Outpatient COVID-19 Treatments

There are now oral outpatient treatment options available for COVID-19 patients at Yale New Haven Health, particularly those who may be at risk for developing more severe illness, but are not sick enough to require hospitalization. The available oral therapies prevent the COVID-19 virus from reproducing which helps to decrease the amount of virus present.

Currently, there are two oral treatments, nirmatrelvir/ritonavir (Paxlovid™) and molnupiravir, which received an Emergency Use Authorization by the FDA.

If you or a loved one has been diagnosed with COVID-19, your primary care physician may refer you to receive one of these oral treatments. At this time, oral therapy prescriptions for patients are available at many retail pharmacies throughout the community.

Researchers have found these medicines reduce the need for hospitalization in outpatients with mild to moderate COVID-19, compared to patients who received a placebo. These treatments are only available for outpatients who meet specific criteria and your provider has to prescribe them.

To learn more about how these treatments work and for a full list of requirements, read more below. For additional questions or help referring a patient for treatment contact the COVID call center at 833-275-9644 (833-ASK-YNHH).

How are these medicines administered?

Nirmatrelvir/ritonavir (Paxlovid™) and molnupiravir are available as tablets, which are taken by mouth twice a day for five days.

Who is eligible?

The clinical criteria for these oral therapies are based on current FDA and National Institutes of Health guidance. Your provider will assess your risk of severe complications from COVID-19 based on these criteria and decide if any of these therapies are appropriate for you.

Of the medicines, which one will patients receive?

All of these medicines work to prevent hospitalizations from COVID-19. There are many considerations for your health care provider when prescribing these medications including certain pre-existing health conditions and/or interactions with medications that you are currently taking. It is important to make sure your provider is aware of all of your health conditions as well as all medications you are taking including over the counter medications. Therefore, which one you will receive will depend on which is most appropriate for you as determined by your health care provider.

What are the possible side effects?

Possible side effects from nirmatrelvir/ritonavir (Paxlovid™) include altered sense of taste, diarrhea, elevated blood pressure and muscle aches. Molnupiravir’s possible side effects include diarrhea, nausea, and dizziness.

Nirmatrelvir/ritonavir (Paxlovid™) and molnupiravir are all still being studied so it is possible that all of the risks are not known at this time.

What if I’m pregnant or breastfeeding?

There is limited experience treating pregnant people or breastfeeding mothers with nirmatrelvir/ritonavir (Paxlovid™) and molnupiravir. Molnupiravir is not currently recommended at Yale New Haven Health for patients who are pregnant and/or breastfeeding. For a mother and unborn baby, the benefit of receiving nirmatrelvir/ritonavir (Paxlovid™) may be greater than the possible risk from treatment. We advise our patients to discuss any possible treatment with their obstetrician or midwife.

What are the recommendations for receiving these medicines and the COVID-19 vaccine?

The COVID-19 vaccine can be given at any time following receipt of oral therapies. CDC guidelines state you can get vaccinated once you your symptoms are resolved and you are and out of quarantine. We strongly recommend COVID-19 vaccination even after treatment because it can help to protect against future infection.