Who is currently recommended for oral use of COVID-19 antiviral drugs?

Patients are divided into several categories based on age, whether they have been vaccinated against COVID-19, whether they have co-immunodeficiency, and various clinical risk factors including obesity, diabetes, and cardiovascular disease:

Priority in the first category: immunosuppressed patients (whether or not vaccinated); Patients over 75 years of age who have not been vaccinated or patients over 65 years of age who have concomitant risk factors;
Priority ii: unvaccinated patients over 65 years of age or patients under 65 years of age with concomitant risk factors;
Priority iii: vaccinated patients older than 75 years or patients older than 65 years with comorbidities of risk factors;
Priority iv: vaccinated patients older than 65 years or younger with concomitant risk factors.

The use of Paxlovid has several considerations:

Patients with renal insufficiency should reduce the dosage of the drug or even prohibit the use of the drug;
Use with caution in patients with severely impaired liver function;
Pregnancy and breastfeeding: No clinical data are available on this drug in pregnant women and during breastfeeding. In animal experiments, the embryo weight was reduced after 10 times the human dose of Nirmatrelvir, and no other abnormalities affecting development were observed.
There is no data available on the drug in children, so the FDA-approved emergency authorization is for use in people over 12 years of age who weigh at least 40 years;
Paxlovid interacts with many commonly used drugs. Common lipid-lowering drugs, including statins, prostate drugs, antiarrhythmic drugs, antitumor drugs, anticoagulants, antifungal drugs, etc., all interact with Paxlovid and should be used cautiously or contraindicated.

Precautions for use of Molnupiravir:

Contraindicated in pregnant women (teratogenic);
For women of childbearing age, it is recommended to take contraceptive measures during and within 4 days after taking the medication;
Breast-feeding is not recommended for nursing women during and within 4 days after taking the medicine;
Therefore, it is recommended that men use contraception during treatment and within 3 months after treatment when having sex with women of childbearing age.
Because Molnupiravir may affect bone and cartilage development, it should not be used in people under 18 years of age.

It can be seen that the old Chinese saying “three drugs are poisonous” is also applicable to specific drugs for COVID-19. If you are infected with COVID-19, please consult your medical staff on whether you need to take oral antiviral drugs, how to use them, and precautions during use.

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