Some Texas pharmacies now have two oral medications to treat the symptoms of COVID-19.
The U.S. Food and Drug administration granted emergency use authorization to molnupiravir and Paxlovid, which can help prevent a mild or moderate case of COVID-19 from becoming severe.
Kunal Nagarsheth, the pharmacist at Liberty Pharmacy in Georgetown, spoke to the Texas Standard about how the drugs work, and who’s eligible to receive them. Listen to the interview with Nagarsheth in the audio player above or read the transcript below.
This interview has been edited lightly for clarity.
Texas Standard: Tell us a little bit about these two oral medications for COVID-19. I think it’s safe to say that a lot of listeners may not have heard about or only heard about them peripherally. What are they called? How do they work?
Kunal Nagarsheth: There’s two medications that have just received FDA emergency use authorization in December. One is molnupiravir and the other one is Paxlovid. They’re both used for people who are with mild to moderate, lab-confirmed COVID-19 infections. So, both molnupiravir and Paxlovid bid inhibit viral replication, and so they help reduce the progression to severe COVID or hospitalizations.
Given that there’s currently a limited supply of these drugs available, who’s eligible to receive them, and have you been seeing much demand?
These medications can only be prescribed by a physician or a physician’s assistant or a nurse practitioner. The molnupiravir, you have to, first of all, be 18 years of age and older, whereas the Paxlovid is approved for ages 12 and up as long as they meet 40 kg weight requirement. They have to be what we call ambulatory patients, so people who are able to walk, are able to do normal daily activities without losing their their breath. So, for example, somebody with mild to moderate COVID-19 would have fever, cough. They would not have any shortness of breath just doing normal stuff.
Do you have to explicitly ask your doctor to prescribe if you’ve if you’ve tested positive for the virus?
Since I have not been on that side of things, I think that would generally be the way. Part of the way that it would be prescribed is if somebody has a positive COVID test and they go see their doctor. As long as it’s been within five days of symptom onset, among other other things to consider, they would be eligible in some ways to receive one of these medications.
What about side effects? What are you hearing when it comes to things people need to be aware of?
The side effects that we’re seeing in those small clinical trials that they have done are very minimal, really, some of these side effects, it’s hard to distinguish – is it a COVID infection that’s causing it or is it the medication? So, things like diarrhea, things like altered perception of taste, those kinds of things are what they commonly saw in those trials.
And they do have some clinical considerations like pregnancy and males who are of reproductive age, something to be considered with the prescribing of the molnupiravir. Whereas the Paxlovid, you worry about a lot of drug interaction, some which can be managed clinically and some which would just be a contraindication to using the medication.
Is there any particular reason why yours and just a small number of other pharmacies in Texas are the only ones with these pills? Is there any reason why they’re not more widely available?
I think it’s a supply issue from my understanding, right now, just kind of like the vaccine rollout. It’s like déjà vu in a lot of ways that, you know, they start off with a limited supply, try to distribute them to the areas of highest need, and they’re going to be rolling it out as the supply increases. So molnupiravir is more readily available right now than Paxlovid.
