The US Food and Drug Administration (FDA) has recently approved two drugs for curing certain high-risk covid patients. First, it authorized Pfizer’s Paxlovid on Wednesday, 22 December, and one day later, Merck’s Molnupiravir. The authorization of these antiviral pills enhanced the US arsenal of medication against the viral surge caused by the Omicron variant. Before the covid pill, the FDA only approved Veklury’s Remdesivir, an antiviral drug administered through injection, to treat covid positive patients. However, oral antiviral treatment is available, and both medicines have shown promising results in clinical trials of humans treated soon after the diagnosis.
Unlike Remdesivir, pills would be less expensive, and patients can administer them easily at home before getting sick enough to be hospitalized. Health experts are optimistic that the authorized medications can change the course of the pandemic. They are also reportedly effective against the Omicron variant and all future coronavirus strains. However, both drugs also have limitations regarding who can take them and who cannot.
Pfizer’s Covid Pill is 90% Effective in Cutting Death Rate
Paxlovid is allowed for individuals aged 12 and above with mild-to-moderate disease, at high risk of getting worse. Reportedly, it is administered as 3 pills (2 Nirmatrelvir and 1 Ritonavir) two times daily for 5 days, i.e. 30 tablets in total. It can only be taken thorough prescription within 5 days since symptoms start and cannot be used for more than 5 days.
Paxlovid’s trial result published in November reportedly showed that it cut the rate of covid-related hospitalizations and deaths by nearly 90% in high-risk patients. The 28-day trial of more than 2,200 individuals showed no casualties in the Paxlovid arm, but 12 people died in the placebo arm. In clinical terminology, a placebo arm represents a group of people who receive inactive drugs instead of the one being tested.
Pfizer’s covid pill also comes with side effects: loss of sense of taste, high blood pressure, muscle pain, and diarrhoea. Furthermore, the Ritonavir it contains can cause liver damage. The authority urged extreme caution in administering the pill to patients with pre-existing liver conditions. It also did not recommend Paxlovid to people with severe kidney or liver damage. The FDA also advised that it may cause drug-drug interaction and develop HIV drug resistance in those who have undiagnosed or uncontrolled HIV. Those already taking drugs that induce the same enzymes as Paxlovid must not go for this oral treatment. FDA warned that elevated concentrations of certain medications could result in life-threatening reactions, and it was mandatory to consult a healthcare professional before using the drug.
Can Merck’s Covid Pill Cover Where Pfizer Lacks?
The second covid pill authorized by FDA showed less efficacy than Pfizer’s in clinical trials. According to reports, it has been shown to reduce hospitalization and death rates of high-risk individuals by 30% in the early stages. Between 90% and 30%, it is clear which one would be more in demand. However, there were other reasons to authorize this drug, considering the high potential for drug-drug interactions. The differences between the efficacies of the 2 pills are challenging for the doctors to choose which pill to prescribe to whom.
FDA reportedly did not recommend one brand over the other. It approved Molnupiravir in cases where other authorized treatments such as Pfizer’s Paxlovid are not accessible or not “clinically appropriate”. Pregnant women are prohibited from taking this drug as it poses risks to the fetus. FDA recommended using contraception for 4 days after taking the last dose. Molnupiravir’s treatment involves taking a total of 40 pills in 5 days, like 4 x 200mg pills, two times a day.
Both antiviral covid pills prevent the virus from replicating. Molnupiravir does that by introducing tons of mutations into the coronavirus’ genetic code. Some FDA experts were doubtful that encouraging mutations could lead to more troublesome variants. The advisory committee of the FDA voted 13 – 10 in favour of Molnupiravir to be approved besides Pfizer to tackle the pandemic. The authority also banned the drugs for patients under 18 because there were concerns that it could affect bone cartilage and growth. Former US Presidential Candidate Tulsi Gabbard also advocated that Merck’s covid pill was dangerous.
The availability of oral covid treatment doesn’t mean that humans are exempted from vaccination. Getting 2 doses and a booster shot is much more important than ever. Pfizer, who first came up with the covid pill is also the leading pharma giant for the coronavirus vaccine.