Pfizer antiviral Covid-19 tablet “Paxl... - British Liver Trust

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Pfizer antiviral Covid-19 tablet “Paxlovid” a word of caution

Richard-Allen profile image
19 Replies

On 22 December the U.S. Food and Drug Administration issued an emergency use authorisation (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults. Pfizer has also announced an agreement with the UK government to supply an additional 2.5 million treatment courses of its investigational candidate Paxlovid (nirmatrelvir), subject to local authorisation. This is in addition to the 250,000 treatment courses previously contracted by the UK government, bringing the total amount of treatment courses to 2.75 million.

So, what’s this wonder drug about then? This treatment is for those who have contracted covid-19, or display Covid-19 symptoms. The pill is one that sick people will take at home before they’re hospitalised. It is claimed that 89% of those patients treated didn’t need hospitalisation.

But there are now concerns that this drug may be dangerous for some people as it can cause liver damage. It is therefore advised not to be taken by those who have a preexisting liver or kidney condition.

There is also now a warning of possible side effects of this drug. It would appear that it can interact with other medications a person may be taking, and make those ineffective. These include statins, antidepressants, Thyroid hormone replacement therapy, to name just a few.

The FDA (US Food &Drugs) reports the following:

Q. Are there potential side effects of Paxlovid?

A. Possible side effects of Paxlovid include dysgeusia (altered or impaired sense of taste), diarrhoea, increased blood pressure, and myalgia (muscle aches). Nirmatrelvir and ritonavir, which comprise Paxlovid, also interact with other medicines, which may lead to serious or life-threatening adverse reactions. Patients should tell their health care providers all of the medicines they are taking, including over-the-counter medications and herbal supplements, when deciding whether to take Paxlovid. Liver problems have occurred in patients receiving ritonavir. Therefore, caution should be exercised when administering Paxlovid to patients with pre-existing liver diseases, liver enzyme abnormalities, or hepatitis. Patients should talk with their health care provider if they have a history of liver problems. 12/22/2021 Paxlovid is not recommended for patients with severe kidney problems, and a different dose is needed for patients with moderate kidney problems. Patients should talk with their health care provider if they have a history of kidney problems.

I also went in search of any interaction with some of the various anti-rejection medications. Cyclosporine, Tacrolimus, Everolimus. Once again this is another quote:

Ritonavir dosed as a pharmacokinetic enhancer or as an antiretroviral agent inhibits CYP3A4 and as a result is expected to increase the plasma concentrations of cyclosporine, tacrolimus or everolimus. Careful monitoring of therapeutic and adverse effects is recommended when these medicines are concomitantly administered with ritonavir.

I think there could be a danger here that a liver consultant, and not a family doctor would be the best person to advise on the use of this tablet, but then having said that, I’ve not seen a liver consultant (due to Covid) for almost 2-years. So, that won't be an option for many.

I think the bottom line is to try and avoid using this medication for the time being as it may end up doing more harm than good.

This is for information only as I am not medically qualified in any way to voice an opinion or advise others.

The following website and video may be of interest: nbcnews.com/health/health-n...

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Richard-Allen
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19 Replies
DavyGravy profile image
DavyGravy

Hi Richard

Another gem that you have found. Information is always so important when we have decisions to make.

This looks as though it could be effective (for people without underlying problems).

At present I am deferring my 3rd jab (booster) because my liver team are unsure if it will conflict with my antivirals. another 10 weeks to finish the course and I will have the booster but obviously the highest risk is my Hepatitis and so that takes priority.

Dave

Richard-Allen profile image
Richard-Allen in reply to DavyGravy

Many thanks Davy, I have had the two first covid jabs but have not had the third, or the booster jab.

What I would like to know is if after the first jab, did my body start to produce Covid antibodies? No one can tell me. If after the second jab, has my body now started to produce covid antibodies? No one can tell me. Having a turned down immune system it is unlikely that body has any defences against Covid. Antibody tests are only available to those people working in the NHS and those who are taking part in Covid research tests. They are not available to the general public.

I understand that approximately 44% of all organ transplants patient's coming from the Royal Free in London, have produced no antibodies, even though many have had all four jabs.

If I knew for sure that these jabs were indeed working, then of course I'd have more. But until someone can advise me better, (by having an antibody test) then I can only see this as being a waste of money.

Daphnis61 profile image
Daphnis61 in reply to Richard-Allen

Hi Richard , I'm new to this site and not posted before, but I thought you'd like to know that you can always get a private antibody test to see if you have made any antibodies to the Covid vaccine. I did this with via a company called Monitor My Health, where you do a finger prick test and send it to them. (An NHS lab so perfectly reputable.) It has to be said that how well your immune system has responded is not just about how many antibodies you've made but of course it is reassuring to know if you have! I'm not a medic and I don't know what advice you've been given re the booster but unless you've been told not to have it the general advice is to have it because the two vaccines are not effective even in a healthy individual against the Omicron variant. Good luck.!

Very good information for people Richard. Basically if covid doesn't kill you the medication might. ( sounds about right)

Zukosmile07 profile image
Zukosmile07

I will ask on Thursday Richard. I'll show her the hole article.I've had a PCR kit through the post today and it is very official and in a box stated to send it straight back to the NHS. (Only test yourself with symptoms). Then it goes on to say that I am entitled to the treatment if tested positive.

So I'll definitely ask Thursday!

Wow... What next Danny x

AyrshireK profile image
AyrshireK in reply to Zukosmile07

You'll have been sent the PCR test in line with the 'in community' treatment for priority groups. gov.uk/government/news/uks-...

The anti-virals being rolled out here are Molnupiravir and Ronapreve.

Also, being mentioned for post transplant folks is Sotrovimab bbc.co.uk/news/health-59721240

I read somewhere that all patients with chronic liver disease and other long term health conditions were to receive a PCR test kit through the post for testing and early intervention. Waiting to see if hubby gets one because he seems to have been totally forgotten throughout the pandemic - not listed for shielding or anything.

Katie

Zukosmile07 profile image
Zukosmile07 in reply to AyrshireK

I'll send you a photo of the pamphlet. It is very official and it goes on record.

AyrshireK profile image
AyrshireK in reply to Zukosmile07

It's been discussed a lot on AIH Facebook page and i've seen an article online about it. Yep it's all official. It's to speed the whole process up from symptoms, self-test, pcr then early treatment.

Hopefully you'll not need it. Keep safe.

Katie

in reply to AyrshireK

My partner has received the PCR test along with an email telling him to expect it and explaining why - the reason Katie gives here - and his consultant has advised he can now have the booster as he's more than 6 weeks post op. Thanks also to Richard for this additional information as the email mentions new treatment which must be acted on quickly, and it could be this... Always best to be well informed 😊, K

Zukosmile07 profile image
Zukosmile07 in reply to AyrshireK

I can send you page by page but I bet your old boy will receive one soon.

Blue
Daphnis61 profile image
Daphnis61 in reply to AyrshireK

Hi Katie, I read on the BBC website earlier that Paxlovid is also being rolled out in the UK, which sounds surprising given what Richard has written above about the contra-indications, which must affect a lot of people. Many thanks for that info, Richard and Katie.

Thank you for your post Richard.

This website has the NHS info on new treatments:

nhs.uk/conditions/coronavir...

Always worth checking with your own consultant as to the advisability/safety of taking any kind of new treatment.

regards

pushthrough profile image
pushthrough

Thank you for the info Richard!

deanw41 profile image
deanw41

Thanks Richard,great work!!😊👍

deanw41 profile image
deanw41

Yes I got one through....

TT-2018 profile image
TT-2018

Richard,

If you check out this trial from Imperial, it’s to test the results of the vaccine for solid organ recipients. I have done mine at home and it shows that the vaccine is working but at some point, I will need a fourth shot.

As a transplant recipient, all you need to do is register and they will send you the kit.

reactstudy-covid-testing.co...

Mark

Katielou14 profile image
Katielou14

Hi Richard, Thanks for the info, maybe Dr Alvuhara, could comment on this ,on the liver trust web site. Many thanks good to know. Keep safe

Zukosmile07 profile image
Zukosmile07

Hi Richard.I have just spoken to the post transplant consultant and the advice for the covid 19 treatment is (post transplant only) to take the treatment if confirmation of a positive result but have usual blood tests every week to check liver and kidney functions. So it's a little like taking your post transplant meds and have to be monitored until all readings settle down.

That is about as much information I could get due to the fact that he was supposed to be on a ward.

So people who suffer with liver disease and pre transplant need to double check with their liver teams before taking anything.

Richard, he also said to contact my own team first if suspected COVID symptoms and not to send the PCR kit off in a rush.

(Didn't ask why)

The hospital didn't seem busy but he was still in a rush.... Danny x

Richard-Allen profile image
Richard-Allen in reply to Zukosmile07

Many thanks Danny.

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