Top 3 questions – Oral Treatments for COVID-19 (Part 1)

Hear from Dr Lucas de Toca PSM on COVID-19 oral treatments, how the various medicines differ from each other, and who is eligible to receive them.

Date published:
General public

Hello there. My name is Dr Lucas De Toca from the Department of Health. Today, I want to talk about treatments for COVID-19, and what you need to know if you're in a high-risk group for developing severe illness. As we move through the third year, yeah, third year, of living with COVID-19 in our community, and plenty of us have now had the illness, we must not forget that there are many people for whom the disease can still be very serious.

Thankfully, we now have better treatments available to help, which fall broadly into two categories. The firsthand, there are several treatments that are given in hospital, often intravenously or via a drip for people who become very sick and need intensive therapy. Since early on in the pandemic, there have been several frontline drugs that have shown to be effective in helping those with critical illness. Sotrovimab or Xevudy is one of such medications. It has been genetically engineered to bind to the spike protein of the coronavirus and neutralise its effect, which has been shown in several studies. Sotrovimab can be used in the first five days of symptoms starting in children and adults aged 12 years or older with mild to moderate COVID-19 symptoms who are at risk of progressing to severe disease.

The second category is what we call the oral treatments, which you can take by mouth as tablets or a capsule. The great advantage of these medications is that you can take a five-day course at home as soon as symptoms appear and you test positive without needing to go to hospital for inpatient care. This is particularly beneficial for older Australians living independently and in residential aged care facilities, for First Nations people aged over 50, and for people living in remote or regional locations or supported accommodation with a disability who may find it harder to move to receive care in hospital. Lagevrio and Paxlovid, these two oral medications have both been found to be effective for people with mild to moderate COVID in adults, who may be at risk of progressing to severe disease or hospitalisation. But unlike Sotrovimab, the one by drip, you don't need to go to hospital to get these medications. Lagevrio and Paxlovid were provisionally approved by the Therapeutic Goods Administration in January, and are now listed in the Pharmaceutical Benefits Scheme. What that means is that if you are eligible, you can now get them from a local pharmacy with a PBS prescription from your doctor.

It's important to note that there are some important differences between each medication. Lagevrio or Molnupiravir is available as capsules, whereas Paxlovid comprises two separate tablets, Nirmatrelvir and Ritonavir. But in both cases, the medicines are taken twice a day for five days. If you have severe kidney or liver disease, you should not have Paxlovi as a treatment. Also, Paxlovid must not be used with a number of other commonly used medications. Plus, if you are pregnant or breastfeeding, you should not have either oral COVID-19 treatment.

Finally, women should use effective contraception during treatment and for four days after the last dose of Lagevrio and seven days after Paxlovid. Men should use contraception during and for three months after taking Lagevrio. This is a lot of information to absorb, and we don't expect you to get this level of detail from a social media post. So, please talk to your treating doctor about what medication is best for you and how to use it. Now, let's look at the eligibility for the treatments. If you are over 65 or you're a First Nations person over 50, or if you're over 18 and have a health condition like diabetes, chronic lung and heart, or kidney disease, obesity, or you're living in a remote area with reduced access to high levels of health care, you may be eligible. Remember, these medicines, tablets or capsules, need a prescription. So, talk to your doctor. And don't delay. The medications should be taken as soon as possible after symptoms first appear. Remember, vaccination is still our best prevention against COVID-19, so please stay up to date with your COVID-19 shots. However, it is great to know that treatments are available too for those most at risk. Talk to your doctor now, as it's actually useful to ascertain whether you may be eligible for these drugs before you get COVID, so that you can access a script as soon as possible if you become positive. As always, more information is available on Thank you so much for watching.

Top 3 questions

  1. What are the advantages of oral treatments for COVID-19? 
  2. What is the difference between each medication? 
  3. Who is eligible to receive these treatments? 

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