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Prevention and Treatment of COVID-19

Are you a health care provider looking for information on COVID-19 therapeutics? Visit the provider prevention and treatment page.

There are now multiple COVID-19 prevention and treatment options authorized by the FDA for emergency use:

Individuals with questions about COVID-19 prevention or treatment options are encouraged to speak with a trusted healthcare professional. These professionals may be able to help you determine if you are eligible for one of these medicines.

You can find locations for prevention medicines and treatment at Therapeutics Distribution | HHS Protect Public Data Hub.

These medicines are not substitutes for vaccination against COVID-19. Vaccines remain the best protection available to prevent COVID-19. FDA has authorized three vaccines to prevent COVID-19 and serious clinical outcomes caused by COVID-19, including hospitalization and death, and we encourage you to get vaccinated and receive your booster if eligible.

Pre-Exposure Prevention

What Is Pre-Exposure Prevention (PrEP) And How Does It Work?
PrEP medicines are designed to proactively protect certain individuals from COVID-19 infection prior to exposure.

These medicines use monoclonal antibodies (laboratory-made proteins that mimic the immune system's ability to fight off harmful pathogens) to block the COVID-19 virus' attachment and entry into human cells.

What Medicines Are Available?
In the United States, AstraZeneca's Evusheld (tixagevimab co-packaged with cilgavimab and administered together) is the only product currently authorized for pre-exposure prevention.

Am I Eligible to Receive PrEP?
Evusheld is only authorized for adults and pediatric individuals (12 years of age and older weighing at least 40 kilograms [about 88 pounds]) who are not currently infected with COVID-19 virus and who have not recently been exposed to an individual infected with COVID-19.

The authorization also requires that individuals either:

  • have moderate to severely compromised immune systems and may not mount an adequate immune response to COVID-19; or
  • are recommended to not receive vaccination against COVID-19.

What Are the Side Effects of PrEP?
Possible side effects of Evusheld include: allergic reactions (including anaphylaxis), cardiac events, bleeding at the injection site, headache, fatigue and cough. 

How Can I Get PrEP?
You should talk with your health care provider to determine whether Evusheld is an appropriate pre-exposure prevention option for you.

Due to limited supply of Evusheld, product will only be stocked in certain locations across the Commonwealth, which can be found here: COVID-19 Public Therapeutic Locator | HealthData.gov.

If you have specific inquiries about obtaining Evusheld, you can get in touch with one of these locations using the information found here. You may also contact COVID19therapeutics@hhs.gov to ask questions regarding how to obtain Evusheld.

How Is PrEP Administered?
Evusheld is administered as two intramuscular injections given in immediate succession.

How Much Does PrEP Cost?
Check with your insurance provider to determine the cost of PrEP medicines.

Post-Exposure Prevention

What Is Post-Exposure Prophylaxis (PEP, or Post-Exposure Prevention) And How Does It Work?
PEP medicines are designed to proactively protect certain individuals who have been exposed to the COVID-19 virus from infection.

These medicines use monoclonal antibodies (laboratory-made proteins that mimic the immune system's ability to fight off harmful pathogens) to block the COVID-19 virus' attachment and entry into human cells.
 
What PEP Medicines Are Available?
In the United States, there are two products with emergency use authorizations (EUA) from the FDA for post-exposure prophylaxis:

Am I Eligible to Receive PEP Medicines?
You may be eligible if you are:

  • At high risk for progression to severe COVID-19, including hospitalization or death, and
  • Not fully vaccinated or not expected to mount an adequate immune response to complete vaccination (for example, if you have immunocompromising conditions, including taking immunosuppressive medicines), and
    • have been exposed to an individual infected with COVID-19, or
    • are at high risk of exposure to an individual infected with COVID-19 because that individual is in the same institutional setting (for example, the same nursing home or detention facility)

High risk reasons for more serious symptoms include, but are not limited to:

  • Age ≥ 65 years
  • Obesity or being overweight based on Centers for Disease Control and Prevention clinical growth charts
  • Pregnancy
  • Chronic kidney disease
  • Diabetes
  • Immunosuppressive disease or immunosuppressive treatment
  • Heart or circulatory conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure
  • Chronic lung diseases including COPD, asthma, interstitial lung disease, cystic fibrosis, and pulmonary hypertension
  • Sickle cell disease
  • Neurodevelopmental disorders such as cerebral palsy
  • Having a medical device

To better understand your eligibility for PEP, you should talk to your health care provider.

How Can I Get PEP Medicines?
You can receive a PEP medicine if you:

  • Have been exposed to COVID-19 via:
    • interacting with an individual who tests positive for COVID-19
    • living in the same institutional setting as an individual who tests positive for COVID-19
  • Receive a referral from your health care provider

You can find locations for post-exposure prevention medicines at Therapeutics Distribution | HHS Protect Public Data Hub.

How Is PEP Administered?
Regeneron's REGEN-COV (casirivimab plus imdevimab) and Eli Lilly's bamlanivimab plus etesevimab (bam/ete) are administered through a one-time intravenous (IV) infusion. The infusion takes about one hour to complete, and you must stay at the infusion center for another hour to be monitored for allergic reactions or other side effects. REGEN-COV may also be administered via subcutaneous injection.

What Are the Side Effects of These Medicines?
Allergic reactions can occur during and after infusion with these medicines. Tell your healthcare provider right away if you get any of the following signs and symptoms of allergic reactions: fever; chills; nausea; headache; shortness of breath; low blood pressure; wheezing; swelling of your lips, face, or throat; rash, including hives; itching; muscle aches; and/or dizziness.

An infusion of any medicine may cause brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion site.

The most common side effects for Eli Lilly's bamlanivimab plus etesevimab are:

  • Fever
  • Difficulty breathing
  • Rapid/slow heart rate
  • Tiredness
  • Weakness
  • Confusion

The most common side effects for Regeneron's REGEN-COV are:

  • Nausea
  • Vomiting
  • Hyperglycemia
  • Pneumonia

Potential side effects of sotrovimab include anaphylaxis and infusion-related reactions, rash, and diarrhea.

These are not all the possible side effects of these medicines. Serious and unexpected side effects may occur.

How Much Do PEP Medicines Cost?
Check with your insurance provider to determine the cost of PEP medicine.

COVID-19 Treatments

What Are COVID-19 Treatments and How Do They Work?
Treatment for COVID-19 is designed to protect certain individuals who test positive for COVID-19 from progressing to more severe infections.

There are multiple treatment options for COVID-19 infections. Oral antiviral medications are pills that can be taken at home, while monoclonal antibodies are administered through a one-time intravenous (IV) infusion.

Oral Antiviral Medications

What Oral Antivirals Are Available for Treatment of COVID-19?
In the United States, there are two oral antiviral medications with emergency use authorizations (EUA) from the FDA for treatment of COVID-19. Please visit the webpages below for complete information about these products.

Am I Eligible to Receive Oral Antivirals?
You may be eligible for molnupiravir if you are an adult who has tested positive for COVID-19 and:

  • have mild-to-moderate COVID-19 symptoms
  • are at high risk for progression to severe COVID-19, including hospitalization or death, and

You may be eligible for Paxlovid if you are an adult or pediatric individual (12+ years of age and weighing at least 40 kg [88 pounds]) who has tested positive for COVID-19 and:
mild-to-moderate COVID-19 symptoms and:

  • have mild-to-moderate COVID-19 symptoms
  • are at high risk for progression to severe COVID-19, including hospitalization or death, and

High risk reasons for more serious symptoms include:

  • Age ≥ 65 years
  • Obesity or being overweight based on Centers for Disease Control and Prevention clinical growth charts
  • Chronic kidney disease
  • Diabetes
  • Immunosuppressive disease or immunosuppressive treatment
  • Heart or circulatory conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure
  • Chronic lung diseases including COPD, asthma, interstitial lung disease, cystic fibrosis, and pulmonary hypertension
  • Sickle cell disease
  • Neurodevelopmental disorders such as cerebral palsy
  • Having a medical device

How Can I Get Oral Antivirals?

Talk with your health care provider to determine if molnupiravir or Paxlovid is an appropriate treatment option for you. If it is determined by your doctor that you would benefit from one of these treatments, your doctor will write you a prescription for the appropriate medication. There are a limited number of pharmacies that currently have these products. These pharmacies can be found using the links below or through this locator: COVID-19 Public Therapeutic Locator | HealthData.gov. You or your doctor may want to contact the pharmacy to determine availability of the product before submitting the prescription.

How Are Oral Antivirals Administered?
Molnupiravir is administered as 4 capsules every 12 hours for 5 days. It is important that patients complete the full 5 days of treatment with molnupiravir, even if they feel better.

Paxlovid consists of 2 medicines: nirmatrelvir and ritonavir. Patients should take 2 tablets of nirmatrelvir (150 mg) with 1 tablet of ritonavir (100 mg) by mouth twice daily (in the morning and in the evening) for 5 days. For each dose, all 3 tablets should be taken at the same time.
 
What Are the Side Effects of Oral Antivirals?
Common side effects of molnupiravir are diarrhea, nausea, and dizziness.
 
Paxlovid is contraindicated in patients with a history of clinically significant hypersensitivity reactions [e.g., toxic epidermal necrolysis (TEN) or Stevens-Johnson syndrome] to its active ingredients (nirmatrelvir or ritonavir) or any other components of the product.

Potential side effects of Paxlovid include, but are not limited to:

  • Liver problems
    • Signs and symptoms of liver problems include loss of appetite, yellowing of the skin and the whites of the eyes (jaundice), dark-colored urine, pale-colored stools and itchy skin, or stomach area (abdominal) pain
  • Resistance to HIV Medicines
  • Altered sense of taste
  • Diarrhea
  • High blood pressure
  • Muscle aches

Monoclonal Antibodies

What Monoclonal Antibodies Are Available for Treatment of COVID-19?
In the United States, there are three products with emergency use authorizations (EUA) from the FDA for treatment of COVID-19:

Please note that early data indicates that sotrovimab may be the only currently available monoclonal antibody that remains efficacious against the Omicron variant of COVID-19.

Am I Eligible to Receive Monoclonal Antibodies for Treatment of COVID-19?
Depending on your age, health history, and how long you've had symptoms of COVID-19, you may qualify for treatment. You may be eligible for certain treatment options if you:

  • Have tested positive for COVID-19
  • Are experiencing mild or moderate symptoms of COVID-19
  • Experienced your first symptoms of COVID-19 in the last 10 days (optimally before 7 days; earlier intervention likely leads to better results)
  • Are at high risk for having more serious symptoms of COVID-19 and/or needing to go to the hospital

High risk reasons for more serious symptoms include, but are not limited to:

  • Age ≥ 65 years
  • Obesity or being overweight based on Centers for Disease Control and Prevention clinical growth charts
  • Pregnancy
  • Chronic kidney disease
  • Diabetes
  • Immunosuppressive disease or immunosuppressive treatment
  • Heart or circulatory conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure
  • Chronic lung diseases including COPD, asthma, interstitial lung disease, cystic fibrosis, and pulmonary hypertension
  • Sickle cell disease
  • Neurodevelopmental disorders such as cerebral palsy
  • Having a medical device

To better understand your eligibility for treatment, you should talk to your health care provider.

How Can I Get Monoclonal Antibodies?
To receive treatment for COVID-19, you should:

  • Have a positive test result for COVID-19
  • Be within 10 days of symptom onset (optimally before 7 days; earlier intervention likely leads to better results)
  • Receive a referral from your health care provider

You can find locations for COVID-19 treatments at Therapeutics Distribution | HHS Protect Public Data Hub.

How Are Monoclonal Antibodies Administered?
Regeneron's REGEN-COV (casirivimab plus imdevimab), Eli Lilly's bamlanivimab plus etesevimab (bam/ete), and GSK's sotrovimab are administered through a one-time intravenous (IV) infusion. The infusion takes about one hour to complete, and you must stay at the infusion center for another hour to be monitored for allergic reactions or other side effects. Although infusion is the recommended form of administration for treatment, REGEN-COV may also be administered via subcutaneous injection.
 
What Are the Side Effects of Monoclonal Antibodies?
Allergic reactions can occur during and after infusion or injection with these treatments. Tell your healthcare provider right away if you get any of the following signs and symptoms of allergic reactions: fever; chills; nausea; headache; shortness of breath; low blood pressure; wheezing; swelling of your lips, face, or throat; rash, including hives; itching; muscle aches; and/or dizziness.

An infusion/injection of any medicine may cause brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the infusion/injection site.

The most common side effects for Eli Lilly's bamlanivimab plus etesevimab are:

  • Fever
  • Difficulty breathing
  • Rapid/slow heart rate
  • Tiredness
  • Weakness
  • Confusion

The most common side effects for Regeneron's REGEN-COV are:

  • Nausea
  • Vomiting
  • Hyperglycemia
  • Pneumonia

Potential side effects of sotrovimab include anaphylaxis and infusion-related reactions, rash and diarrhea.

These are not all the possible side effects of treatment. Serious and unexpected side effects may happen.

What Should I Do After Receiving Monoclonal Antibody Treatment?
Even if you start feeling better, you could still spread the virus. Isolate at home until all the following occur:

  • At least 10 days have passed since your first symptoms of COVID-19;
  • You haven't had a fever in at least 24 hours, without taking any fever-reducing medicine; and
  • Your other symptoms of COVID-19 are improving.

How Much Does Monoclonal Antibody Treatment Cost?
Check with your insurance provider to determine the cost of treatment.

Can I Receive Monoclonal Antibody Treatment If I Have Received a COVID-19 Vaccine?
Yes, you are eligible for treatments if you received one or more doses of a COVID-19 vaccine.

Can I Receive a COVID-19 Vaccine If I Had Monoclonal Antibody Treatment?
You should not be vaccinated for COVID-19 within 90 days of treatment.

 
Updated: January 10, 2021