Paxlovid: An overview
Paxlovid is an oral antiviral medication developed by Pfizer for treating mild to moderate COVID-19. It acts by inhibiting a protein essential for the metabolism of COVID-19 [1].
It has been authorised for use in adults and children over 12 years old, especially in vulnerable individuals [2, 3].
Paxlovid has exceptional results. Particularly in high-risk groups, paxlovid halved the mortality [2].
The treatment is most effective when initiated within 5 days of the onset of COVID-19 symptoms [2].
Paxlovid is sold as a combination of two active ingredients: nirmatrelvir and ritonavir. Nirmatrelvir is a protease inhibitor that blocks the replication of the COVID-19 virus [3]. Ritonavir is added to the treatment to elevate the level of nirmatrelvir in the body, enhancing its ability to combat the COVID-19 virus [4].
Paxlovid has shown potential in preventing the progression of COVID-19 to a severe form in adults [5].
Side effects of Paxlovid
Paxlovid has been associated with several side effects. Some of the
- Common side: foul taste in the mouth, malaise (general feeling of unwellness), muscle pain, diarrhoea, nausea, abdominal pain, and high blood pressure. It is often difficult to ascribe these specifically to Paxlovid vs COVID-19 symptoms.
More severe side effects of taking Paxlovid include:
- Allergic reactions
- Liver problems [2]
- Rebounds of COVID-19 symptoms (typically 2 to 8 days after completing a 5-day course of Paxlovid)
Can I Drink Alcohol While Taking Paxlovid?
The pharmacological interaction between alcohol and Paxlovid is not well-studied. It is recommended not to drink alcohol when feeling unwell, ill, or during high fever, as alcohol suppresses the body's immune response, making disease progression more likely [6]. Alcohol can potentiate the illness and even hamper the response to antiretroviral drugs similar to Paxlovid [7].
What will happen if I take alcohol while taking Paxlovid?
Drinking alcohol while taking Paxlovid can increase the risk of side effects or exacerbate symptoms of Covid-19. For instance, Covid-19 is associated with headaches, and alcohol could potentially worsen this side effect. Headaches have also been reported as a side effect of taking Paxlovid [6].
Alcohol can also increase the risk of developing acute respiratory distress syndrome, a severe complication of COVID-19 [6].
What should I do if I drank alcohol while taking Paxlovid?
As mentioned above, drinking alcohol can increase the risk of mild to moderate side effects, such as drowsiness or dizziness. It can also interfere with the effectiveness of the medication, meaning that you may need longer to recover from Covid-19. However, always consult a medical professional before increasing the duration of your treatment.
If you have drunk alcohol while taking Paxlovid, it's recommended to keep the alcohol content at a minimum. If you notice any unusual symptoms or side effects, contact your healthcare provider immediately to discuss a treatment management plan [8].
Interactions of Paxlovid
As an active drug that travels through the bloodstream and is metabolised in the liver, Paxlovid can interact with several other substances. These include:
Ritonavir (the antiviral-enhancer) increases the antiviral drug's activity by limiting its breakdown by Cytochrome P450 (CYP450), an essential metabolic enzyme for a spectrum of medication [9]. Therefore, ritonavir can also reduce the breakdown of other medication, leading to potential toxicity.
The most prominent of these include:
- Statins (cholesterol-lowering drugs) [10]. Patients taking statins may need to adjust their medication type or dose to avoid cardiovascular complications.
- Anti-seizure medication (e.g. phenytoin, phenobarbital) [8, 11].
- Immunosuppresant drugs (e.g. Voclosporin) [12, 11]
- Other medication: blood thinning medication, antipsychotics (e.g. clozapine), St. Johns Wart, and chemotherapeutic agents [11].
To summarise, you should not drink alcohol when taking Paxlovid due to the detrimental effects of alcohol on the immune system and the increased risk of side effects.