Treatments and Therapies for COVID-19
Many people who contract COVID-19 can easily manage their symptoms and recover at home with common over-the-counter medications, such as acetaminophen and ibuprofen. However, if you're at high risk for severe disease and you experience even mild symptoms, you may benefit from treatment from a healthcare provider.
Therapies and treatments for COVID-19 are still being developed and evaluated. Treatments have become available under an Emergency Use Authorization by the FDA for mild-moderate COVID-19. Healthcare systems including Beth Israel Lahey Health and the Massachusetts Department of Public Health are providing these treatments.
Here's an overview of these treatment options currently available at BILH. For additional information, visit the Massachusetts Department of Public Health website or the US Centers for Disease Control and Prevention website.
Talk to your health care provider to find out if you're eligible for any of these treatments, and if so, your provider can give you a referral for care at BILH or at an alternative treatment site.
Nirmatrelvir packaged with ritonavir (Paxlovid) is an antiviral medication that can slow the replication of viruses, like the virus that causes COVID-19.
Who can receive Paxlovid?
Paxlovid is for adults and adolescents 12 years of age and older who:
- Weigh at least 88 pounds (40 kg)
- Have mild to moderate COVID-19 symptoms
- Tested positive for COVID-19 through a PCR or antigen test
- Are within 5 days of symptoms onset
- Who are not currently hospitalized due to COVID-19
Who should NOT take Paxlovid?
Paxlovid should not be given to people with:
- Symptoms for more than 5 days
- Severe liver disease (Child-Pugh Class C)
- Severe kidney disease
- Poorly controlled HIV infection
- An allergy to one of the medicine's ingredients
Patients taking the following medications are not recommended to take Paxlovid because of serious or life-threatening side effects or because they affect how Paxlovid works. This is not a complete list.
- Pethidine, piroxicam, propoxyphene
- Amiodarone, dronedarone, flecainide, propafenone, quinidine
- Lurasidone, pimozide, clozapine
- Dihydroergotamine, ergotamine, methylergonovine
- Lovastatin, simvastatin
- Sildenafil (Revatio®) for pulmonary arterial hypertension (PAH)
- Triazolam, oral midazolam
- Carbamazepine, phenobarbital, phenytoin
- John's Wort (hypericum perforatum)
What are the important possible side effects of Paxlovid?
- Liver problems may occur, including loss of appetite, yellowing of your skin and the whites of eyes (jaundice), dark-colored urine, pale colored stools and itchy skin, stomach area (abdominal) pain.
- Altered sense of taste
- High blood pressure
- Muscle aches
How is Paxlovid administered?
Paxlovid is taken by mouth. The usual dose is 3 tablets twice a day for five days.
How can I get Paxlovid?
Telehealth is a quick and easy way to see if Paxlovid is right for you. Learn more about free telehealth for COVID-19 treatment.
Or talk to your provider as soon as you have symptoms and/or test positive to find out if you are eligible for Paxlovid treatment through BILH or alternative treatment sites.
Remdesivir is an FDA-approved anti-viral medication that helps prevent progression of COVID-19.
Who can receive remdesivir?
- Remdesivir is for adults and adolescents 12 years of age and older who:
- Weigh at least 88 pounds (40 kg)
- Are hospitalized for COVID-19
- Are not hospitalized, tested positive for COVID-19 through a PCR or antigen test within the last 7 days, are exhibiting mild to moderate COVID-19 symptoms, and are at high risk of progression to severe COVID-19
Who should NOT receive remdesivir?
Remdesivir should not be given to people who had a severe allergic reaction to any ingredient in it or have had symptoms for more than seven days. Additionally, patients with pre-existing liver and/or kidney conditions may not be eligible for receiving remdesivir. Before taking remdesivir, please discuss your situation with your healthcare provider.
How is remdesivir administered?
Remdesivir is given through the vein (intravenous or IV infusion) over 60 minutes. Remdesivir is given in three doses over the course of three consecutive days. All three doses must be administered for this medication to be effective.
What are the possible side effects of remdesivir?
The side effects of getting any medication through a vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion site.
Remdesivir can cause elevations in liver function tests and kidney injury. Before taking Remdesivir, please notify your healthcare provider if you have kidney or liver problems and discuss eligibility for remdesivir.
Allergic reactions can happen during and after infusion with remdesivir. You will be observed for 30 minutes after your infusion to see if you have a reaction. Tell your healthcare provider right away if you experience any of the following signs and symptoms of allergic reactions:
- Difficulty breathing or shortness of breath
- Low oxygen level in your blood
- Fast or slow heart rate
- Chest discomfort or pain
- Low or high blood pressure
- Swelling of your lips, face, or throat
- Rash including hives
- Muscle aches
- Feeling faint
How do I schedule an appointment for remdesivir?
Talk to your provider as soon as you have symptoms and/or test positive to find out if you are eligible for remdesivir treatment through BILH or alternative treatment sites.
Bebtelovimab and Sotrivimab are monoclonal antibody therapies that are no longer available for treatment of COVID-19. The FDA revoked its emergency use authorizations (EUAs) for Bebtelovimab and Sotrivimab in April and November 2022, respectively, based on changes in the predominant strains of COVID-19, which impact the effectiveness of these medications.
Aside from COVID-19 vaccines, there are currently no medications to prevent COVID-19 infection.
Tixagevimab packaged with cilgavimab (Evusheld) is a long-acting monoclonal antibody (mAb) therapy that was given emergency use authorization by the FDA to prevent COVID-19 in specific patients who are not likely to be adequately protected by vaccination. However, changes in the predominant strains of COVID-19 have decreased the effectiveness of the current formulation of Evusheld such that it is no longer expected to prevent infection and the FDA has withdrawn emergency use authorization at this time (January 2023).
Due to loss of efficacy against current circulating COVID-19 variants, we will no longer be offering initial or follow-up doses of the current formulation of Evusheld.
Patients who previously received Evusheld should be aware that they are now less well protected against COVID-19, talk to their provider about getting vaccinated and boosted, wear masks, improve indoor ventilation as possible and practice physical distancing to protect themselves from COVID-19 exposure. It is also important to talk to your provider to have a COVID-19 treatment plan in place and report any possible COVID-19 symptoms right away so that proper testing and treatment can be arranged.