Pfizer’s Paxlovid and Merck’s Molnupiravi, two oral drugs for the treatment of COVID-19, have been supplied to Hong Kong one after another. How can the public get prescriptions for this drug? Those kinds of people should not use it? And “conflict” with those drugs? This article invites Xu Shuchang, chair professor of the Department of Respiratory System of the Chinese University, and Cui Junming, president of the Society of Pharmacists, to dismantle the top ten common questions of citizens.
Q1 Who is the oral medicine suitable for?
Pfizer: People 12 years of age or older, including pregnant or breastfeeding women.
Merck: People over the age of 18, including those with kidney or liver failure.
Both are suitable for high-risk individuals including those with chronic diseases such as diabetes, lung or heart problems, obesity (BMI over 30), immune system disorders such as cancer, those who need to take drugs that suppress the immune system, and those who have not been vaccinated.
Q2 Who should not take it?
Pfizer: Not suitable for those with severe kidney and liver problems, and those with moderate liver and kidney problems may reduce the dose after evaluation by the doctor.
Merck: The drug affects the growth of the fetus and baby, not suitable for pregnant and breastfeeding women; also affects the growth of bone and cartilage, not suitable for people under the age of 18.
Q3 What are the side effects?
Pfizer: Diarrhea, increased blood pressure, muscle pain.
Merck: Diarrhea, headache, skin rash, nausea and stuffiness.
Q4 How effective is it?
Pfizer: The risk of hospital admission and death can be reduced by 89%.
Merck: The risk of hospital admission and death can be reduced by 30%.
Q5 When is the best time to take oral medicine?
People with mild symptoms should take it as soon as possible. It is ideal to take it within the first 5 days of the onset, when there is no obvious respiratory failure, and the blood oxygen is above 94%.
Q6 Where can I get oral medicines?
Public hospitals and government-designated clinics can prescribe prescriptions for confirmed patients who are hospitalized or seeking medical treatment according to clinical guidelines and patient conditions; confirmed patients in residential care homes for the elderly can be prescribed by doctors according to clinical guidelines; some private hospitals are also loaned by the HA. Take the medicine, but the assigned amount is small.
Q7 How long does the medication course take?
The patient must take the drug for 5 days, twice a day. During the period, no matter whether the condition deteriorates or recovers, the patient cannot stop the drug rashly, otherwise the virus may develop drug resistance.
Q8 Can it be taken with other medicines?
Pfizer: “Clashing” with multiple drugs, and taking them at the same time can cause serious side effects or ineffectiveness. Serious or life-threatening side effects can occur when taken with statin cholesterol drugs such as Lovastatin and Simvastatin. (see list for details)
Merck: No interactions with other drugs have been found so far.
Q9 Can it be purchased at a pharmacy?
There are currently only two oral medicines purchased by the Hospital Authority in Hong Kong, so do not believe other people claiming that they can sell the same medicine.
Q10 If a child under the age of 12 is diagnosed, are there any oral medicines available?
There is currently no oral medicine suitable for children under the age of 12, and doctors recommend vaccination to enhance protection.
Source: Xu Shuchang, Chair Professor of Respiratory System, CUHK; Cui Junming, President of the Society of Pharmacists
The drug that “contradicts” with the new coronary pneumonia oral drug Pfizer’s Paxlovid
Serious or life-threatening side effects when taken together:
1. Benign prostatic hypertrophy: Alfuzosin
2. Elegance analgesics: Pethidine, Propoxyphene
3. Angina pectoris: Ranolazine
4. Arrhythmias: Amiodarone, Dronedarone, Flecainide, Propafenone, Quinidine
5. Uric acid: Colchicine
6. Schizophrenia: Lurasidone, Pimozide, Clozapine
7. Migraine: Dihydroergotamine, Ergotamine, Methylergometrine
(Methylergonovine)
8. Cholesterol lowering: Lovastatin, Simvastatin
9. Pulmonary Hypertension: Sildenafil for Pulmonary Hypertension (Revatio®)
10. Sedatives: Triazolam, Oral Midazolam
Concomitant use can cause oral medicines to fail:
Apalutamide, St. John’s Wort, Carbamazepine, Phenobarbital, Phenytoin, Rifampin
Source: Xu Shuchang, Chair Professor of Respiratory System, CUHK; Cui Junming, President of the Society of Pharmacists