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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.

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 a 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 using these federal locators: COVID-19 Therapeutics Locator (arcgis.com) and 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.

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:

  • 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 a health care provider to determine if molnupiravir or Paxlovid is an appropriate treatment option for you. If it is determined that you would benefit from one of these treatments, the healthcare provider 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 federal locator: ASPR COVID-19 Medication Locator (arcgis.com). You or the healthcare provider may want to contact the pharmacy to determine availability of the product before submitting a 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, one monoclonal antibody product has Emergency Use Authorization (EUA) from the FDA and is recommended for treatment of COVID-19: Eli Lilly's bebtelovimab. Data indicates that bebtelovimab may be the only currently available monoclonal antibody treatment that is efficacious against the Omicron variant (both BA.1 and BA.2 sub-variants) of COVID-19. GSK's sotrovimab has been found to be unlikely to be effective against the BA.2 sub-variant and as of April 5th, 2022 is no longer authorized to treat COVID-19 in any U.S. state or territory due to increases in the proportion of COVID-19 cases caused by BA.2. Eli Lilly's bamlanivimab/etesevimab (bam/ete) and Regeneron's REGEN-COV (casirivimab/imdevimab), two other monoclonal antibody products, have likewise been de-authorized and should no longer be used for treatment of COVID-19 due to a lack of efficacy against the Omicron variant. Please refer to fda.gov for the latest therapeutic product information.

Am I Eligible to Receive Monoclonal Antibody Treatments?

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 bebtelovimab if you:

  • Have tested positive for COVID-19
  • Are at high risk1 for progression to severe COVID-19, including hospitalization or death
  • Are not able to access alternative COVID-19 treatments or these options are not clinically appropriate

To better understand your eligibility for treatment, you should consult a healthcare provider.

1
For information on medical conditions and factors associated with increased risk for progression to severe COVID-19, see the Centers for Disease Control and Prevention (CDC) website. Healthcare providers should consider the benefit-risk for an individual patient.

How Can I Get Monoclonal Antibodies?

To receive bebtelovimab, you should:

  • Have a positive test result for COVID-19
  • Be within 7 days of symptom onset
  • Receive a referral from a healthcare provide

How Are Monoclonal Antibodies Administered?

Eli Lilly’s bebtelovimab is administered through a single intravenous injection over at least 30 seconds. You must stay at the administration site for at least 1 hour after the injection is complete to be monitored for allergic reactions or other side effects.
 
What Are the Side Effects of Monoclonal Antibodies?

Bebtelovimab

Allergic reactions can occur during and after intravenous injection with this treatment. Tell a healthcare provider right away if you experience any of the following signs and symptoms of allergic reactions: fever, difficulty breathing, low oxygen level in your blood, chills, tiredness, fast or slow heart rate, chest discomfort or pain, weakness, confusion, nausea, headache, shortness of breath, low or high blood pressure, wheezing, swelling of your lips, face, or throat, rash including hives, itching, muscle aches, dizziness, feeling faint, and sweating. These reactions may be severe or life threatening.

The side effects of receiving any medicine by vein may include brief pain, bleeding, bruising of the skin, soreness, swelling, and possible infection at the injection site.

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

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 treatment 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?
Yes, getting vaccinated is a priority and updated CDC guidance states that it is not required to delay COVID-19 vaccination following receipt of monoclonal antibodies.


 
Updated: April 25, 2022