COVID-19 pills: Who are they really meant for?

NEW ORLEANS (WVUE) - With COVID-19 infections continuing to surge in Louisiana and across the country some people may wonder if the recently authorized COVID-19 pills are right for them.

LSU Health Infectious Diseases expert Dr. Fred Lopez discussed who the pills are intended for and why the pill manufactured by Pfizer comes with an FDA warning about possible drug interactions.

Lopez said the Omicron variant that is fueling the soaring number of COVID cases is not slowing down.

“It is still very, very aggressive in transmissibility, again people are comparing it to measles and chickenpox, in terms of its contagiousness, I think the numbers reflect that, they continue to go up,” said Lopez.

And the list of medical therapeutics or drugs to treat COVID patients is increasing, too.

“We have monoclonal antibodies, we have Remdesivir, we now have these medications, one of which is the preferred one which is the Paxlovid and it’s nice to have more options,” said Lopez.

Paxlovid is Pfizer’s COVID pill, it along with Merck’s Molnupiravir pill received emergency use authorization from the FDA in December.

“You need to be diagnosed with COVID-19, you have to be within five days of the beginning of symptoms,” said Lopez.

Lopez says the pills are meant for certain people with COVID.

“The Paxlovid, for example, is recommended for people who have mild to moderate COVID-19 illness but who are at high-risk for complications and again that would be increased age or medical co-morbidities,” said Lopez.

“Folks who took Paxlovid early, within three days of demonstrative onset had a 90% reduction in hospitalization or death compared to those who took placebos,” said Dr. Jonathan Reiner of George Washington University Heart and Vascular Institute.

And Lopez said, “They seem to work quite well at decreasing hospitalizations and death, the Paxlovid data shows that the risk for hospitalization and death decreases by about 88%, in fact, which is significant.”

Still, the FDA warns that, “The concomitant use of Paxlovid and certain other drugs may result in potentially significant drug interactions.

“The Paxlovid is actually two medications, it’s an anti-viral medication combined with a drug known as Ritonavir,” said Lopez.

He talked about some specific medications that could interact with Paxlovid.

“These include but not limited to blood thinners, seizure medications, some drugs that are used for irregular heart rhythms, some high blood pressure medications, some cholesterol medications, anti-depressants, anti-anxiety medications, immuno-suppressants, steroids, some HIV therapies, it’s a long list of drugs that potentially interact with this same enzyme,” said Lopez.

So, Lopez said it is critical that people communicate with their doctor about the drug.

“And so with these interactions you need to be aware of them and discuss them with your primary care provider, discuss them with a clinical pharmacist,” said Lopez. “So that you know whether this Paxlovid would be contra-indicated, if you’re on certain medications or whether those medications that you’re on that might interact with Paxlovid might need to have a reduction in their dose and how to monitor the levels and effects of the Paxlovid while taking some of these medications that interact at the same enzyme that metabolizes these drugs.”

And Lopez says some people may want to check with their physician in advance about whether they will be able to take the COVID pill.

“It would be a very reasonable thing if you are on some of these medications to address them now with your primary care provider to see what would you do if you got COVID-19,” he said.

And he stressed that COVID therapeutics are not a substitute for being fully vaccinated and also encourages vaccinated people to get the booster shot.

“We have a preventative measure which is quite effective against Omicron and that is the COVID-19 vaccine and boosting vaccine. It is very effective, it can very significantly impact the effect of the infection on an individual, most of the cases, hospitalizations and deaths are still being seen in unvaccinated individuals predominantly,” said Lopez.

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