Paxlovid Medication
Paxlovid medication requires careful assessment from a physician. The medication is initiated as quickly as possible after coronavirus symptoms have emerged but no later than 5 days from the start of symptoms.
Treatment can be started on the basis of a positive home test and should be verified with laboratory testing as soon as possible. The medication target groups differ from the general COVID 19 infection risk groups.
If you belong or suspect you belong to the Paxlovid medication target groups below, contact your own health centre if you are found to have coronavirus infection or you suspect that you have contracted it. Those in active cancer treatment or patients who are strongly lacking immunity can also contact their own special health care unit via Turku University Hospital Services.
Main target groups for treatment with Paxlovid for patients at home
The home care patients group lists conditions that carry a risk of severe COVID 19 regardless of vaccination. Advanced age significantly increases the risk of COVID 19 and the risk increases further if the patient has multiple conditions that increase the risk of COVID 19.
However, the risk of drug interactions is also increased and can be difficult to manage when treating the elderly, so clinicians assess the benefits and risks of treatment. COVID 19 vaccination also reduces the risk of severe disease in older people.
Organ transplantation
- Paxlovid is generally not suitable due to significant risks of drug-drug interactions. Cyclosporine, tacrolimus or everolimus medications are absolute contraindications to Paxlovid treatment. Intravenous in-hospital administration of remdesvir (Veklury) in most cases is possible.
- Allogeneic stem cell transplantation/CAR-T cell therapy if the patient is not on cyclosporine, tacrolimus or everolimus medication (contraindications) and less than 12 months after transplantation or more than 12 months after transplantation and immunosuppressive medication is ongoing.
Cancer under active treatment (severely immunocompromised cancer or treatment, less than six months from autologous intensive care).
Severe congenital or related immune dysfunction (e.g. advanced HIV infection).
Treatment with rituximab (or other CD20 antibody such as ofatumumab, obinutuzumab) within less than 12 months or known low immunoglobulin levels after previous treatment with rituximab or other CD20 antibody therapy.
Severe renal impairment (GFR < 30 ml/h) (note: dose should be adjusted).
Severe chronic lung disease, with the exception of asthma.
- Unvaccinated people under 65 years of age have a low risk of hospitalised COVID 19 infection in the absence of other risk factors.
- For people over 65 years of age without a history of COVID 19, Paxlovid treatment is at the discretion of the physician, taking into account the risk factor for severe disease.