Articles / The best COVID antivirals to prescribe
Overcoming the drug-interactions barrier.
Under national guidelines, patients with COVID at high risk of serious illness should be prescribed nirmatrelvir (Paxlovid) by GPs, with the less effective molnupiravir (Lagevrio) a second-line option.
Right now, the opposite is occurring probably because GPs are inundated or overworked, says infectious diseases physician Dr Alex Padiglione.
“My understanding is that about 80% of the scripts currently being written by GPs are for Lagevrio, and only 20% are prescribing Paxlovid, and it really should be the other way around. Paxlovid is a significantly more effective drug,” he says.
“It’s because there are a long list of drugs where Paxlovid is contraindicated or you need to adjust a dose or withhold a drug. There are also contraindications for people with liver or kidney problems.
“If you’re running a busy practice and you’ve got someone on the end of the phone, it’s easier to give a script of Lagevrio, even if it is slightly less effective, rather than look up drug interactions.”
Dr Alex Padiglione will deliver a COVID Update at Healthed’s upcoming webcast on 27 September. You can register for free here.
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