Paxlovid, Lagevrio, Remdesivir, Etc.: COVID-19 Drugs Compared

Why Compare COVID-19 Medications?

New variants of COVID-19 are continually emerging. The treatment guidelines that we’re supposed to be following are evolving all the time, too.

This leaves many people – including, perhaps, yourself – left with reasonable and even urgent questions.

For example:

Do I need an antiviral? Is Paxlovid still the best option? Is molnupiravir safer if I’m on multiple medications? Does remdesivir work better? And what about ivermectin or Tamiflu? Do they play any role in all of this?

Taking the time to compare all of these medications does matter.

Why?

Because each option is different:

Here, we’ll focus primarily on the medications that show up most often in patient searches – e.g., those “this versus that” comparisons, the things people search when they really don’t know what works, what doesn’t, and how to choose the right therapy when time matters.

This information should help.

Paxlovid (Nirmatrelvir + Ritonavir) Is Still the First-Line Outpatient Antiviral

Paxlovid is the most widely recommended outpatient COVID-19 treatment for high-risk adults.

It’s an oral antiviral taken twice a day for five days and must be started within five days of the first time you feel COVID-19 symptoms.

Here’s What Paxlovid Is And How It Works

Paxlovid combines two medications:

By having these two powerful medications grouped together in one relatively easy-to-take drug, patients can benefit from leveraging a dual-approach treatment.

These two ingredients together can help stop the virus from multiplying.

That, in turn, significantly reduces the likelihood of severe illness, hospitalization, or death.

And Here’s Who Paxlovid Is For

Paxlovid is generally prescribed for:

When a patient qualifies as high risk for these or other reasons, usually, doctors and healthcare teams tend to think of Paxlovid as the preferred first-line oral treatment.

Paxlovid 150 vs 300 mg – Is There a Difference?

Typically, Paxlovid treatment regimens feature Paxlovid at one of two doses: 150 mg and 300 mg of one of the two active ingredients, nirmatrelvir.

That lower dose of nirmatrelvir is specifically for people with moderate kidney impairment. (This medication is processed by the kidneys, which can make it tough on the kidneys if your kidneys are already going through a lot!).

The standard dose is perfectly fine for most other adults.

Here’s When NOT to Use Paxlovid

Paxlovid can be helpful for many people in many situations.

Like most powerful drugs, though, it’s not perfect for everyone, all the time, always.

If you meet any of the following conditions, it may be worth exploring your options or discussing your eligibility for Paxlovid with your doctor:

If you do meet these conditions, your healthcare provider will help you figure out what alternative COVID-19 drug may be best for you.

Lagevrio (Molnupiravir) vs Paxlovid

If Paxlovid is a bit too intense for you and you’re seeking a safer, gentler, or more accessible alternative, you might be a good candidate for Lagevrio (or its generic, molnupiravir).

While Lagevrio can be easier to work with in some ways – it is, for example, easier to prescribe – it can also be a less effective option.

That doesn’t have to be a bad thing.

Depending on your health situation and goals, Lagevrio may be a good pick for you.

Here’s How Lagevrio Works

Molnupiravir, the active ingredient in Lagevrio, works by introducing strategic errors into the virus’s genetic material.

These new genetic errors prevent the virus that causes COVID-19 from replicating in your body, the way it normally would.

This is a different way of shutting down the virus than Paxlovid’s, but the goals of the two medications are the same:

Slow viral replication early to reduce condition severity.

The Key Difference Between Paxlovid and Remdesivir Is Effectiveness

We noted above that Lagevrio may not be as effective as Paxlovid for most people.

That does seem to be the case.

The studies we have access to about these meds consistently show:

Now, this doesn’t mean that Lagevrio doesn’t have its valid use cases.

If you’re in a situation where …

…then Lagevrio might be a good option to pursue.

Who Can Take Lagevrio?

The ideal candidate for Lagevrio is an adult with mild to moderate COVID-19 who is at high risk for progression and is not a good candidate for other treatments.

Lagevrio Does Have Some Major Safety Notes

Lagevrio itself does have some situations in which it should not be used, or potential challenges that patients need to take into consideration before they decide to take it.

For example:

What About Molnupiravir vs Paxlovid?

Molnupiravir is the generic name for Lagevrio, so the same general takeaways as Lagevrio vs. Paxlovid remain consistent.

While Paxlovid tends to show a strong reduction in hospitalization and death associated with COVID-19 when taken as directed, molnupiravir may not be as effective.

Still, if you’re not a good candidate for Remdesivir or Paxlovid, molnupiravir or brand Lagevrio may be worth being aware of.

Remdesivir vs Paxlovid: How Do They Compare?

If Lagevrio is considered a solid second-line treatment, a good backup option when compared to both Remdesivir and Paxlovid, that begs a follow-up question:

Which is better – Remdesivir or Paxlovid?

Both Remdesivir and Paxlovid are antiviral treatments for early COVID-19.

They are, however, used in very different ways.

While Paxlovid is a series of oral tablets you can take at home, Remdesivir is an intravenous infusion that requires dosing within a medical facility.

Because Remdesivir requires in-clinic dosing (usually three consecutive daily infusions for outpatient treatment), access to it does tend to be a bit more limited.

Generally, if it’s an option, doctors tend to recommend Paxlovid as a first-line outpatient option since it’s very effective and much more convenient.

Who Benefits Most from Remdesivir?

If Paxlovid is the #1 choice most of the time, which patients might actually want to consider Remdesivir first?

Here’s the quick list:

For most people, Paxlovid remains the practical option.

Remdesivir is the go-to alternative when Paxlovid is contraindicated.

Paxlovid vs Ivermectin

In the early days of the COVID-19 pandemic, there was a large amount of misinformation spread about ivermectin. Some of that latent data may still be causing some confusion, so, let’s take a moment to keep things simple, clear, and easy to understand.

Is Ivermectin an antiviral?

No.

Ivermectin is an antiparasitic medication.

It is not an antiviral drug and is not authorized or recommended for the treatment of COVID-19.

Why the confusion?

Early lab studies (in cell cultures) showed ivermectin could inhibit viral replication.

However, if we look a bit closer, we can realize that ivermectin only does this at concentrations far higher than the human body can safely tolerate.

So, what about Paxlovid vs. ivermectin?

Paxlovid is an health regulator-authorized COVID-19 medication that is associated with a strong, consistent benefit when taken as directed.

Ivermectin is not recommended for use in treating COVID-19.

Tamiflu vs Paxlovid

Tamiflu (oseltamivir) and Paxlovid are compared quite frequently, and that makes sense. They both treat viral infections, and they both do so effectively.

They do treat different viral infections, though.

Here’s What Tamiflu and Paxlovid Treat

For better or worse, there is no overlap.

Tamiflu does not treat COVID-19, and Paxlovid does not treat the flu.

Here’s How Tamiflu and Paxlovid Work

Tamiflu works by blocking something called “neuraminidase,” a flu-specific enzyme the virus needs to replicate. If the virus can’t replicate, it’ll die out – and the disease will end, and you’ll heal.

Paxlovid, in a similar way, blocks a SARS-CoV-2 protease to stop COVID-19 viral replication.

Here’s When to Take Each

The short answer, here, is simple – it’s “as soon as possible.”

Once you start feeling symptoms, call your doctor, there’s no reason to delay.

Ideally, you’d start taking Tamiflu within 48 hours of first flu symptom onset.

Paxlovid, on the other hand, must be started within 5 days of COVID-19 symptom onset. If it’s been six days, you may need to consider other treatment options.

Patient Guide: How to Choose the Right COVID-19 Treatment

The best way to choose the right COVID-19 treatment for your condition is not to do so alone!

Talk to your trusted healthcare team or a doctor at your local healthcare facility. They’re trained to know the latest options and how they may interact with any other medications or affect your health goals.

It doesn’t hurt to know your options, though.

Just remember that because COVID-19 therapies are highly time-sensitive, decision-making often comes down to urgency and eligibility rather than patient preference.

Start with these questions:

Once you and your doctor have determined which of these COVID-19 medications is best for you and your goals, follow their advice, but remember to listen to your body.

If you have any questions our pharmacists or friendly team members can assist with here at NorthWestPharmacy.com, feel free to reach out. We remain committed to you and your health!