a different dose.
Swallow the tablets whole with a drink of water. Do not chew, break or crush the tablets. You can take them with or without food.
Even if you start to feel better, it's important you complete the course.
If you forget to take it
If you forget to take one of your tablets and no more than 8 hours have passed, take the missed dose as soon as you can. Take your next dose at the usual time.
If you forget to take your dose and it's been more than 8 hours, skip the missed dose and take your next dose at the usual time.
Do not take 2 doses to make up for a missed one.
If you take too much
Urgent advice: Contact your GP or go to an emergency department (ED) immediately if:
- you take too much Paxlovid
Get someone else to drive you or call 112 or 999 for an ambulance. Do not drive yourself.
Take the Paxlovid packet or leaflet inside it, any remaining medicine, and your other medicines with you.
Stopping Paxlovid
Talk to your GP if you want to stop Paxlovid before finishing the 5-day course.
If you stop taking Paxlovid, it may no longer protect you from the severe symptoms of COVID-19.
Side effects of Paxlovid
Like all medicines, Paxlovid can cause side effects in some people.
Common side effects of Paxlovid include:
Headaches
Rest and drink plenty of fluids. Do not drink alcohol. Ask your pharmacist to recommend a painkiller. Talk to your GP if the headaches last longer than a week or are severe.
Change in taste
Try sugar-free gum or sweets, or sipping cold drinks. If this does not help, ask your pharmacist or GP for advice.
Diarrhoea
Drink plenty of fluids to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
If you take contraceptive pills and have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Getting sick (vomiting)
If you’re getting sick, take sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Contact your GP if you keep getting sick (vomiting).
If you take contraceptive pills and you're getting sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Feeling sick (nausea)
Try to stick to simple meals and do not eat rich or spicy food.
See the patient information leaflet that comes with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Serious side effects
In rare cases, Paxlovid may cause a serious allergic reaction (anaphylaxis).
Signs of a severe allergic reaction include:
- wheezing or coughing
- trouble breathing or talking
- swelling in your mouth, or on your face, lips, tongue or throat
- feeling weak or light-headed all of a sudden
- a skin rash that may include red, swollen, blistered or peeling skin
- itchy skin
You will need emergency help if you have a serious allergic reaction.
Emergency action required: Phone 112 or 999, or go to an emergency department (ED) immediately if:
- you have symptoms of a severe allergic reaction
If you get any other side effects, talk to your GP.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie