Pfizer’s antiviral drug Paxlovid is designed to reduce the risk of hospitalization in patients with COVID-19, and is approved for use through Canada.
Although it has the potential to take some pressure off hospitals during coronavirus waves, some doctors and pharmacists believe it’s not being used as widely as it should.
Dr. Brian Conway is the medical director of the Vancouver Center for Infectious Diseases and an assistant professor in the Department of Pharmacology and Therapeutics at the University of British Columbia. He said the lack of uptake could be due to a number of factors, including restrictions on who can prescribe it and a lack of knowledge about the treatment, both among the public and medical professionals.
“It may be that we’re not prescribing it broadly enough,” Conway told CTVNews.ca. “My feeling is that when I talk to GPs who might be the front line, they don’t know. A lot of pharmacists I’ve had to work with and explain to them what this is. There hasn’t been a lot of effort to make sure everyone know what it is.”
HOW DOES IT WORK
According to Health CanadaPaxlovid is an antiviral drug in pill form that works best to limit the severity of COVID-19 when taken early in the course of an infection with mild to moderate symptoms.
Patients take two doses each day for five days, with each dose consisting of two pink nirmatrelvir tablets and one white ritonavir tablet. Nirmatrelvir is an antiviral drug that inhibits a SARS-CoV-2 protein to stop the virus from replicating, while ritonavir slows down the breakdown of nirmatrelvir to help it work in the body longer.
Eligible patients take medication at home after testing positive for COVID-19. According to the Ontario COVID-19 Scientific Advisory Board, side effects They are generally mild and can include an altered sense of taste, diarrhea, muscle pain, vomiting, high blood pressure, and headache.
WHO IS ELIGIBLE
In Canada, Paxlovid is approved for people who have tested positive for COVID-19 and who are at increased risk of developing severe symptoms of COVID-19 that could require hospitalization.
It’s up to the provinces and territories to prioritize who is eligible, but Health Canada says age is the strongest risk factor due to severe illness and hospitalization, with older adults who are unvaccinated or whose vaccinations are not up to date at greatest risk.
Other eligible adults include those who are immunocompromised and those who have serious underlying conditions, such as obesity or diabetes, and people age 60 and older who live in rural or remote underserved communities or congregate care settings.
paxlovid is not approved for people who have not tested positive for COVID-19, patients already being treated in the hospital for COVID-19, or anyone under the age of 18.
The drug interacts with dozens of common drugsincluding some heart medications, certain antibiotics, hormonal contraceptives, and those used to treat erectile dysfunction, blood cholesterol, and seasonal allergies.
It is also not recommended full strength for people with kidney problems. Anyone with kidney problems or who is taking a medication that may interact with Paxlovid should consult their healthcare provider.
Provinces and territories are in charge of prioritizing access to Paxlovid, so anyone with questions about their own eligibility should contact their local or provincial public health service or healthcare provider.
WHO CAN PRESCRIBE AND DISPENSE IT
Provinces and territories have the authority to decide who can prescribe and dispense Paxlovid, which Conway says has created a patchwork of policies that range from simple and streamlined to complicated and bureaucratic.
“So different provinces have different approaches, the simplest is if someone tests positive on a rapid test, they can communicate that result to a pharmacist or the pharmacist can do the test on the spot, and then the pharmacist can connect with a doctor. , a brief interaction occurs and the medication is prescribed,” Conway said. “So that’s the simplest thing.”
In other provinces, pharmacies can dispense Paxlovid, but only doctors and nurses can prescribe it. This is the case in Ontario and British Columbia.
“The most complicated [system] it’s potentially the one we have here in British Columbia, where there’s a form that needs to be filled out and they’ve established eligibility criteria for Paxlovid, and the person has to meet these requirements,” Conway said.
Conway says the process is so complicated that some doctors have chosen not to prescribe Paxlovid to avoid completing the paperwork.
in a Press release on July 11, Dr. Danielle Paes, Chief Pharmaceutical Officer of the Canadian Pharmacists Association, urged provincial governments to empower pharmacists to provide point-of-care testing and prescribe COVID-19 treatments such as Paxlovid
“Quebec was the first jurisdiction in the world to allow pharmacists to prescribe Paxlovid and saw a marked increase in the use of the COVID-19 antiviral, helping to keep patients out of hospitals. Other provinces have followed suit, but many have yet to enable this critical service,” said Dr. Paes.
“Paxlovid prescribed by a pharmacist is just one example of the kind of innovative community care that will reduce strain on our hospitals while expanding access to services and care that Canadians trust.”