As COVID-19 continues to wreak havoc on our community and with limited supplies of monoclonal antibodies it may have you wondering, “What options do I have for treatment?”
The Food and Drug Administration (FDA) issued emergency use authorization for two oral antivirals, Paxlovid and Molnupiravir. These two medications will help fill the gap in terms of treatment.
What is the difference between the two medications?
Both medications are antiviral medications that work by enabling the SARS-Cov-2 virus from replicating thus reducing the viral load, which can lead to a reduction in symptom severity and disease progression.
Molnupiravir is a single medication whereas Paxlovid is a combination of two medications, nirmatrelvir, and ritonavir. The nirmatrelvir is responsible for disabling the replication process of the SARS-Cov-2 virus. Ritonavir does not inhibit the replication process but rather inhibits the body from metabolizing the nirmatrelvir and increases the body’s concentration of the nirmatrelvir.
Who is eligible to receive oral antiviral treatment for COVID-19?
At this time oral medications are also in short supply so there is a screening process and unfortunately not everyone will qualify for treatment. Providers are utilizing the Oral Antiviral & Monoclonal Antibody Screening Score also known as an OMASS score to determine eligibility.
This scoring helps providers determine a patient’s risk factor for developing severe disease. The patient score will determine the patient’s eligibility for treatment and will also dictate which medication they qualify for.
Risk Factor | Points |
Age 65 years or older | 2 |
BMI 35kg or higher | 2 |
Diabetes Mellitus | 2 |
Chronic Kidney Disease | 3 |
Cardiovascular Disease in those 55 years and older | 2 |
Chronic Respiratory Disease in those 55 years and older | 3 |
Hypertension in those 55 years and older | 1 |
Immunosuppresses and unlikley to have responded to vaccines (CD20 inhibitors, BTK inhibitors, organ transplant, etc.) | 3 |
Pregnancy | 4 |
BIPOC (Black, Indigenous, People of Color) status | 1 |
This table can also be seen on the NMDOH website: https://cv.nmhealth.org/providers/covid-19-oral-treatments-for-providers/
Paxlovid will be available to people who:
· Have tested positive for COVID-19 and have not yet been admitted to the hospital and
· Are high risk for developing severe COVID-19 and
· Are 12 years of age or older (and at least 88 pounds) and
· OMASS score 6 or greater
Molnupiravir will be available to people who:
· Have tested positive for COVID-19 and have not yet been admitted to the hospital and
· Are high risk for developing severe COVID-19 and
· Are 18 years of age or older and
· OMASS score 3 or greater
*All medications must be started within 5 days of symptom onset.*
Are these treatments safe to use during pregnancy or during breastfeeding?
There are currently no available human data on the safety of use for Paxlovid or Molnupiravir during pregnancy or while breastfeeding.
I qualify for treatment. What should I do next?
If you or a loved one qualify for treatment, please call our office to schedule an in-person or telehealth appointment with our provider. Our office cannot prescribe these medications without an appointment.
I don't qualify for treatment, now what?
If you don't qualify for treatment, but are still needing to be seen by our provider we can still schedule a visit and maybe offer other treatment modalities to help with symptoms you maybe experiencing. At this time insurances are waiving all out-of -next work costs for COVID-19 related visits. Avoid the ER if you can.
Patient Resources For Oral Therapeutics:
To learn more about the different treatment options please visit the NMDOH website at: https://cv.nmhealth.org/covid-19-oral-treatments/
Patient fact sheets for each medication are listed below:
As always are office is here to answer any additional questions you may have regarding treatment!
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