Some people experience a ‘paxlovid rebound’ after taking antiviral COVID pills. Here’s what you should know.

A box of Paxlovid tablets containing three tablets imprinted with PFE and R9.

Paxlovid is an antiviral drug produced by Pfizer for the treatment of COVID-19. (Reuters/Wolfgang Ratte/Illustration)

When the antiviral drug Paxlovid was approved in 2021 to treat COVID-19, doctors began noticing a baffling trend among some of the patients who had taken it: a relapse of the virus. After treatment, some people recover and test negative for the virus, only to test positive or have symptoms return a few days later. The “Paxlovid Rebound,” as it is known, received a lot of media attention from President Biden and First Lady Jill Biden, as well as Drs. Both Anthony Fauci and Rochelle Walensky, director of the Centers for Disease Control and Prevention, experienced it last year after taking the drug.

Scientists aren’t sure why this rebound effect occurs after taking paxlofide, but here are a few things we do know.

What is Paxlovid? How it works?

Paxlovid is an oral antiviral tablet that may be prescribed for people with COVID-19 who are at risk of severe disease. These could be unvaccinated individuals, the elderly, or people with other medical conditions, such as cancer or diabetes. The drug, developed by Pfizer, could protect these high-risk patients from needing hospitalization. Those who have been vaccinated but are at risk of severe outcomes from COVID-19 can also benefit from taking Paxlovid.

US regulators granted emergency use authorization for Paxlovid in December 2021. Today the drug is available by prescription only, from a doctor or pharmacist. Anyone 12 years of age or older who weighs at least 88 pounds and is at risk for severe disease is eligible for the drug. Patients with severe kidney disease — or those on dialysis — or people with severe liver disease, should not take it. The drug can also interact with other medications such as those that treat high cholesterol, high blood pressure, and migraines, so patients taking these medications should avoid taking Paxlovid.

Like many antivirals, Paxlofide works best when it is taken early in the course of the disease. The CDC recommends starting treatment within the first five days of the onset of symptoms. Once a person has been prescribed the drug, they will take three Paxlovid tablets twice daily for five days, for a full course adding up to 30 tablets.

Antiviral treatment consists of a combination of two oral antiviral drugs — nirmatrelvir and ritonavir — which work together to stop the virus’s replication process. By reducing a person’s viral load, the drug reduces the severity of their symptoms.

in Clinical trials, which was performed when the delta variant was dominant, found that Paxlovid reduced the risk of hospitalization or death by 89% in high-risk subjects. Since its approval, numerous clinical studies conducted around the world have also confirmed its high level of protection against hospitalization and death.

With Omicron being a highly elusive variant of immunity Many antibody therapies are ineffectiveVaccine experts worried that Paxlovid might lose its effectiveness, too. Fortunately, this does not appear to be the case. According to recent research, the drug Continues to offer great protection against hospitalization and death and could also provide significant benefit even to vaccinated patients diagnosed with COVID-19.

However, other studies found no evidence of benefit from paxlovid People under the age of 65.

Dr. Bruce Farber, chief of public health and epidemiology at Northwell Health, the largest healthcare system company in New York State, told Yahoo News. “But in people at high risk, the elderly, those who have not been vaccinated, those with comorbidities, and those who are immunosuppressed, [for] those people [it] It can make a huge difference.”

In addition to preventing high-risk patients from becoming severely ill, Paxlovid can do this Reducing the risk of long-term symptoms of COVID-19found a November study by the Veterans Affairs Administration.

What is baxlovid recovery?

The CDC defines paxlovid reflux as occurring when, after completing the full five-day course of treatment, a person either experiences a return of symptoms or positive tests after testing negative for COVID-19. According to the CDC, this rebound effect It tends to occur between two and eight days after the initial recovery. But the agency said a rebound did not mean the person was resistant to Paxlovid, nor did it mean they were reinfected with the virus. In addition, the CDC said that cases of baxlovid reflux are usually mild and resolve within a few days, and there is no evidence that additional treatments are needed for these patients.

Although Paxlovid is effective even in the setting of Omicron, the drug is underused in the United States and other parts of the world. According to a report by London-based health analytics company Airfinity, US doctors prescribed the drug in only about 13% of new COVID-19 cases. Experts said concern about a possible rebound of paxlovid may be one reason why this is happening.

Another reason not to use Paxlovid, Farber said, has to do with the virus itself. “This virus is less virulent even though it is more contagious,” he said, adding that the need for baxlovid “has become less.”

Scientists are still studying why a rebound effect occurs when taking paxlofide, as well as who is most likely to be exposed to it. However, recent research has found that rebounding can also happen in people who get COVID-19 and don’t take paxlovid. Farber said studies are underway to understand why this happens.

“More recent data suggests that rebound also occurs in people recovering from COVID who did not get Paxlovid, and likely occurs at similar rates, whether you take Paxlovid or not,” Farber said, adding that rebounds after taking the drug were initially thought to be It occurs in approximately 5% of cases but this research has shown just that It may happen more often than initially thought. “Recent articles suggest that it may be as common as 10 or 15% of cases,” he said.

What to do if you experience baxlovid reflux

If someone’s symptoms return or they test positive after treatment with Paxlovid, the CDC advises follow-up direct isolation And isolation again for five days. Isolation can end after this period if the person has been fever-free for 24 hours without the use of fever-reducing medication. The agency also recommends wearing a mask for 10 days after rebound symptoms begin.

The CDC encourages doctors and patients to report cases of paxlovid reflux Pfizer portal For drug-related adverse events.

Finally, Farber said that baxlovid rebound is still fairly uncommon and that it shouldn’t stop people and their doctors from using life-saving medications when needed.

In theory, it could prolong their isolation. But I think [people] You should be aware that this can happen even without Paxlovid. So it doesn’t really become a significant factor in distinguishing whether they get it or not.”

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