There is widespread discussion about which medications to take or not to take during the COVID-19 pandemic. NCOA offers this guide for older adults to use while consulting with their health care providers.
Medications approved for the treatment of COVID-19
If you test positive for COVID-19, treatments are available that can decrease your chances of getting seriously ill and dying from COVID. People who are more likely to get very sick:
- Adults age 50 and older (with risk increasing with age)
- People who are not vaccinated against COVID-19
- People with certain medical conditions, such as chronic lung disease, heart disease, or a weakened immune system.
Medications to treat COVID-19 must be prescribed by a health care provider, including your pharmacist. And for treatment to be effective, it must be started within days after you first develop COVID symptoms.
Contact a health provider right away to see if you are eligible for treatment, even if your symptoms are mild right now. Check with your health care provider or pharmacist if you are taking any medications to make sure the COVID-19 treatments can be safely taken at the same time.
Types of COVID-19 treatments
The U.S. Food and Drug Administration (FDA) has authorized certain medications to treat mild to moderate COVID-19 in people who are more likely to get very sick:
- Antiviral treatments target specific parts of the virus to stop it from multiplying in the body, helping to prevent severe sickness and death.
- Monoclonal antibodies help the immune system recognize and respond more effectively to the virus.
The following table gives a summary of FDA-authorized COVID treatments:
| Treatment | When given | How given |
|
Nirmatrelvir with Ritonavi Antiviral | Start as soon as possible: must begin within 5 days of when symptoms start | Taken at home by mouth (orally) |
|
Remdesivir (Veklury) Antiviral | Start as soon as possible; must begin within 7 days of when symptoms start | Intravenous (IV) influsions at a health care facility for 3 consecutive days |
|
Molnupiravir (Lagevrio) Monoclonal antibody | Start as soon as possible; must begin within 5 days of when symptoms start | Taken at home by mouth (orally) |
Some treatments might have side effects or interact with other medications you are taking. As your health care provider if medications to treat COVID-19 are right for you. If you don't have a health care provider, contact your local community health center or health department.
If you are hospitalized with COVID-19, your helath care provider might use other types of treatments, depending on how sick you are. These could include medications to treat the virus, reduce an overactive immune response, or treat COVID-19 complications.
What is Paxlovid rebound?
You may have heard that some people, including President Joe Biden and First Lady Jill Biden, got a second or 'rebound' COVID-19 infection after being treated with Paxlovid. Recent reports show that some patients with normal immune response who take a five-day course of Paxlovid for laboratory-confirmed infection and recover, testing negative for COVID-19, can then test positive and have COVID symptoms 2 to 8 days later, including patients who have been vaccinated and/or boosted.
The Centers for Disease Control and prevention reports that both the recurrence of illness and positive test results improved or resolved after about three days without additional anti-COVID-19 treatment. Federal health officials believe the cases of so-called "COVID-19 rebound" did not mean reinfection with coronavirus or the development of resistance to Paxlovid. The CDC continues to recommend Paxlovid early stage treatment of mild to moderate COVID-19 among people at high risk for becoming seriously ill.1 And Paxlovid also might reduce the chances of getting Long COVID.2
Medications NOT approved for the treatement or prevention of COVID-19
Hydroxycholoroquine (Plaquenil®)
You might have heard about the use of hydroxychloroquine (Plaquenil®) plus azithyromycin (Z-pack®) to prevent or reduce the impact of COVID-19. Other reports include chloroquine or quinine in place of hydroxychloroquine. No large-scale clinical studies have been conducted that show that these medications are safe and effective for treating coronavirus.
Hydroxycholoroquine is a prescription drug that is an essential medication for many people with autoimmune disorders such as rheumatoid arthritis, lupus, Crohn’s disease, or other such conditions. Unfortunately, the hype and disinformation about these medications has caused them to be hoarded by some people, making them no longer available for people who need them each day. Chloroquine is used to treat malaria. Some people have found these ingredients in other products and been poisoned. The medications definitely have side effects and should only be taken if directed by your doctor.
Medications used for fever
A French health official gave an update that indicated nonsteroidal anti-inflammatory drugs, also called NSAIDs, should be avoided if you have COVID-19 disease and a fever. Medications in this category include ibuprofen (Motrin®, Advil®); naproxen (Aleve®); meloxicam (Mobic®); and celecoxib (Celebrex®).
Since that report came out, doctors and pharmacists have been reviewing the concerns presented in the statement. U.S. officials have not found enough evidence to support the statement. If you already take one of these medications, please continue to take it and talk with your doctor if you have concerns.
If you have a healthy liver, then take acetaminophen (Tylenol®) for your fever.
Besides any impact on your ability to fight COVID-19, NSAIDs can upset your stomach (so take with food), can raise your blood pressure, and can worsen your kidney function if taken for a long time. So, unrelated to COVID-19, use these medications for pain, fever, or inflammation sparingly or under the guidance of your doctor. Do not take higher than the recommended dose.
Medications used for high blood pressure
A scientist posted a theory from animal data (mostly mice) that certain blood pressure medications might be a poor choice during the COVID-19 pandemic. Almost immediately, other scientists and doctors had an opposite theory that they might actually help if someone ends up with pneumonia from COVID-19. So, since there is no evidence that these medications have either hurt or helped anyone with COVID-19, experts are encouraging people to stay on them. If you are concerned, please DO NOT STOP your medication. Talk with your doctor about your concerns.
These medications include angiotensin converting enzyme inhibitors (called ACE inhibitors). ACE inhibitor medication chemical names end in -pril, such as lisinopril and enalapril. Also, angiotensin receptor blockers (called ARBs). ARBs chemical names end in -sartan, such as losartan. Many people take these for high blood pressure, kidney disease, heart failure, and other conditions.
The bottom line is...
DO NOT change any of your medications without talking with your doctor or pharmacist. Ask questions of medical professionals about your health concerns.
This article, originally published on Sept. 13, 2022, was updated on March 29, 2023 to reflect updated federal health approval and guidance.
Sources
1. Centers for Disease Control and Prevention. COVID-19 Rebound After Paxlovid Treatment. CDC Health Advisory. May 24, 2022. Found on the internet at https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_467.pdf
2. Department of Veterans Affairs. Paxlovid reduces risk of Long COVID. Nov. 6, 2022. Found on the internet at https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5837
