The Quebec government is making Paxlovid, an antiviral treatment against COVID-19, available in pharmacies to reduce the risk of hospitalization. Who is this medicine for? What are its contraindications? How to get it? Dr. Julien Viau-Lapointe and pharmacist Jean-François Morin answer our questions.
If the drug produced by Pfizer has been available in pharmacies for a week, most citizens are unaware of the arrival behind the counters of such a treatment.
“We really want to inform the population that this new treatment is an additional tool that will allow those most at risk to avoid hospitalization,” says Christian Merciari, communications officer at the CIUSSS de l’Est-de-l’Île-de-Montréal.
Paxlovid, what is it exactly?
Dr. Julien Viau-Lapointe: Paxlovid is an antiviral treatment by tablets that will prevent hospitalizations and mortality linked to COVID-19. It combines two drugs, nirmatrelvir, which will target the main protein of the coronavirus, and ritonavir, which is used to maintain the level of effectiveness of nirmatrelvir. The treatment works against all variants known to date.
Who is Paxlovid for?
J. V.-L. : This medication is for people who have mild symptoms and a high risk of complications related to COVID-19. We are talking about people who are not vaccinated, or who have health conditions that put them at risk of having complications from COVID.
We will also use this treatment for people who are immunosuppressed, who do not respond to the vaccine or who are at risk of complications due to another disease. It is also prescribed to people who have been vaccinated but who are still at risk, such as the elderly or people with several health problems.
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Are there any contraindications to Paxlovid?
J. V.-L. : The two main contraindications are severe liver and kidney problems. The main issue is that Paxlovid interacts a lot with other drugs. Some just can’t be taken at the same time, and there are others you just have to stop using for a few days. It is very important for the pharmacist to look at the pharmacological and natural profile of the patient before the patient takes the medication.
How many tablets should be taken, and at what time of illness?
J. V.-L. : The treatment consists of two tablets of nirmatrelvir and one of ritonavir, to be taken twice a day for five days. This therefore represents thirty tablets in total. The dose is lower for people with kidney problems.
Paxlovid should be given within the first five days after the first symptoms appear. According to the first results of studies, there does not seem to be any noticeable efficacy if it is given later.
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I am at risk and have symptoms of COVID-19; what should I do?
Jean-Francois Morin: This person should first get tested using a rapid home test. If it is positive, she can look on the government website to see if she qualifies for Paxlovid. She can then make an appointment with her pharmacist by phone without going anywhere, who, in turn, will check if everything is safe in relation to the patient’s file. If this is not the case, he can refer him to a hospital center to receive another antiviral intravenously.
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My pharmacist has confirmed that I can take Paxlovid; how can i collect my treatment?
J.-F. M. : We ask sick people not to come to the pharmacy and to stay at home. To pick up the Paxlovid, we favor third party picking that is non-positive. A relative can therefore come in place of the sick patient. A delivery service can also deliver the treatment directly to the patient’s home if necessary.
Are there any issues regarding the availability of Paxlovid in Quebec?
J.-F. M. : Paxlovid is available in almost all pharmacies in Quebec. We currently have 12,000 to 15,000 treatments available, and we will be receiving more soon. It is estimated that 100 to 250 treatments are currently prescribed by pharmacists per day. There is therefore no difficulty at this level.
How much does Paxlovid treatment cost?
J.-F. M. : It is estimated that a treatment is worth around $900, but it is available free of charge for the population of Quebec.
