How Could an Oral Antiviral Drug Help Against COVID?

Every tool we can muster against COVID-19 is welcome. That is why we have embraced masks, hand hygiene and effective ventilation as well as vaccination. Now two different pharmaceutical firms have announced that they have each developed an oral antiviral drug. That too is good news.

Pfizer Introduces its Oral Antiviral Drug:

Last month, we wrote about a pill from Merck and Ridgeback Biotherapeutics that could help clear infection. This week, Pfizer submitted its application to the FDA for Emergency Use Authorization of its new oral antiviral drug Paxlovid. This follows on the heels of Merck’s request for authorization of its oral drug molnupiravir. British regulators have already approved the Merck pill under the name Legevrio. In addition, the UK government has purchased 250,000 courses of Paxlovid (BMJ, Nov. 8, 2021).

Both drugs appear to reduce the chance of serious illness or death. Molnupiravir cut the risk of serious COVID-19 outcomes in half.

Paxlovid may be even better. Specifically, in a study of more than 1200 adults who contracted COVID-19, those getting paxlovid within the first three days were 89% less likely to die or be hospitalized. Patients will take Paxlovid together with an anti-AIDS drug, ritonavir (Norvir), which keeps the body from breaking it down too soon.

How Does This Change Our Outlook?

To be effective, any antiviral medication should be taken at the earliest possible stage of infection with COVID-19. With a compound like remdesivir, this is complicated. Doctors give the drug by IV infusion. That is also how they administer monoclonal antibodies. When infection rates are high, they could have trouble finding space and staff to infuse such medications to patients who do not require hospitalization.

In contrast, any pharmacy could fill a prescription for an oral antiviral drug. The patient can then take it in the security of isolation in their own home. With widespread use of home tests and these medications, no one who becomes infected should have to just wait it out or spread it to others.

How Soon Will These Pills Become Available?

We expect the FDA to grant Emergency Use Authorization (EUA) for each oral antiviral drug, probably before the end of 2021. The US Government has already purchased over 3 million courses of molnupiravir and has just announced it will purchase 10 million courses of Paxlovid. Like Merck, Pfizer will permit generic manufacturers abroad to make and distribute its oral antiviral COVID pills at significantly reduced cost. That is good news, as the pandemic does not stop at borders.

Would you like an insider’s view of both molnupiravir and Paxlovid? The guest on our radio show this week is Dr. Ralph Baric. He has been studying coronaviruses for over 30 years. He will discuss the pros and cons of both medications. Keep in mind that he was involved in the development of molnupiravir and remdesivir. You can listen starting 11/22/2021 at this link.