Antivirals for COVID-19: What You Need to Know

What Are Antiviral Drugs?

Antiviral medications help your body fight off viruses that cause disease, reduce the symptoms of a viral infection, and shorten the length of illness. In most cases, viruses clear up without these drugs. But if your infection is chronic or life-threatening, like in some cases of COVID-19, your doctor may want to treat you with an antiviral medication.

There are two major types of antiviral drugs: antiviral pills and antiviral therapy. The goal of the drugs is the same. You take antiviral pills by mouth, but antiviral therapy requires a health care professional to give you an intravenous (IV) infusion.

What Are the Different Types of COVID Pills?

Though there are many types of antiviral pills, experts have approved only one for COVID-19 treatment.

Lagevrio (molnupiravir). Britain approved the world’s first antiviral pill for COVID-19, developed by Merck Sharp and Dohme (MSD) and Ridgeback Biotherapeutics. This is the first antiviral drug that people can take at home to treat COVID-19. Since this drug is a pill instead of an intravenous (IV) treatment, it’s easier to use outside of a hospital. A similar antiviral pill is in the works in the U.S.

Lagevrio is safe and effective for those with mild to moderate COVID-19 who are at a higher risk of severe illness. Data shows that the pill can lower the risk of death or hospitalization from a COVID-19 infection.

After you swallow the Lagevrio pill, the medication interferes with the COVID-19 virus’s replication process. This stops the spread of the virus throughout your body. Because of this, your body’s virus level will be low, and you won’t have as intense symptoms.

Clinical trials show that Lagevrio works best when you take it in the early stages of infection. Experts suggest that you take the pill as soon as possible after you receive a positive COVID-19 test and within 5 days of your first symptoms.

Right now, Lagevrio is only available in Britain for people who:

  • Have mild to moderate COVID-19
  • Have at least one risk factor for severe illness with COVID-19

Paxlovid (ritonavir). Experts in the U.S. are working on other COVID pills, including one from Pfizer called Paxlovid. 

Pfizer says the drug may reduce hospitalization or death by 89%. The company says it has stopped clinical trials on Paxlovid and plans to seek FDA emergency approval for it.

Continued

Other Types of Antiviral Drugs

The FDA approved remdesivir to treat COVID-19 in adults hospitalized for the virus and children 12 and older who weigh at least 88 pounds. It’s also available through the FDA Emergency Use Authorization (EUA) for hospitalized children who weigh 7-88 pounds and kids under 12 years old who weigh 7 pounds or more.

This drug is an intravenous treatment and is only available in hospitals or certain health care settings. Remdesivir stops viral replication of COVID-19 so that you can recover quicker.

While you may have heard of other antiviral therapies, experts don’t recommend all of them for COVID-19 treatment. Guidelines suggest against the use of chloroquine or hydroxychloroquine and/or azithromycin, lopinavir/ritonavir and other HIV protease inhibitors, and nitazoxanide (except in clinical trials) for people with COVID-19.

Similarly, there’s not enough evidence to support or not support the use of the drug ivermectin for COVID-19 treatment. Experts need to do more research.

How Effective Are Antiviral Drugs in COVID-19 Treatment?

During clinical trials, experts found that Lagevrio was able to lower the risk of hospitalization or death in at-risk adults with mild to moderate COVID-19 by 50%.

Studies show that remdesivir reduced the risk of serious complications with COVID-19 and helped people get better with the virus. But the same study also showed that the drug didn’t affect the risk of death after the 14th day of treatment.

While these are effective treatments for people with COVID-19, they’re not meant to replace the COVID-19 vaccine.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on November 05, 2021

Sources

SOURCES:

Cleveland Clinic: “Antivirals.”

Gov.uk: “First oral antiviral for COVID-19, Lagevrio (molnupiravir), approved by MHRA.”

National Institutes of Health: “Antiviral Therapy,” “Remdesivir,” “Table 2a. Remdesivir: Selected Clinical Data.”

Pfizer: “Pfizer’s Novel COVID-19 Oral Antiviral Treatment Candidate Reduced Risk of Hospitalization or Death by 89% in Interim Analysis of Phase 2/3 EPIC-HR Study.”

Journal of Pharmacy and Pharmaceutical Sciences: “Safety and Efficacy of Remdesivir for the Treatment of COVID-19: A Systematic Review and Meta-Analysis.”

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