Test positive for COVID or flu? Here’s expert advice on finding antivirals in Lexington

As Fayette County and many other Kentucky areas are seeing elevated COVID-19 community levels in the weeks since the holiday season, more residents may be seeking early treatment for a viral infection.

Antiviral medication, such as Paxlovid or Lagevrio, is recommended for certain COVID-19 patients and can help lessen the severity of symptoms and potentially help people recover from the virus more quickly.

Specific medicine is also available for patients with influenza, provided they test positive and seek treatment quickly enough.

Dr. Brooke Hudspeth, associate professor and chief practice officer at the University of Kentucky’s Pharmacy Practice and Science Department, told the Herald-Leader there are steps you can take to more easily access treatments. Here’s what to know.

When should you seek antiviral treatment?

Those who are at higher risk of severe illness due to a respiratory virus who test positive for COVID-19 or influenza should contact their health care provider as soon as possible to discuss treatment options, Hudspeth said.

Depending on the virus, factors such as age, vaccination status, health conditions or weakened immune systems may affect a person’s risk level.

For COVID-19, people who are 50 years or older or have chronic lung disease, heart disease or a weakened immune system are particularly at risk.

Influenza patients at a higher risk include children under two years of age, patients 65 years or older, pregnant people and people with asthma, diabetes, heart disease or other health conditions.

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Additionally, those who are not necessarily at a higher risk but are experiencing severe symptoms, such as shortness of breath, should contact their provider about options, Hudspeth said.

COVID-19 antivirals

Paxlovid is the primary antiviral medication given to COVID-19 patients, Hudspeth said, and the window to start receiving treatment is about five days after the onset of symptoms. But the sooner you can start treatment, the better.

Paxlovid is an “investigational” medicine used to treat mild to moderate COVID-19 in adults and children over the age of 12 and weighing at least 88 pounds, according to the U.S. Food and Drug Administration.

The antiviral is generally recommended for patients who test positive for COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization and death, the U.S. Centers for Disease Control and Prevention says.

“With Paxlovid, it’s still kind of a limited distribution model where the pharmacies work together with the government, it’s kind of a distribution process that’s a little different from how they get their normal medication,” Hudspeth said.

Because Paxlovid is not available everywhere, a provider might prescribe Paxlovid to a patient and send an electronic prescription to a pharmacy that doesn’t have it. This can create issues when a patient has already left the doctor’s office and finds out their pharmacy does not have it available.

“Sometimes there’s kind of a gap in that communication link,” Hudspeth said. “So the patient being their own advocate and calling the pharmacy ahead of time is probably going to be the best just to make sure that it is there and it’s available for them.”

Currently, Paxlovid is available for free to patients with prescriptions, but PBS reported in December the U.S. Department of Health and Human Services will stop supplying it in mid-2023.

Although Paxlovid is currently available at no cost, it requires a prescription, so office visit and testing costs may apply, depending on your insurance.

Paxlovid interacts with some other medicines, so the FDA advises patients to tell their doctors about any other prescriptions, over-the-counter medicines, vitamins and herbal supplements they are taking. The FDA also recommends people who take birth control pills to use another form of contraception when taking Paxlovid, as it may affect how combined hormonal birth control pills work.

Paxlovid consists of two medicines, nirmatrelvir tablets and ritonavir tablets. They are taken together twice daily for five days, the FDA says. Dosage may vary for patients with kidney disease or other conditions.

Lagevrio is another antiviral sometimes prescribed to COVID-19 patients. It is not recommended for use during pregnancy, and the FDA recommends people who can become pregnant to use a reliable form of birth control during treatment with Lagevrio and four days after the last dose.

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Those who are seeking treatment for COVID-19 can use an online locator to find antivirals near them. Hudspeth recommended people use this locator and online screening tools from pharmacies when trying to access the medicines.

The online locator shows test-to-treat options at certain Kroger Pharmacy locations in Lexington, as well as the CVS at 2000 Harrodsburg Road.

Flu antiviral medication

Oseltamivir, the generic name for Tamiflu, is approved by the FDA for early treatment of “uncomplicated” influenza in people at least two weeks old.

Patients need to start taking Oseltamivir within one to two days of symptoms beginning, Hudspeth said, though certain exceptions may be made for people at a higher risk for severe illness.

Tamiflu, or its generic form, is usually covered by most health insurance plans, Hudspeth said, but co-pays may apply.

Patients may be able to work with their provider to identify any programs allowing pharmacies to offer the antiviral at a lower cost. With no discount program or insurance, Oseltamivir typically costs about $160 to $170, Hudspeth said.

This story was reported in response to reader questions and comments from our Know Your Kentucky project. If you have a question about Kentucky, we’d like to hear from you. Fill out the form below or email ask@herald-leader.com.